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Pathology > Exam 3: Neoplasia I > Flashcards

Exam 3: Neoplasia I Flashcards

1
Q

Adenoma

A

a. derived from or forming glands b. also: Liver
1. Hepatocelllular adenoma c. kidney
2. Renal tubular adenoma

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2
Q

Cystadenoma

A

cystic masses arise from product of neoplastic glandular cells
1. cyst: closed cavity or sac lined by epithelium

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3
Q

Papilloma

A

forming finger-like projections

  1. squamos papilloma
  2. papillary adenoma
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4
Q

Polyp

A

growth pattern projects above the skin or mucosal surface; neoplastic or nonneoplastic

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5
Q

Name and define all benign mesenchymal neoplasms

A 
OSTEOMA
FIBROMA
CHONDROMA
LEIOMYOMA
RHABDOMYOMA
LIPOMA
HEMANGIOMA
LYMPHANGIOMA
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6
Q

Name and define all malignant mesenchymal neoplasms

A 
Carcinoma= epithelial tumors
Sarcoma= tumors derived from mesenchyme
Osteosarcoma, osteogenic sarcoma
Fibrosarcoma
Chondrosarcoma
Leiomyosarcoma
Rhabdomyosacroma
Liposarcoma
Hemangiosarcoma, angiosarcoma
Lymphangiosarcoma
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7
Q

Name and define all malignant epithelial neoplasms

A

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

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8
Q

Name two neoplasms of neuroectodermal cells /melanocytes.

A

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

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9
Q

What two neoplasms are derived from the placenta?

A

A. HYDATIDIFORM MOLE: benign

B. CHORIOCARCINOMA: malignant

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10
Q

What are two examples of tumors of more than one neoplastic cell type, usually derived from one germ cell layer?

A

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

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11
Q

Define teratoma. What are the 1) origin and 2) names of the benign and malignant types?

A 
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
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12
Q

What is a myxoma? Where is it the most common tumor? What is the significant about this tumor?

A

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

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13
Q

What neoplasms, despite their name, are always malignant?

A

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

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14
Q

What are two types of hematopoietic neoplasms?

A

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

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15
Q

What are some neoplasms of the nervous system?

A 
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
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16
Q

Define heterotopias/choristoma. Know the examples given.

A

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

17
Q

Define hamartoma.

A

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.

18
Q

Define: Transformation

A

Transformation: The initial change/mutation in the 1st cell that makes it malignant

19
Q

Differentiation. What is tumor grading and what is the general significance of grade?

A

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

20
Q

Growth fraction. How is it determined and what is the significance?

A

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)

21
Q

Know the morphologic features of anaplasia; recognize illustration.

A

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.

22
Q

Define dysplasia and carcinoma in situ. What are the histologic features?

A

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.

23
Q

Describe the origin of cancer and define tumor progression; tumor heterogeneity

A

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

24
Q

Compare/contrast benign with malignant neoplasm by ability to invade.

A

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

25
Q

Define metastasis. What is meant by “primary” malignancy? What is the significance of metastases?

A

A. define metastasis
i. tumor implants discontinuous with the primary tumor
ii. most reliable source of malignancy
B. Primary malignancy
i. unknown primary A malignancy of unknown 1º site or origin that is symptomless, which first manifests itself as metastases
C. Significance of metastasis= MOST RELIABLE SIGN OF MALIGNANCY

26
Q

What two malignancies do not metastasize but may still kill the patient?

A

Almost all cancers can metastasize, but there are a couple of exceptions:
1.Gliomas: glial cell tumors of the CNS
2.Basal cell carcinomas: of the skin
Local aggressiveness, the large size tends to correlate with metastatic potential.

27
Q

What are the three pathways of metastases? Recognize which tumors are more likely to spread by each path.

A
  1. Seeding:
  2. Lymphatic metasteses
  3. Blood borne metasteses
28
Q

What is staging? What is its significance? Understand the TNM and stage group systems of staging.

A

Cancer staging is a way of using statistical studies to determine tumor outcomes, and determine the need for further
therapy. Staging varies with each organ and uses the TMN to determine the stage.
T= primary tumor size and depth of invasion T1= always invasive, small and confined to the organ in which tumor arises and T2-T4= tumor increasing in size and/or extension or depth invasion
M= blood born metastases M0= none or M1= metastases present (always stage IV)
N= nodal involvement N0= no nodes involved or N1= regional nodes involved

29
Q

What are Tis, stage 0, stage I and stage IV neoplasms?

A

4 Stages: 0-IV
Stage 0: in situ carcinoma
Stage I: small invasive primary tumor (no nodes, no blood-borne metastases)
Stage II & III: increasing tumor size, extension, and possible LN involvement
Stage IV: blood borne metastases

30
Q

Compare/contrast characteristics of benign vs malignant neoplasms (figure 7-20 recommended).

A

Benign tumors: usually encapsulated (clear boundaries); differentiated (resemble normal tissue from which the tumor is derived); low mitotic rate (slow growth over a number of years); do not metastasize; autonomous (function as an independent organism); usually clonal; malignant transformation is rare.

Malignant tumors: Locally invasive (infiltrating); reduced differentiation (anaplasia and atypical structure); erratic growth (rapid with atypical mitotic rates); metastasize frequently; clonal; autonomous

Pathology (8 decks)

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