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PATHOLOGY > Diagnosis of malignant lesions > Flashcards

Diagnosis of malignant lesions Flashcards

1
Q

Specimen collection must be

A

adequate, representative, and properly preserved

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2
Q

Sampling approaches are:

A

total excision, biopsy, fine needle aspiration, cytology smears

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3
Q

Fixation methods

A

freezing, formaldehyde (paraffin), glutaraldehyde (e- microscope), refrigeration (molecular analysis)

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4
Q

H&E stain

A

H: basic, blue, basophilic: nucleic acids, ribosomes
E: acidic, pink, eosinophilic: cytoplasm, proteins

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5
Q

Yellow or brown on H&E stain?

A

intrinsic cellular pigments, melanin, etc

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6
Q

PAS

A

stain basal laminae (good for malignant lesions)

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7
Q

Silver stain

A

stain reticular fibers

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8
Q

Clear structure on H&E?

A

hydrophobic structures - rich in fat (adipocytes, myelin, golgi)

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9
Q

Oil red O stain

A

stain fats

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10
Q

Fine-needle aspiration

A

aspirating cells and attendant fluid with a small bore needle –> cytological examination

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11
Q

Papanicoloau stain is used

A

to demonstrate cells that have neoplastic characteristics

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12
Q

Avidin-Biotin Conjugation ABC/DAB

A

specimen + incubation with primary Ab for suspected tumor antigen; incubation with secondary ant-IgG conjugate to biotin; + avidin = complexes with biotin (ABC-tissue) + DAB -> chromogen for brown coloring

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13
Q

Use of ABC/DAB immunohistochemistry

A

identification of tumors that resemble each other

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14
Q

Immunohistochemistry for intermediate filaments

A

for malignant tumor identification of origin, tumor cells contain intermediate filaments consistent with their origin

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15
Q

Distinguishing class of leukemia and lymphoma

A

use of immunohistochemistry

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16
Q

Immunohistochemistry for tissue-specific or organ-specific antigens

A

determines origin or metastatic tumor

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17
Q

Tumor cells expressing cytokeratins

A

epithelial origin

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18
Q

Tumor cells expressing desmin

A

muscle origin

19
Q

Immunohistochemistry can distinguish between subtypes of cancer (ER-positive, ER-negative, capthesin D) relies on

A

overexpression of proteins within the cells

20
Q

Importance of distinguishing subtypes in cancer

A

determining susceptibility to therapy

21
Q

ER-positive therapy

A

ER expression; responsive to tamoxifen

22
Q

Tamoxifen action

A

binds ER, cannot bind coactivators

23
Q

ER-negative therapy

A

no ER expression; responsive to Herceptin

24
Q

Herceptin action

A

cancer overexpresses ERBB-> HER2/neu protein; Herceptin binds and inactivates the cell surface GFR

25
Q

Cathepsin-D breast cancer

A

rapid development of metastases (metastatic potential)

26
Q

FC

A

gives information about physical and chemical structure of each cell

27
Q

FSC =

A

cell volume

28
Q

SSC =

A

shape of nucleus, cytoplasmic granule types, membrane roughness

29
Q

Fluorescence in FC

A

presence (relative quantity) or antigen on surface

30
Q

FC used to

A

classify leukemia and lymphoma, detection of ploidy

31
Q

aneuploidy is associated with

A

poorer prognosis for cancer patient

32
Q

Primary modality for cancer diagnosis

A

histology

33
Q

FISH

A

used to differentiate B and T cell malignancies, by detection of specific translocations that activate oncogenes

34
Q

FISH procedure

A

DNA probe for specific sequence + sample + fluorophores –> reveals translocations and other chromosomal rearrangements

35
Q

Array based comparative Hybridization

A

examine the molecular profile (quantify the expression of large numbers of genes) of different tumors using mRNA levels -> gives clues of potential over expression of tumor markers

36
Q

Array based comparative Hybridization complications

A

uses mRNA which do not directly correspond with proteins; this is due to rate of translation, protein breakdown, and protein export

37
Q

Complications of using tumor markers

A

low specificity/sensitivity, used as supporting evidence

38
Q

Carcinoembryonic antigen (CEA)

A

glycoprotein produced in embryonic tissues of the digestive tract, pancreas, and liver; may be elevated in colorectal and pancreatic carcinoma

39
Q

CEA tumor marker use

A

because it is also elevated in certain non-malignant disease, there is LOW specificity and sensitivity; but may be useful as a prognostic indicator (CEA increased with tumor size)

40
Q

Alpha fetal protein

A

glycoprotein produced early in fetal life by the yolk sac, liver, and GI tract; may be elevated in hepatocellular carcinoma and germ cells of the testis

41
Q

PSA

A

prostate specific membrane antigen used as a marker for prostate cancer

42
Q

HCG

A

testicular tumor marker

43
Q

CA125

A

tumor marker for ovarian tumors

44
Q

Main factors for prognosis and therapy

A

tumor size, metastases

PATHOLOGY (18 decks)

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