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DND Unit 2 > Clinical Aspects of Common Cancers > Flashcards

Clinical Aspects of Common Cancers Flashcards

1
Q

What are the pathologic features of a benign neoplasm?

A
  • NEVER invade or metastasize
  • Necrosis is uncommon
  • circumscribed/encapsulated
  • Can cause injury by compression/interference with the function of adjacent structures-tumor grade: none
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2
Q

What are the pathologic features of a malignant neoplasm?

A
  • Invade and metastasize
  • cause injury by local and distant tissue destruction
  • necrosis is common
  • Tumor grade: from low-high
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3
Q

What is the difference between a low grade and a high grade tumor?

A

Low: well-differentiated
High: poorly differentiated, possibly anaplastic (no morphology)

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4
Q

Malignant tumors of epithelium arise from a ____

A

malignant stem cell

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5
Q

What are the key mutations of a malignant stem cell to become a malignant tumor?

A

oncogenes, lose tumor suppressor genes, develop genome instability, lose ability to undergo apoptosis

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6
Q

What are the histological features that define invasion?

A

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).

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7
Q

What is the difference between stage and grade?

A

stage: how much has the tumor spread
grade: how much have the tumor cells differentiated

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8
Q

What is the strongest predictor of prognosis (stage or grade)?

A

Stage

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9
Q

What is T in the TNM classification for staging?

A

T=size of tumor (Tis- “tumor in situ” (still confined to epithelium) or T1-4 for increasing size and involvement

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10
Q

What is N in the TNM classification for staging?

A

Lymph Node involvement. No= no involvement, N1-4 for increasing size and involvement

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11
Q

What is M in the TNM classification for staging?

A

presence of metastasis . Mo= no evidence of distant mets, M1 evidence of mets

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12
Q

What is advanced stage cancer?

A

large primary, + nodes, and + distant mets.

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13
Q

How do you check grade?

A

check patients histo slides

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14
Q

What does low vs high grade mean?

A

low- well differentiated, normal cell features: goodhigh- poorly differentiated, anaplastic: bad

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15
Q

What are the four major types of cancer?

A
  1. Squamos cell carcinoma (25-40%)
  2. Adenocarcinoma (25-40%)
  3. Large Cell carcinoma (10-15%)
  4. Small Cell carcinoma (20-25%)
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16
Q

Normally the respiratory tree is lined by ______ cells

A

pseudostratified ciliated columnar epithelial

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17
Q

Which kinds of lung cancer are linked to smoking?

A

small cell, adenocarcinoma, squamos cell. (Just not Large cell)

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18
Q

Features of squamos cell carcinoma.

A
  • metaplasia: pseudostratified ciliated columnar epithelia change to large squamos epithelia
  • typically arise centrally, in major bronchi
  • stain + for keratin
19
Q

features of adenocarcinoma.

A
  • can occur centrally in major bronchi or in periphery
  • Form gland-like structures
  • stain + for mucin
20
Q

What is bronchioalveolar carcinoma?

A

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

21
Q

What are general features of large cell carcinoma?

A
  • 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
22
Q

What are general features of small cell carcinoma?

A
  • 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
23
Q

What are the classic symptoms of pancreatic carcinoma?

A
  • back pain
  • unexplained, painless jaundice
  • migratory thrombophlebitis
24
Q

what are risk factors of pancreatic carcinoma?

A

diabetes mellitus, ki-ras mutation (often loss of p16, SMAD4, and p53), chronic pancreatitis,

25
Q

What is the prognosis of pancreatic carcinoma?

A

terrible, 5 year survival=

26
Q

What is a whipple procedure? what type of cancer is it used in?

A

pancreatic carcinoma. removes large part of pancreas, common bile duct, gall bladder, and duodenum

27
Q

Why would a patient with pancreatic carcinoma need a common bile duct stent?

A

relieves obstruction, the cancer in the pancreas often compresses the common bile duct causing jaundice

28
Q

What are typical pathologic features of colorectal cancer?

A
  • moderately well differentiated
  • mainly sporadic (non- genetic)
  • arise in innermost mucosal layer of bowel wall in pre-existing polyps
29
Q

how does colon cancer develop?

A

pre-existing polyps

30
Q

If colon cancer arises on L side of the colon what clinical features can be expected?

A

constipation, change in stool caliber, sometimes colon is obstructed

31
Q

If colon cancer arises on R side of the colon what clinical features can be expected?

A

less symptoms. fecal stream is mostly liquid at this point so tumors can grow large before any obstruction occurs

32
Q

What are inherited conditions that increase the risk of colorectal cancer?

A
  • Familial Adenomatous polyposis or adenomatous polyposis coli-HNPCC (lynch syndrome)
  • loss of mutY base excision repair enzyme’-ki-ras, p53, DCC, MCC problems= genomic instability
33
Q

what do values of 8-10 indicate on the Gleason scale?

A

aggressive behavior. can kill a patient

34
Q

How does the gleason score work?

A

Your predominant pattern (scored 1-5 based on microscopic appearance; 5 is worst) is added to your subordinate pattern so max is 10

35
Q

high grade lesions in prostate cancer behave _____ and predict ______

A

aggressively fatal disease

36
Q

How do the cells appear in grade 5 on gleason score?

A

no gland formation, tumor cells infiltrate as sheets and cords.

37
Q

PSA is a screening tool for what cancer?

A

prostate. stands for serum prostate specific antigen.

38
Q

What is the gold standard for prostate cancer diagnosis?

A

blind “random” biopsiesthese are only about 50% sensitive

39
Q

Whats this bad boy? (lung cancer?

A

squamos cell carcinoma

40
Q

Who dat bad mamma jamma? (lung cancer)

A

adenomatous carcinoma

41
Q

Who dat bumma gumma? (lung cancer)

A

bronchioalveolar carcinoma (growing in the septum of the lung)

42
Q

What U call this guy? (lung cancer)

A

large cell carcinoma

43
Q

WHO DAT? (lung cancer)

A

small cell carcinoma

DND Unit 2 (15 decks)

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