DD Neoplasms Flashcards
Hypertrophy
Increase in cell size
Hyperplasia
Increase in cell number, may be associated with increased risk of neoplasia
Metaplasia
change from one benign differentiated cell type to another, usually in response to injury. May be associated with an increased risk of neoplasia
Neoplasia
disruption of normal homeostatic mechanisms, unchecked increase in cell number, is a clonal process, altered cell-autonomous and cell-nonautonomous mechanisms
T or F: neoplasia clonality are monoclonal
TRUE
T or F: benign neoplasms invade or metastasize
false, malignant neoplasms do.
T or F: benign neoplasms cause injury largely by compression/interference in function of adjacent structures
TRUE
T or F: malignant neoplasms cause injury by local tissue destruction and distant dissemination and tissue destruction
TRUE
T or F: malignant neoplasms are invasive and necrosis is common
TRUE
T or F: benign tumors circumscribed/encapsulated and necrosis is common
false, they are encapsulated, but necrosis is uncommon
Give 4 characteristics of benign neoplasms
well differentiated, low rate of cell turnover, cytologic uniformity, boundary between tumor and adjacent tissue maintained
Give 4 characteristics of malignant neoplasms
variable differentiation, high rate of cell turnover, cytologic pleomorphism, loss of boundary between tumor and adjacent tissue
Malignant Epithelial, Mesenchymal, and Hematopoietic neoplasm names
Carcinoma, Sarcoma, Lymphoma/Leukemia respectively
Benign epithelial and mesenchymal neoplasm names
adenoma/papilloma and osteoma/chondroma/fibroma are some examples respectively
How are benign neoplasms treated?
treated by excision/surgical resection
T or F: benign tumors may recur and generally do not progress to malignancy
TRUE, but exception is premalignant neoplasms such as colonic adenoma
T or F: there are both genetic and non-genetic factors that affect Cancer
TRUE
basic pathobiology of cancer
normal cell => DNA damage (hereditary defect) => increased proliferation/decreased apoptosis => clonal expansion => tumor progression => malignant neoplasm => invasion and metastasis
Dysplasia
disordered growth, loss of cytologic uniformity, normal histologic maturation, and architectural orientation, hallmark of early premalignant neoplasia
T or F: higher grade tumors are more aggressive and have worse prognosis
TRUE
T or F: pre-malignant lesions are seen in carcinomas and myelodysplasia
TRUE
T or F: Carcinomas are the only cancer without an In-situ phase
Flase, they are the only cancer with this phase
What is Invasion?
infiltration of adjacent tissues by malignant cells
What is metastasis?
transfer malignant cells from primary site to a non-connected (secondary) site. Metastases are tumors discontinuous with the primary tumor
What is the pre-invasive stage?
this is in situ phase, has malignancy features without invasion of basement membrane.
T or F: Malignant tumors are often poorly demarcated from the surrounding normal tisue
TRUE
Dissemination of cancers occurs through what pathways? (hint-3 ways)
1)direct seeding of body cavities or surfaces 2) lymphatic spread 3) hematogenous spread
T or F: malignant tumors recognize normal anatomic boundaries
FALSE
Describe the metastatic cascade (hint- 4 main steps)
Invasion through basement membrane and ECM, EMT, Intravasation (getting into blood or lymph vessel), Extravasation (getting out of vessel), MET, and Colonization
When do primary tumor metastasize?
moves beyond basement membrane when conditions get crowded and harsh (hypoxia and limited nutrients)
T or F: primary tumor size is positively related to metastasis
TRUE
What is the first step for metastasis?
Dissociation of cells from one another
What glycoprotein holds epithelial cells together and what downregulates them?
E-cadherins and ZEB1, respectively
E-cadherins are linked to the cytoskeleton by what?
catenins
Give 4 ways E-cadherin expression is lost
loss of heterozygosity, inactivating mutation (rare), silencing of gene expression via hypermethylation of promotor, Transcriptional repressors (Snail, Slug, Twist, ZEB 1/2)
What promotes Epithelial-to-Mesenchymal transition (EMT)?
repressing E-cadherin
T or F: EMT Transition is a normal process during development abused by cancer
TRUE
What is the 2nd step in invasion?
degradation of basement membrane and interstitial connective tissue
How do they do the 2nd stage?
remodeling basement membrane by releasing ECM growth factors, promoting angiogenesis, or ameboid migration (squeezing through), or using collagen fibers as “high speed railways”
What is the 3rd step in invasion?
changes in attachment of tumor cells to ECM proteins
how does the tumor undergo stage 3?
by loss of adhesion and cleavage of basement membrane proteins by MMP (matrix metalloproteases)
T or F: Locomotion is the 4th and final step of invasion
TRUE
4 steps to locomotion
protrusion, adhesion, translocation, retraction
different types of motility
collective, Mesenchymal, Amoeboid
What 2 things can destroy a tumor cell?
mechanical shear stress, and apoptosis b loss of adhesion
T or F: tumor cells aggregate in circulation
TRUE
T or F: arrest and extravasation of tumor emboli at distant sites involves adhesion to the endothelium
TRUE
T or F: Overexpression of CD44 (normally on T cells) may favor metastatic spread
TRUE
What are the theories for metastasis?
“Seed and Soil” Theory and anatomic location by getting stuck in cap beds.
4 models of metastasis
1) caused by rare variant clones from primary tumor 2) gene expression of most cells of primary tumor have metastatic signiture 3) combination of first two 4) greatly influenced by tumor microenvironment which affects angiogenesis, invasiveness , and resistance
T or F: petroleum, paper, ship building, chemical industries increase risk for lung cancer
TRUE
T or F: Boulder has a high rate of breast cancer
TRUE
T or F: in Africa liver cancer is uncommon and esophogeal cancer is prevalent
False, other way around
T or F: In US, Liver Cancer is uncommon, but breast, prostate, lung, and colon/rectum cancer are common
TRUE
T or F: Women have more deaths by cancer than men in the US
FALSE
T or F: In CO, lifetime risk of cancer is 1 in 2 for men and 2 in five for women
TRUE
3 most common cancers for men
Prostate, lung/bronchus, colon and rectum
3 most common cancers for women
Breast, lung/bronchus, colon and rectum
Miller’s theory of chemical carcinogenesis (3-things)
1) chemical carcinogens are metabolized by microsomal enzymes 2) active metabolite is a strong electrophile 3) these can modify protein, DNA, and RNA
what chemical carcinogens do not require microsomal activation
alkylating agents and acylating agents
How does the AMES test work
tests chemicals ability to mutagenize. Salmonella test strain needs histidine to grow, when mutagenized it no longer needs histidine supplement to grow and it grows on plate
T or F: 90% of chemicals shown to be carcinogenic are mutagens
TRUE
T or F: a fully differentiated cell can never become malignant
TRUE
Cancer develops develops in two stages. What are they and which are reversible?
1) initiation caused by mutagen, irreversible 2) promotion by non-mutagen. Step is reversible.