Exam 3: Neoplasia I Flashcards
Adenoma
a. derived from or forming glands b. also: Liver
1. Hepatocelllular adenoma c. kidney
2. Renal tubular adenoma
Cystadenoma
cystic masses arise from product of neoplastic glandular cells
1. cyst: closed cavity or sac lined by epithelium
Papilloma
forming finger-like projections
- squamos papilloma
- papillary adenoma
Polyp
growth pattern projects above the skin or mucosal surface; neoplastic or nonneoplastic
Name and define all benign mesenchymal neoplasms
OSTEOMA FIBROMA CHONDROMA LEIOMYOMA RHABDOMYOMA LIPOMA HEMANGIOMA LYMPHANGIOMA
Name and define all malignant mesenchymal neoplasms
Carcinoma= epithelial tumors Sarcoma= tumors derived from mesenchyme Osteosarcoma, osteogenic sarcoma Fibrosarcoma Chondrosarcoma Leiomyosarcoma Rhabdomyosacroma Liposarcoma Hemangiosarcoma, angiosarcoma Lymphangiosarcoma
Name and define all malignant epithelial neoplasms
A. Defined
i. malignant tumor of squamos epithelium
B. Nomenclature
i. Squamos cell carcinoma= malignant tumor of squamos epithelium
ii. Basal cell carcinoma= basal cells of skin or adnexa (hair, sweat glands) iii. Adenocarcinoma= glandular, duct or columnar cell origin
Name two neoplasms of neuroectodermal cells /melanocytes.
A. NEVUS: benign (moles)
i. common, brown pigment
ii. small; circumscribed
iii. does not enlarge; change significantly over time
B. MALIGNANT MELANOMA: melanoma
i. enlarging; may ulcerate; outline irregular
What two neoplasms are derived from the placenta?
A. HYDATIDIFORM MOLE: benign
B. CHORIOCARCINOMA: malignant
What are two examples of tumors of more than one neoplastic cell type, usually derived from one germ cell layer?
i. Salivary Gland tumor
ii. Lacrimal gland tumor
a. mixed tumor or pleomorphic adenoma; usually benign
b. MOST COMMON neoplasm at each location
iii. Wilms Tumor–> RENAL ANLAGE (embryonic precursor)
a. Common in children (malignant) iv. Breast
a. tumor of glands and fibrous tissue
Define teratoma. What are the 1) origin and 2) names of the benign and malignant types?
A. Define i. Terato=monster B. Origin i. totipotential cells C. Benign Type i. Mature Teratoma a. ie: cystic variety--> dermoid cyst (ovary) D. Malignant Type i. Immature Teratoma
What is a myxoma? Where is it the most common tumor? What is the significant about this tumor?
A. Myxoma: (myxo=mucous in appearance/mucoid)
i. benign tumor of mesenchyme (stroma) w/mucoid appearance
B. Tumor Location?
i. MOST COMMON TUMOR OF ADULT HEARTS
C. Significance
i. Kills pt by virtue of location
What neoplasms, despite their name, are always malignant?
A. Hepatoma= hepatocellular carcinoma
B. Melanoma= Malignant melanoma
C. Lymphoma= ALWAYS malignant lymphoma
D. Multiple Myeloma= (myelo=bone marrow): plasma cell malignancy
E. Mesothelioma= arises from pleura; peritoneum, pericardium
F. Gliomas= Brain tumors
G. Seminomas= testicular tumor
What are two types of hematopoietic neoplasms?
A. Lymphoma*
i. malignant neoplasm formed of masses of lymphocytes in lymph nodes or extranodal tissues
B. Leukemia
i. malignant blood forming cells involves bone marrow diffusely (no mass); neoplastic cells may circulate in peripheral blood
What are some neoplasms of the nervous system?
A. Meningioma i. benign neoplasm of covering of brain ii. SERIOUS, possibly fatal due to location B. Ganglioneuroma i. benign tumor of nerve origin C. Gliomas i. malignant neoplasms of the brain
Define heterotopias/choristoma. Know the examples given.
Heteropia is normal tissue that is present at an abnormal site.
Synonyms: choristoma (used with lesions of the eye); ectopic tissue
Examples include: pancreatic tissue in the stomach, breast tissue in the axilla
Define hamartoma.
A hamaratoma is a focal malformation composed of proliferation of abnormal mixture of tissues native to the site.
May be a result of development, or benign neoplasia.
Define: Transformation
Transformation: The initial change/mutation in the 1st cell that makes it malignant
Differentiation. What is tumor grading and what is the general significance of grade?
Degree of differentiation is the basis of tumor grading.
Malignant tumors are graded 1-3
Grade 1: well differentiated; low grade: tumors that grow very slowly
Grade 2: moderately differentiated
Grade 3: poorly differentiated; high grade: tumors that grow rapidly and leads to hemorrhage and necrosis
Growth fraction. How is it determined and what is the significance?
Growth fraction (GF): proportion of cells in the proliferative pool
Measured by: S-phase or proliferative phase markers
↑GF: means tumor cells are rapidly growing because many cells are in the S-phase or proliferative phase (more aggressive tumor)
↓GF: means tumor cells are slowly growing because there are less cells in the proliferative S-phase
***Rapidly growing or aggressive tumors tend to have a growth fraction of ≤20% (# of cells are in the S-phase) these rapidly growing cells make them an excellent target for chemotherapy (chemo is most effective on rapidly growing cells)
Know the morphologic features of anaplasia; recognize illustration.
Anaplasia has two definitions depending upon the type of cell that is undergoing this process.
In stem cells: anaplasia means “lack of differentiation”. Because stem cells are already at their most primitive form, they cannot revert back to a prior state of differentiation.
In non-stem cells: anaplasia means to “revert back to a previous state”. Differentiated cells (epithelial cells, muscle cells etc), would revert back to be more like their precursor stem cells.
Define dysplasia and carcinoma in situ. What are the histologic features?
Dysplasia: disordered premalignant growth in tissue with hyperchromatic cells, loss of polarity, pleomorphisms and increased mitosis. The disordered growth or the increased mitosis do not span the entire epithelium and has not reached the basement membrane. The severity of the dysplasia is dependent upon the thickness of the abnormality.
Carcinoma in situ: continued dysplasia (precancer) process that involves the full thickness of the epithelium, but does not reach the basement membrane.
Describe the origin of cancer and define tumor progression; tumor heterogeneity
Cancer is monoclonal in origin: arises from either a stem cell or progenitor cell. Many cancers have tumor initiating cells (T-IC stem cells) which are resistant to chemotherapy due to slow growth.
Tumor Progression: acquisition of more aggressive behavior; greater malignant potential. INCREMENTALLY acquired, multiples in different tumor cells (accelerated growth, invasiveness, ability to form distant metastases) –> produces HETEROGENEITY
Tumor heterogeneity: populations of cells that differ with respect to phenotype (invasiveness, karyotype, growth rate)
-Tumors ARE heterogeneous at time of PRESENTATION with multiple subclones
Compare/contrast benign with malignant neoplasm by ability to invade.
A. Benign
i. usually encapsulated, cohesive, well demarcated
ii. Differentiated: closely resembles the normal tissue from which tumor is derived
iii. Low mitotic rate
iv. Slow growth rate period of yearsv. DOES NOT metastasize
vi. Autonomous and usually clonal; malignant transformation uncommon & rare
B. Malignant
i. predominantly locally invasive; infiltrating; some may appear cohesive
ii. Differentiation reduced; anaplasia and atypical structure present
iii. Erratic growth rate; may be rapid; mitoses often present; may be atypical
iv. Metastases frequently present; particularly enlarge; become undifferentiated
v. Clonal; autonomous growth
C. Synonyms for invasion: infiltrate or metastasize
