Clinical Aspects of Common Cancers Flashcards
What are the pathologic features of a benign neoplasm?
- NEVER invade or metastasize
- Necrosis is uncommon
- circumscribed/encapsulated
- Can cause injury by compression/interference with the function of adjacent structures-tumor grade: none
What are the pathologic features of a malignant neoplasm?
- Invade and metastasize
- cause injury by local and distant tissue destruction
- necrosis is common
- Tumor grade: from low-high
What is the difference between a low grade and a high grade tumor?
Low: well-differentiated
High: poorly differentiated, possibly anaplastic (no morphology)
Malignant tumors of epithelium arise from a ____
malignant stem cell
What are the key mutations of a malignant stem cell to become a malignant tumor?
oncogenes, lose tumor suppressor genes, develop genome instability, lose ability to undergo apoptosis
What are the histological features that define invasion?
carcinoma has brooken through the basement membrane at the base of the epithelium (some tumor cells can metastasize by directly shedding into and seeding body cavities w/o breaking through the bm).
What is the difference between stage and grade?
stage: how much has the tumor spread
grade: how much have the tumor cells differentiated
What is the strongest predictor of prognosis (stage or grade)?
Stage
What is T in the TNM classification for staging?
T=size of tumor (Tis- “tumor in situ” (still confined to epithelium) or T1-4 for increasing size and involvement
What is N in the TNM classification for staging?
Lymph Node involvement. No= no involvement, N1-4 for increasing size and involvement
What is M in the TNM classification for staging?
presence of metastasis . Mo= no evidence of distant mets, M1 evidence of mets
What is advanced stage cancer?
large primary, + nodes, and + distant mets.
How do you check grade?
check patients histo slides
What does low vs high grade mean?
low- well differentiated, normal cell features: goodhigh- poorly differentiated, anaplastic: bad
What are the four major types of cancer?
- Squamos cell carcinoma (25-40%)
- Adenocarcinoma (25-40%)
- Large Cell carcinoma (10-15%)
- Small Cell carcinoma (20-25%)
Normally the respiratory tree is lined by ______ cells
pseudostratified ciliated columnar epithelial
Which kinds of lung cancer are linked to smoking?
small cell, adenocarcinoma, squamos cell. (Just not Large cell)
Features of squamos cell carcinoma.
- metaplasia: pseudostratified ciliated columnar epithelia change to large squamos epithelia
- typically arise centrally, in major bronchi
- stain + for keratin
features of adenocarcinoma.
- can occur centrally in major bronchi or in periphery
- Form gland-like structures
- stain + for mucin
What is bronchioalveolar carcinoma?
a variant of adenocarcinoma, not linked with smoking, tumor cells grow in alveolar septae and most spots in lung. very little stroma produced by tumor. Good prognosis
What are general features of large cell carcinoma?
- high grade cancer
- can arise anywhere in lungs
- cancer cells do not produce keratin, or mucin and don’t form glands.
- pleomorphic, bizarre looking cells
What are general features of small cell carcinoma?
- can arise anywhere in lungs
- cancer cells don’t produce mucin, keratin, or form glands-terrible prognosis-brain mets are common
- small, dark staining cells that form clusters
- stain + for neuroendocrine markers
- can produce paraneoplastic syndrome
What are the classic symptoms of pancreatic carcinoma?
- back pain
- unexplained, painless jaundice
- migratory thrombophlebitis
what are risk factors of pancreatic carcinoma?
diabetes mellitus, ki-ras mutation (often loss of p16, SMAD4, and p53), chronic pancreatitis,
