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OBIOL 305 > Epithelial Neoplasia > Flashcards

Epithelial Neoplasia Flashcards

1
Q

What is skin?

A
  • largest organ
  • covers all external surfaces
  • many layers
    > epidermis
    > dermis - supporting fibrous layer
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2
Q

What is mucosa?

A
  • lines all cavities which connect with outside of body (GI tract, genitourinary tract, respiratory tract)
  • layers:
    > epithelium
    > lamina propria - supporting fibrous layer
  • may be keratinized or not depending on location
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3
Q

What’s the difference between epithelium and epidermis?

A
  • epidermis is found on skin (external) and epithelium is found on external surface of mucous membranes only
  • both are avascular
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4
Q

What are melanocytes?

A
  • dendritic
  • attach to basement membrane via hemidesmosomes
  • neural crest origin
  • produce melanin which is transported by phagocytosis
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5
Q

What are Langerhan’s cells?

A
  • dendritic
  • not attached to epithelial cells
  • located in stratum spinosum
  • phagocytic
  • have MHC Class II molecules
  • antigen presenting
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6
Q

Describe the three main types of oral mucosa.

A

Lining mucosa - sacrifices surface toughness for flexibility
Masticatory mucosa - well keratinized and adapted for heavy masticatory frictional forces
Specialized mucosa - compelx surface to support taste buds, maximize flexibility and resist masticatory forces

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7
Q

_______ means neoplasms in which the cells do not metastasize. Still able to cause local destruction if they extend into and compromise vital structures.

A

Benign

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8
Q

_____ refers to neoplastic cells which are so poorly differentiated that is is impossible or difficult to determine the tissue of origin.

A

Anaplasia

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9
Q

_______ means “new growth.” May be benign or malignant neoplasms that arise from a single cell which has changed significantly, to permit it to proliferate in an autonomous fashion; does not respond to the normal growth regulatory mechanisms

A

Neoplasm

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10
Q

___________ refers to histologically evident alterations of epithelial cells which correlate with an increased potential for malignancy

A

Epithelial dysplasia

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11
Q

_____ is the detachment of neoplastic cells from the original growth site and migration to other sites. The cells usually migrate through the lymphatic system or the blood vessels.

A

Metastasis

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12
Q

_____ neoplasms which have a potential for metastatic spread. Usually more aggressive in growth and are more likely to result in death.

A

Malignant

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13
Q

________ describes the degree to which the neoplastic cells resemble the cells in the “normal” parent tissue. A well-differentiated neoplasm has a high degree of resemblance.

A

Differentiation

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14
Q

Describe the model of carcinogenesis.

A
  • increasing accumulation of genetic damage with time - results in the release of the cell from the normal constraints governing cell proliferation
  • genetic damage from various sources targets oncogenes causing unrestrained clonal proliferation
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15
Q

What are the histologic attributes of a cancer cell?

A
  • nuclear hyperchromatism
  • nuclear and cellular pleomorphism
  • altered nuclear/cystoplasmic ratio
  • increase and abnormal mitotic figures
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16
Q

What is grading?

A

describing the extent to which a malignant tumor has differentiated to resemble the parent tissue from which the tumor arose.

  • assigned various grades (1,2,3) or verbally described (well, moderate, poorly differentiated)
  • typically a well differentiated tumor is better than a poorly differentiated one
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17
Q

What is staging?

A

a clinical decision describing the extent to which a malignancy has spread. Usually the size of the tumor, whether it has crossed natural anatomic barriers and whether it has mestasized.
- assigned stage 1-4, 4 being the worst

18
Q

How do you name a benign tumor?

A
  • prefix indicates originating tissue

- suffix is “oma”

19
Q

How do you name a malignant tumor?

A
  • tumor usually grouped into one major category depending on originating tissue:
    > epithelium: carcinoma
    > mesenchymal: sarcoma
    > hematopoeietic: lymphoma, leukemia, myeloma
20
Q

Name type and location of cancer: liposarcoma

A

fat, malignant

21
Q

Name type and location of cancer: osteoma.

A

bone, benign

22
Q

Name type and location of cancer: leimyosarcoma

A

muscle, malignant

23
Q

Name type and location of cancer: chondroma

A

cartilage, benign

24
Q

Name type and location of cancer: verrucous carcinoma

A

lining epithelium, malignant

25
Q

Name type and location of cancer: melanoma

A

neuroectoderm, malignant

26
Q

What is the most common malignancy in the mouth?

A

epithelial malignancy derived from lining of the mucosa

27
Q

Describe verrucous carcinoma.

A
  • correlation with smokeless tobacco
  • low malignancy, good prognosis
  • well differentiated, cohesive mass grow outwards
  • locally destructive, but usually does not metastiasize
  • may transform to SCC
28
Q

Describe squamous cell carcinoma.

A
  • over 90% of oral cancers
  • atypical epithelial cells infiltrate, individually or in irregular islands and ribbons
  • generally poor prognosis, marked tendency to mestastasize
29
Q

Why are verrucous carcinomas typically underestimated?

A
  • well differentiated epithelial cells - suggesting no malignancy
  • do not show detachment from epithelial mucosal lining like SCC
  • sometimes mimicked by other warty projections (viruses: papilloma, verrucae)
  • heavy infiltration of inflammatory cells suggesting reactive hyperplasia
30
Q

What are risk factors for oral cancer?

A
  • Age: risk of SCC increases with age (mean: 60)
  • Sex: men 3:1
  • Site: floor of mouth, lateral aspect of tongue, soft palate
31
Q

What is Plummer Vinson Syndrome?

A

a sideropenic dysphagia

32
Q

What is erythroplakia?

A
  • clinical term referring to a red lesion which cannot be otherwise identified, usually represents a malignancy or a premalignant lesion
  • red lesions: vasculature of lamina propria becomes discernible, epithelial atroph, inflammation, increase # of vessels, blood extravation, thinning by disorderly epithelial maturation (SCC)
33
Q

What is leukoplakia?

A
  • clinical term referring to a white lesion which cannot otherwise be identifed, 5% become SCC
  • White lesion: lamina propria thickens, epithelial hyperplasia, hyperkeratosis, exudate on surface, thick epithelium from disorderly epithelial maturation
34
Q

What does staging involve?

A

T - primary lesion size
N - extent of spread to lymph nodes
M - whether there are distant metastases

35
Q

Describe the stages.

A

Stage 1: primary tumor less than 2cm with no lymph node involvement or metastases (85% survival)
Stage 2: tumor 2-4 cm with no lymph node involvement or metastasis (66% survival)
Stage 3: tumor more than 4 cm, single lymph node involvement (41% survival)

36
Q

What is epithelial dysplasia?

A
  • usually progressive, clinical evident epithelial alterations
37
Q

What is papilloma?

A
  • “cauliflower like” lesion on oral mucosa
  • HPV 6 and 11
  • finger-like projections formed by epithelium covered fibrous cores
  • low virulence and infectivity
38
Q

What is Verruca vulgaris?

A
  • common wart
  • possible oral mucosa presentation, esp. with HPV 2, 4, 6, and 40
  • very contagious
39
Q

What is condyloma acuminatum?

A
  • STD
  • broad based cloustered raised granular masses
  • associated with HPV 2, 6, 11, 16, 18, 53, 64
40
Q

What is multifocal epithelial hyperplasia?

A
  • Heck’s disease
  • presents as multiple soft papules - commonly in younger populations
  • associated with HPV 13 and 32
  • possibly genetics, inuit and native americans
41
Q

What is verruciform xanthoma?

A
  • focal papilla lesion of unknown origin
  • lipid filled macrophages in papilla between hyperplastic rete pegs
  • adult, gingiva mostly but any surface can be involve
42
Q

What is sebaceous hyperplasia?

A
  • derived from fordyce granules

- present as yellow-white nodule

OBIOL 305 (9 decks)

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