Characteristics of Neoplasia

Question 1

What makes a cell a “cancer cell”?

Answer 1

○ Unregulated cell division
○ Loss of safeguards against DNA damage
○ Avoidance of cell death (ie. apoptosis)
○ Tissue invasion
○ Angiogenesis
○ Ability to metastasize

Question 2

Prior to this some thought cancer was contagious, while others thought it was
a metabolic problem

Answer 2

Tumor gene sequencing

Question 3

T/F Mutations could be random or from exposure to carcinogens

Answer 3

T

Question 4

Tumor Suppressor genes function normal

Answer 4

Restrain cell growth, DNA damage control, and regulation of cell life cycle - when
inactivated leads to loss of function
(The brake)
loss of function mutations

Question 5

Proto-Oncogenescan mutate to Oncogenes

Answer 5

Proto-oncogenes have a role in cell regulation, proliferation and differentiation, and when mutated, this normal control is lost
(The gas)
Gain of function mutations

Question 6

Tumor Suppressor Gene Example

Answer 6

p53

Question 7

p53 function

Answer 7

Normally, a Tumor Suppressor Gene
codes for the p53 protein, which
recognizes DNA damage, inhibits cell
proliferation, and induces apoptosis

Question 8

Passenger mutations

Answer 8

not functionally significant; they
simply arose by chance in a single cell that gave rise to an expanding clone

Question 9

Driver mutations

Answer 9

small number of the mutations that alter the cell cycle and promote tumorigenesis

Question 10

Point Mutation

Answer 10

○ Single nucleotide substitution, insertion or deletion
○ Point mutation can lead to faulty proteins due to loss of specific RNA expression, or could lead to loss of function of large sections of the chromosome
○ Usually requires several mutations to create cancer

Question 11

DNA Amplification

Answer 11

Overexpression of a of an DNA sequence/gene product

Question 12

Chromosomes themselves can be
rearranged via ____. What is an example?

Answer 12

translocation
Eg. Philadelphia chromosome in
Chronic Myeloid Leukemia (CML)

Question 13

Tumor cells are said to be _____ compared to normal tissue

Answer 13

poorly differentiated

Question 14

There is typically ”_____ genetic heterogeneity” found in tumor cells, compared to normal tissue

Answer 14

Less

Question 15

Precision Medicine

Answer 15

Knowledge of the genetics of cancer and understanding at the molecular level has brought about fine-tuned, patient specific treatment

Question 16

What is called ____ is actually a group of many diseases with multiple phenotypic and molecular characteristics

Answer 16

“breast cancer”

Question 17

Neoplasia

Answer 17

“New Growth”
○ Abnormal or uncontrolled division of new cells or cells that fail to die when they should

Question 18

Well vs. poorly differentiated

Answer 18

■ Well differentiated – looks mostly like normal cells
■ Poorly differentiated – barely resembles normal cells

Question 19

Can exhibit a mass effect, and compress
surrounding tissue, but does not invade other
tissues (e.g. uterine fibroids, warts)

Answer 19

Benign

Question 20

Unregulated cell growth with the ability to invade tissues

Answer 20

Malignant – “Cancer”

Question 21

Provides insight on how the tumor arose

Answer 21

DNA Sequencing

Question 22

Adenoma

Answer 22

glandular/epithelial tissue

Question 23

Exceptions of “oma” cancers that are not benign

Answer 23

Lymphoma, Melanoma (melanocytes), Astrocytoma (astrocytes), Seminoma
(testicles)

Question 24

Histological cancer stages

Answer 24

● Hyperplasia – An increase in the number of cells in an organ or tissue
● Dysplasia – The presence of abnormal cells within a tissue or organ
● Carcinoma in situ – “in the original place.” Abnormal cells that look like cancer, but haven’t spread/invaded surrounding tissue
● Malignancy
○ Anaplasia – undifferentiated cells with the loss of the mature or
specialized features of a cell or tissue

Question 25

Anaplasia features

Answer 25

1. Cellular Pleomorphism
2. Hyperchromatic Nuclei
3. Nuclear/Cytoplasmic Ratio
4. Abnormal Mitotic Figures

Question 26

Dysplasia

Answer 26

Disordered/abnormal
growth of tissues resulting from
chronic irritation or infection

Question 27

In many cases, ____ this stage is considered precancerous

Answer 27

dysplasia

Question 28

Example of dysplasia

Answer 28

Best example is the detection of
cervical dysplasia on PAP smears.
Cervical dysplasia can lead to cervical
cancer if left untreated

Question 29

“high-grade dysplasia”

Answer 29

Carcinoma in Situ

Question 30

Carcinoma in situ

Answer 30

○ Full thickness dysplasia of the epithelium
○ Abnormal cells that look like cancer, but
haven’t spread/invaded surrounding tissue
■ In many cases, considered precancerous
● Is often confused as cancer (because of
name), but it is dysplasia

Question 31

Anaplasia microscopic findings

Answer 31

Undifferentiated cells with the
loss of specialized cell features (structural and functional)
1. Cellular Pleomorphism
2. Hyperchromatic Nuclei
3. Nuclear/Cytoplasmic Ratio
4. Abnormal Mitotic Figures

Question 32

Cellular Pleomorphism

Answer 32

Variability in size and shape

Question 33

Hyperchromatic Nuclei

Answer 33

Darker color

Question 34

Nuclear/Cytoplasmic Ratio

Answer 34

■ Poor nucleus to cytoplasm ratio 1:1 (Normally 1:5)
■ Rapid growth, limited cytoplasm

Question 35

Abnormal Mitotic Figures

Answer 35

More cells undergoing mitosis, errors in chromosome separation

Question 36

Carcinoma

Answer 36

Derived from epithelial and “lining” tissues (ectoderm and endoderm)
■ Squamous cell carcinoma, renal cell carcinoma, adenocarcinoma

Question 37

Sarcoma

Answer 37

Derived from mesenchymal (connective) tissue (mesoderm)
■ Osteosarcoma (bone)
■ Fibrosarcoma (fibrous tissue)
■ Liposarcoma (fat)
■ Rhabdomyosarcoma (skeletal muscle)

Question 38

Malignant pediatric tumor of embryonic tissue

Answer 38

Blastoma
■ Retinoblastoma
■ Neuroblastoma

Question 39

Blastoma exception in adults

Answer 39

Glioblastoma seen in older adults

Question 40

Germ Cell Tumor types

Answer 40

■ Seminomas
■ Teratoma (rare, benign)
■ Teratocarcinoma (rare, malignant)
■ Non-Seminomas
– Embryonal Carcinoma
– Yolk Sac Tumor (most common)
– Choriocarcinoma (rare)

Question 41

Angiogenesis

Answer 41

Gain access to circulation

Question 42

T/F Metastatic tumor is the same type of cancer as the primary tumor.

Answer 42

T

Question 43

Three main pathways for metastasis

Answer 43

○ Through the Lymphatics: Breast cancer notoriously spreads by invasion of the lymphatic drainage
○ Through the Bloodstream: Many types of cancers are capable of spreading by the vascular system. Tumor invades blood vessel, allowing tumor detachments to “drift away to faraway places”
○ Direct Extension of the Primary Tumor: For example, Renal Cell Carcinoma can invade the adrenal glands, simply due to proximity