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Pathology > Exam 4: Neoplasia 1 > Flashcards

Exam 4: Neoplasia 1 Flashcards

1
Q

What is neoplasia?

A

An abnormal mass of tissue with excessive and uncoordinated growth that persists after the original stimulus is absent

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2
Q

What are causes of neoplasia?

A

Genetic and metabolic cellular changes –> cells fail to respond to normal control
Proliferation –> a microscopic or gross tumor

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3
Q

What is benign neoplasia?

A

Don’t invade local tissues, still may cause disease

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4
Q

What is malignant neoplasia?

A

Invade, spread within the body, resulting in death if not under control

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5
Q

What is metastasis?

A

Spread within the body

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6
Q

What is the preneoplastic change of neoplasia?

A

Stepwise progression
Change in morphology that indicates abnormal cellular content and thus an increased chance for neoplasia
Dysplasia
Anaplasia

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7
Q

What is dysplasia?

A

A disorderly pattern of growth

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8
Q

What is anaplasia?

A

Loss of differentiation

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9
Q

How do you name tumors where the cell of origin is mesenchymal?

A

Benign: -oma
Malignant: -sarcoma

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10
Q

Describe an epithelial tumor

A

Can arise from endoderm, mesoderm, and ectoderm

Malignant is a “carcinoma”

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11
Q

Describe an adenoma

A

Benign, from a gland, or making a tubular pattern

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12
Q

Describe a papilloma

A

Benign, exophytic/fromdose, from a skin or mucosal surface

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13
Q

Describe a polyp

A

Benign, smooth, bulging, mucosal surface

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14
Q

What is carcinoma in-situ?

A

Preinvasive form, neoplasm remains within the epithelium without invasion

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15
Q

What is a squamous carcinoma?

A

Tumors that demonstrate squamous epithelium

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16
Q

What is a mucinous carcinoma?

A

Tumors that produce abundant mucin

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17
Q

What is desmoplasia/scirrhous response?

A

Formation of abundant collagen stroma

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18
Q

What is a mixed tumor?

A

Multiple cell types in the tumor

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19
Q

What are teratomas?

A

Started from completely undifferentiated cells, developed from stem cells
Generally occur in areas with reproductive tissue

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20
Q

What is a harmatoma?

A

Disorganized mature cells in a normal location

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21
Q

What is a choristoma?

A

Normal mature tissue is an abnormal site

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22
Q

What are tumor characteristics that indicate neoplasia?

A

Loss of differentiation

Unlimited proliferative potential due to continuous cell division and resistance to cell death

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23
Q

What established the prognosis and determines treatment of tumors?

A

Tumor grade (degree of differentiation) and stage (extent of spread)

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24
Q

Describe differentiation of a benign tumor

A

Well differentiated
Structure similar to tissue of origin
No anaplasia

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25
Q

Describe differentiation of a malignant tumor

A

Poorly differentiated
Tissue of origin may be unclear
Variable anaplasia

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26
Q

Describe growth rate of a benign tumor

A

Slow, progressive
Rare mitoses
Normal mitoses
Little necrosis

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27
Q

Describe growth rate of a malignant tumor

A

Rapid growth
Frequent mitoses
Abnormal mitoses
Necrosis

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28
Q

Describe local invasion of a benign tumor

A

No invasion
Cohesive growth
Capsule often present

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29
Q

Describe local invasion of a malignant tumor

A

Local invasion
Infiltration
Lacks capsule

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30
Q

Is there metastasis with a benign tumor?

A

No

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31
Q

Is there metastasis with a malignant tumor?

A

It is sometimes present

32
Q

Describe differentiation with neoplasia in general

A

Neoplastic cells lose the mature differentiated features of cell morphology and organization
In general, malignancies are less differentiated than benign

33
Q

What does the change in differentiation reflect?

A

High mitotic rate, chromosomal abnormalitites, and high metabolic activity

34
Q

What is anisocytosis?

A

Variation in cell size

35
Q

What is anisokaryosis?

A

Variation in nuclear size

36
Q

What is pleomorphism?

A

Variation in cell shape

37
Q

What is hyperchromasia?

A

Dark nuclei due to increased DNA content

38
Q

Why do neoplastic cells have a basophilic cytoplasm?

A

Due to many ribosomes

39
Q

What is used to identify characteristic features of cells?

A

Immunohistochemistry

40
Q

How does proliferation occur?

A

Neoplastic cells escape the normal limits on cell division, are independent from stimulatory/inhibitory factors, and apoptotic signals

41
Q

Is tumor growth exponential?

A

No, there is irreversible cell cycle arrest and cell death occurs within tumors

42
Q

How do neoplastic cells accumulate more mutations?

A

Neoplastic cells don’t respond to p53 or other signals

43
Q

What is the mitotic index of neoplasia?

A

Average number of tumor cells in a 400x field that have condensed chromosomes and lack a nuclear membrane

44
Q

What are mechanisms of cell death?

A

Senescence
Apoptosis
Autphagy

45
Q

What is senescence?

A

Damaged cells permanently arrest in G1, a result of p53 or retinoblastoma pathways

46
Q

How do neoplastic cells prevent sensecence?

A

They maintain telomerase

47
Q

How do neoplastic cells remove a pro-apoptotic pathway?

A

Inactivate p53

48
Q

What is the latent period of neoplasia transformation?

A

The time before a tumor is clinically detectable

49
Q

What is transformation of neoplasia altered by?

A

Cell death rate, mitotic rate, blood supply, and immune response

50
Q

What are the stage in the development of tumors?

A

Initiation
Promotion
Progression

51
Q

What is initiation?

A

The introduction of an irreversible genetic change by a carcinogen which may allow a selective advantage in the cell
Genetic and irreversible

52
Q

What is promotion?

A

Stimuli (promoters) cause the growth of the initiated cells- a benign tumor
Promoters are non-mutagenic
Nongenetic and reversible

53
Q

What is progression?

A

Benign tumors become malignant- a complex and poorly understood process of genetic and epigenetic changes in the tumor cells
Genetic/nongenetic
Irreversible/reversible

54
Q

What are tumors believed to derive from?

A

A single cell (clonal)

55
Q

When is heterogeneity generated?

A

During tumor development

56
Q

What does each new mutation in cells lead to?

A

A subclone of tumor cells

57
Q

What are subclones selected for?

A

Increased malignancy

58
Q

What is in the stroma of tumors?

A

The connective tissues

59
Q

What is the stroma of epithelial tumors derived from?

A

Normal mesenchymal cells

60
Q

What is the stroma of mesenchymal tumors produced by?

A

The neoplasm

61
Q

What are the stromal interactions of tumors?

A

Complex- exchange of many factors that modulate growth

An extensive fibrous reaction (desmoplasia) is often referred to as a scirrhous response

62
Q

Describe angiogenesis of neoplasia

A

Without new vessels, tumor size is limited so the angiogeneic switch allows vessel development
This recruits endothelial cells, migration, and maturation

63
Q

What are the vessels of a tumor like?

A

Tortuous
Irregular
Unstable
Leaky

64
Q

How does the immune system interact with neoplastic cells?

A

The immune system can detect a variety of antigens expressed by neoplastic cells and destroy them, but as tumors evolve, they figure out ways to get around the immune response
Most tumor cells that are developed are killed off by the immune system

65
Q

What is a defining characteristic of malignancy?

A

Metastasis

66
Q

What does metastasis occur through?

A

Lymphatics, blood vessels, direct dissemination

This is an inefficient process

67
Q

Why is metastasis the cause of cancer related mortality?

A

Interference with critical organ functions

68
Q

What must a tumor that is trying to metastasize do?

A

Learn how to cut through the basement membrane and then learn how to move

69
Q

What is the site of metastasis determined by?

A

Cell’s ability to interact with endothelial cells and ECM-suitable site for growth

70
Q

What do mets to local lymph nodes indicate?

A

Systemic spread

71
Q

What is lymphatic spread often found with?

A

Carcinomas

72
Q

What is hematogenous spread preferred by?

A

Sarcomas

73
Q

If the neoplasm reaches the vena cava/heart, where will it metastasize to?

A

The lungs

74
Q

If the neoplasm invades the portal vein, where will it metastasize to?

A

The liver

75
Q

What do malignant pheochtomocytomas commonly invade?

A

Vena cava

Pathology (16 decks)

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