Gomez CIS Neoplasia

Question 1

Exfoliative cytology sampling

Answer 1

Exfoliative-the microscopic examination of desquamated cells for diagnostic purposes. The cells are obtained from lesions, sputum, secretions, urine, and other material by aspiration, scraping, a smear, or washings of the tissue

Question 2

Aspiration biopsy cytology

Answer 2

Aspiration biopsy cytology (ABC)-the microscopic study of cells obtained from superficial or internal lesions by suction through a fine needle.

Question 3

Grading and Staging of Tumors

Answer 3

Grading of a cancer is based on the degree of differentiation of the tumor cells and, in some cancers, the number of mitoses or architectural features

Staging of cancers is based on the size of the primary lesion, its extent of spread to regional lymph nodes, and the presence or absence of blood-borne metastases
The major staging system currently in use is the American Joint Committee on Cancer Staging.
T for primary tumor
N for regional lymph node involvement
M for metastases

Stage is the Most Important Prognostic Indicator!!!

Question 4

Tumor marker for ovarian tumors

Answer 4

CA-125

Question 5

alpha fetoprotein as tumor marker

Answer 5

liver cell cancer, nonseminomatous germ cell tumors of testis

Question 6

colon and pancreatic cancer tumor marker

Answer 6

CA-199

Question 7

Breast cancer tumor marker

Answer 7

CA-15-3

Question 8

Neurofibromatosis Type 1 gene

Answer 8

NF1 gene mutation that blocks encoding of neurofibromin (RAS inhibitor)

Question 9

Squamous Cell Carcinoma of the Skin

Answer 9

Lethality is 4.3% for squamous cell carcinoma of the skin
Main etiologic factor = solar radiation
Ki67 is increased due to increased replication
Precursor lesions:
- Actinic keratosis
- Bowen disease

Predisposing abnormality
Xeroderma pigmentosa

Question 10

Other Carcinogenic Factors for SqCC

Answer 10

Tobacco use
Human papilloma viruses (subtypes 5 & 8)
Arsenic
Immunosupression (↓immunosurveilance)
Betel quid or paan use (betel leaf, areca nut +/- slaked lime +/- tobacco)
Chronic ulcers (chronic osteomyelitis)
Burn scars
Ionizing radiation
Etc.

Question 11

Cancer Cachexia

Answer 11

Develops as a secondary disorder in cancer patients
Systemic inflammation, negative protein and energy balance and involuntary loss of lean body mass +/-wasting of adipose tissue
Progressive functional impairment
Significant weight loss in adults and failure to thrive in children

Question 12

Paraneoplastic Syndromes

Answer 12

ADH (hyponatremia)
ACTH (Cushing syndrome)
PTHrp (hypercalcemia) Remember seen more with squamous cell carcinoma!