General Pathology, Autopsy and Forensics Flashcards
What cancers are positive for CK7 and negative for CK20?
Above the diaphragm (lung, breast, thyroid, salivary gland) and female GYN tract (uterus, ovary–except mucinous ovarian lesion which are negative for both) and papillary renal cell carcinoma is usually CK7+
What cancers are negative for CK7 and positive for CK20?
Below the diaphragm (GI tract) and Merkel cell carcinoma
What cancers are positive for both CK7 and CK20?
Peri-diaphragmatic (pancreas, biliary tree, stomach) and BLADDER and mucinous ovarian lesions
What cancers are negative for both CK7 and CK20?
Simple visceral epithelia (except colon): liver, kidney, prostate and adrenal cortex
Several non-myogenic tumors and tissues are unexpectedly desmin positive (but not actin positive). What are they?
Desmoplastic Small Round Blue Cell Tumor Blastemal component of Wilm’s Tumor Mesothelial cells (benign but not malignant) Some people use desmin to differentiate reactive mesothelial cells from mesothelioma
In a forensic autopsy, the College of American Pathology recommends that wet stock tissue be retained for what period of time?
The College of American Pathologists recommends retaining wet tissue from forensic autopsies for one year. Note this is longer than that for hospital autopsies for which the CAP recommends retention for only 3 months after the case has been completed.
In regards to a non-forensic autopsy, according to the College of American Pathologists how long should glass slides and paraffin blocks be retained?
The most recent recommendations from CAP state that wet tissue from non-forensic autopsies be retained for 3 months after the final report is issued and that reports, glass slides, and paraffin blocks be retained for 10 years. In many cases, departments may choose to retain these specimens for a longer period of time. A different set of recommendations applies to forensic autopsies, with many of the materials having an indefinite retention recommendation.
What is the difference between Carney complex and Carney triad?
Carney complex: autosomal dominant condition comprising myxomas of the heart and skin, hyperpigmentation of the skin (lentiginosis), and endocrine overactivity
Carney triad: co-existence of gastric gastrointestinal stromal tumor, pulmonary chondroma, and extra-adrenal paraganglioma
What chromosome is responsible for familial retinoblastoma?
13
What chromosome is responsible for FAP?
5q21
What chromosome is responsible for MEN I and MEN II? (different chromosome for each)
MENI–Chr 11 (menin)
MENII–Chr 10 (RET)
What chromosome is responsible for NF1 and NF2 (diff chrom for each)?
NF1–Chr 17
NF2–Chr 22
What chromosome is responsible for VHL?
3p25
What are the tumor suppressor genes?
Major players for tumor suppressor genes: AD inheritance
p53- 17q13
Rb- 13q14.1
APC-5
VHL-3p
NF-1 an NF-2–17q11 and 22q12
WT-1- 11p13
DCC -18q21
Need both copies knocked out – Knudson’s two-hit hypothesis
Inactivation events – point mut, genetic loss, methylation
What are some proto-oncogenes?
Oncogenes - A proto-oncogene is a normal gene that can become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Upon activation, a proto-oncogene (or its product) becomes a tumor inducing agent, an oncogene. Examples: RAS, WNT, MYC, BRAF, HER2Neu, ERK and TRK.
Only need one proto-oncogene to go bad and your in trouble (no 2-hit here – 1 bad apple ruins the bunch!)
- Point mutations – k-ras
- Amplifications – myc, Her2 (FISH gold standard at detecting overamp)
- Translocations – MLL, FL
