Disturbances of Growth Flashcards
hamartoma
benign tumor-like mass = overgrowth of differentiated cells & tissues that are normally present in affected location
“development” NOT “neoplastic”
characteristics of neoplasms
irreversible
1) tumor cells = increased capacity to survive & reproduce
- -preservation of telomeres
malignant tumors
1) carinoma
- -epithelial & glandular tissue
2) sarcoma
- -mesenchymal
- -young age 90% =
Teratoma
derived from germ cells & *totipotential cells* **most arise in gonads Ex: benign ovarian dermoid cyst testicular teratocarcinoma "parasitic twin"
spread & metastatses of tumors
- -symptomatic metastases = 30%
- -occult metastases = 20%
routes of spread –local tissue
easiest –> hardest to infiltrate
1) loose CT
2) dense CT
3) elastic
4) cartilage
local conditions at secondary site
tumor cell “homing” & “favorable soil hypothesis”
1) adequacy of blood supply & nutrients
2) mutual compatibility btwn tumor surface & endothelium
3) microenvironmental factors fav tumor survival
common locations for metastasis
1) lymph nodes
- -L supraclavicular node “virchow’s” = visceral cancer -> thoracic duct.
- -breast cancer –> axillary nodes
2) liver
- -enspec GI & pancreas
3) lung
4) bone
- -breast, prostate, bone spread to here
5) CNS
- -LEAST common
uncommon sites for metastasis =
spleen & striated muscle
bone metastases general features
1) cancer cells are carried by circulation
2) destroy and replace bone
3) likely to form multiple lesions
(contracts w/ primary cancer = unifocal)
4) COMMON SITES = vertebrae// ribs// pelvis// sternum// proximal ends of long bones
one more time for fun…
what are the common sites for bone metastases
vertebrae ribs pelvis sternum proximal long bones (**remember things like to come to the middle!!)
types of osseous metastasis
osteolytics = typically degrade bone
(except multiple myeloma)
osteoplastics = increase bone
osteoLYTICS
most common bone cancer (radio-lucent)
- -osteoclasts = degrade bone
- -except multiple myeloma = increase bone
osteoPLASTICS
radio-dense
–prostate & breast cancer
clin features = hypercalcemia
most common sites for cancer
M = prostate, lung, lower GI, urinary, leukemia F = breast, lung, lower GI, uterus, leukemia
site of mortality of cancer
M = lung, prostate, lower GI, leukemia, pancreas/urinary F = lung, breast, lower GI, leukemia, ovary
national incident of cancer =
combo of environmental, hereditary, and cultural factors
which gender is more at risk for cancer?
males
hereditary factors & cancer
inherited mutated genes = familial retinoblastoma & familial colon colyposis syndrom
- -familial “clustering” of certain tumors associated w/ less well-defined genetic transmission
- -defects in DNA repair = Xeroderma pigmentosum = skin cancer & familial non-polyposis colon carcinomes
hormone abnormalities
increased estrogen = more likely for breast, and endometrium cancer
–hormone is not carcinogenic but is a promotor of growth
leukoplakia =
white discoloration
–oral mucosa, female vulva
keratosis =
scaly from too much sun
think keratinocytes are repopulating ;)
atrophic gastritis
helicobacter pylori infection
ulcerative colitis
increased risk of colon cancer
cirrhosis contributes to
hepatic cancer
alkylating agents
directly mutagenic (conversion independent) --destroy cancer cells by damaging DNA
Human T-cell leukemia viruses
(HTLV-1 & HTLV-2)
- -RNA virus
- -common in japan and caribbean
warning signs of cancer
1) change in bowel or bladder funx
2) sore that fails to heal
3) lump or thickening in breast
4) unusual bleeding
5) indigestion or difficulty swolling
6) obvious changes in wart or mole
7) nagging cough or hoarseness
clinical manefestations of cancer
local & systemic
–systemic = ectopic hormone production in non-hormonal glands = paraneoplastic syndromes
anti-tumor mech
1) cytotoxic T cells (require sensitization)
2) NK cells (do NOT require sensitization)
- -1st line of defense.
- -interleukins enhance NK & T cells
3) Activated macrophages
- -kill using oxygen-derived free radicles & cytokines
complete remission of glial cells
inject patient w/ own “crippled” cancer cells by an “anti-sense” gene against the tumor’s growth factor
staging (TMN)
T= tumor size, shape, local spread...etc. M= metastasis N= nodes
lab diagnosis
Ig = light chains = elevated in multiple myeloma & B-cell tumors
surgery
about 2/3rds of tumors qualify for surgery
–of those about 2/3rds are cured
chemotherapy side affects
- -damaging marrow, GI mucosa
- -procarbazine: depolymerizes DNA
