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Neoplasia > General Principals > Flashcards

General Principals Flashcards

1
Q

every cell is dividing, reversible, regulated, polyclonal

A

Hyperplasia

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2
Q

Monoclonal, unregulated, irreversible

A

Neoplasia

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3
Q

Parenchymal component

A

Determines biological behavior and classification

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4
Q

Stromal component

A

Determines growth and spread

Provides nutrition (blood vessels) and mechanical support

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5
Q

Increase synthesis of collagen and extra cellular matrix. When you do a Masons trichrome test is stained blue.

A

Normally you see a pink color, but when you have desmoplasia the collage takes a blue color. The blue color is due to hardening of collagen.

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6
Q

Name the test used for Desmoplasia ( infiltrating ductal carcinoma of breast)

A

Masson’s trichrome= blue staining for increase synthesis of collagen and ECM proteins

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7
Q

Exceptions for benign neoplasm that ends with -oma

A
  1. Hepatoma- liver
  2. Melanoma- melanocytes
  3. Mesothelioma- mesothelial
  4. Seminoma- malignant germ cell testis
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8
Q

What is polyp

A

Projects above a mucosal surface into the lumen of hollow viscera ( stomach, intestine, colon)

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9
Q

Benign tumor for glandular tissue

A

Adenoma

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10
Q

Nomenclature for epithelial tumor
Benign and malignant

A

Benign- oma
Malignant- carcinoma

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11
Q

Nomenclature for mesenchymal tumor
Benign and malignant

A

Benign- oma
Malignant- sarcoma

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12
Q

Malignant tumors
Endoderm, ectoderm, Mesoderm

A

Endoderm and ectoderm are carcinoma

Mesoderm is sarcoma

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13
Q

Mixed tumors

A

Teratomas - derived from multiple germ layers
Example: ovarian germ cell tumor

Pleomorphic- multiple component but are derived from the same germ cell
Example- pleomorphic adenoma of the parotid gland

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14
Q

Neoplasm ending in - “blastomas”

A

Neoplasms ending in -blastoma resemble primitive embryonic tissues

Examples:
Retinoblastoma
Neuroblastoma
Hepatoblastoma
Medulloblastoma

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15
Q

Choristoma

A

Tumor like mass consisting of normal cell but in abnormal location (ectopic)

Example: pancreatic choristoma.
Normal pancreatic tissue located in the stomach or small intestine

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16
Q

Hamartoma

A

Benign mass composed of mature cells that are naive to the tissue of origin but is abnormal tissue organization.

Is not ectopic they just have a different organization that is supposed to be.

Example: tuberous sclerosis ( cortical hamartoma)
Pulmonary hamartoma
Iris hamartoma

17
Q

Differentiation

A

Refers to the extend to which the neoplasm, RESEMBLE the corresponding normal parenchymal cell. Morphological and functional.

Two types: well differentiated and poor differentiated

Well differentiated- resembles the normal parenchyma cell. Benign neoplasm are always well differentiated

Poor differentiated- only slightly or no resemble. Highly to be malignant.

18
Q

Examples of well- differentiated tumors

A

Lipoma of the stomach ( the one with fat cell)
Leiomyoma of the uterus

19
Q

which are the morphologic changes of cancer cell poorly differentiated?

A
  1. Pleomorphism- variation in size cell and shape. Appearance of tumor giant cell.
  2. Abnormal nuclear morphology N:C, ratio is high (1:1 instead of 1:4/1:6) hyperchromic nuclei with prominent nucleoli.
  3. Atypical mitotic figure- abnormal dividing cell. the newly created cell receive an unequal amount of DNA.
20
Q

Examples of Metaplasia

A

Metaplasia - Replacement of one type of cell to another type

Examples: In chronic smokers a normal pseudostratified ciliated columnar epithelial cell are replaced by squamous epithelial cell.

Barret esophagus the normal squamus epithelium is replace by glandular intestinal epithelium (goblet cells)

21
Q

Histological characteristics of Dysplasia

A

Pleomorphism - variation in size and shape

High N:C, hyperchromic nuclei

Increase mitotic activity

22
Q

Carcinoma in situ

A

Is when the entire epithelium is involve. In severe dysplasia is Irreversible. But mild dysplasia it can be reversible.

DO NOT penetrate the basement membrane

23
Q

Carcinoma

A

Is when the basement is broken and the cell cross into the inside.

24
Q

Factors promoting invasive carcinoma

A
  1. Upregulation of Type 4 collagenases ( they break collagen), MMP (Matrix metalloproteinases- involve in tumor metastasis) and plasminogen activator (uPA (Urokinase-type plasminogen activator) - a degradation enzyme that is highly expressed in invasive cancer cells)
  2. Downregulating of cadherins
    (E-cadherin) - disrupt of the intracellular adhesion between neighboring cell.
  3. Increased attachment to ECM protein ( high Laminin and CD44/integrin receptor)
25
Q

Dysplasia vs invasive carcinoma

A

Abundant mitosis, disordered maturation, loss cell polarity, nuclear abnormalities, pleomorphism ALL are seen in BOTH dysplasia and Invasive carcinoma.

But if dysplasia is mild to moderate it CAN be REVERSE when the causal factors are withdrawn.

26
Q

Benign vs Malignant
Poor/well Differentiation

A

benign is Well differentiation

malignant is poor differentiation

26
Q

Benign vs Malignant
Macroscopy

A

Benign is well demarcated capsulated where necrosis is rare

Malignant usually do not have capsule and it could have necrosis

27
Q

Benign vs Malignant
invasion

A

Benign do not invade the surrounding

Malignant is locally destructive and invasive

27
Q

Benign vs Malignant
Growth

A

Benign is slow growth

Malignant is unpredictable growth

28
Q

Benign vs Malignant
Microscopy

A

Benign almost do not have any irregularities of cellular structures

Malignant have Pleomorphism, high N:C ratio, hyperchromatic nucleus with prominent nuclei, abnormal mitotic figures

29
Q

Benign vs Malignant
Metastasis and relapse

A

Benign do not metastasis and relapse is rare

Malignant are potential to metastasis and relapses are common.

30
Q

Direct seeding of carcinomas

A

Any body cavity can be affected but the most common one is Peritoneal cavity.

Examples:
1. Omental caking- ovarian carcinoma ( the most common)

  1. Pseudomyxoma peritonei- appendiceal mucinous tumor
30
Q

Three pathways of metastasis routes

A
  1. Direct seeding of body cavities or surfaces
  2. Lymphatic spread- most common route for metastasis of carcinomas
    EXCLUDING- renal cell carcinoma, follicular thyroid carcinoma, hepatocellular carcinoma and choriocarcinoma ( they spread HEPATOGENOUSLY)
  3. Hepatogenous spread- typical for sarcomas, venous dissemination is more common than arterial dissemination because of thin vein that facilitates invasion.
31
Q

which are the exclusions of lymphatic spread?

A

Most carcinomas are spread by lympatic route but there are 4 exceptions

This are spread by hepatogenous

  1. renal carcinomas
  2. thyroid carcinomas
  3. hepatocellular carcinoma
  4. Chroriocarcinoma
32
Q

Lymphatic spread

A

Most common route for metastasis for carcinomas.

The sentinel lymph node is the first lymph node to which cancer are most likely to spread from a primary tumor.

Axillary lymph node with metastatic adenocarcinoma of the breast.

Sentinel lymph node mapping- radiolabeled traces or colored dyes.

33
Q

Cancer arising near the vertebral column often embolize through…

A

The paravertebral venous plexus.

34
Q

Hematogenous Spread

A

Typical of sarcomas

The liver and lungs are frequently involved because all PORTAL areas drain into the LIVER and all CAVAL drain into the lung.

The liver is the most commonest site of metastasis of colorectal cancer.

35
Q

The liver is the most commonest site of metastasis of ?

A

colorectal cancer.

Neoplasia (7 decks)

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