Grading, Staging, And Clinical Manifestation Of Tumors

Question 1

List the Clinical aspect of neoplasia?

Answer 1

1. Location and impingement on adja­cent structures. 2. Bleeding, secondary fractures or infection. 3. Symptoms that result from rupture, obstruction or infarction. 4. Functional activity such as hormone synthesis or the
   development of paraneoplastic syndromes. 5. Cachexia or wasting.

Question 2

• A small (1cm) pituitary adenoma can compress and destroy the
surrounding normal gland, giving rise to?

Answer 2

hypo­pituitarism / location

Question 3

A 0.5 cm leiomyoma in the wall of the renal artery may encroach
on the blood supply, leading to?

Answer 3

renal ischemia and hypertension / location

Question 4

Bleeding, secondary fractures or infection how ?

Answer 4

A tumor may ulcerate through a surface or adjacent structures
causing con­sequent bleeding or secondary infection or fracture.

Question 5

Benign or malig­nant  neoplasms
that  protrude  into  the  gut
lumen  may become  trapped  in
the  peristaltic  pull  of  the  gut,
causin?

Answer 5

intestinal obstruction or

infarction/ Symptoms that result from rupture, obstruction or infarction

Question 6

They are symptom that occur in cancer patients and cannot be

explained

Answer 6

Paraneoplastic Syndrome

Question 7

mimic metastatic disease.

Answer 7

Paraneoplastic Syndrome:

Question 8

represent the earliest manifestation of an occult

neoplasm

Answer 8

Paraneoplastic synd

Question 9

Paraneoplastic Syndrome

The most common such syndromes are?

Answer 9

Hypercalcemia • Cushing syndrome • Nonbacterial thrombotic endocarditis.

Question 10

The most often neoplasms associated with these syndromes

are ?

Answer 10

lung and breast cancers and hematologic malignancies.

Question 11

Progressive loss of body fat and lean body mass,

accompanied by profound weakness, anorexia, and anemia?

Answer 11

Cancer Cachexia

Question 12

The origin of cancer cachexia is multifactorial?

Answer 12

Anorexia (reduced calorie intake): TNF suppresses appetite  Increase basal metabolic rate & calorie expenditure.  General metabolic disturbance.

Question 13

Methods to quantify the probable clinical aggressiveness
of a given neoplasm, and its apparent extent and spread
in the individual patient are necessary for making an accu­rate
prognosis and for comparing end results of various
treatment protocols.

Answer 13

Grading and Staging of Cancer

Question 14

attempts to establish aggressiveness or

level of malignancy ?

Answer 14

Grading

Question 15

Based on the cytologic differentiation of tumor cells and

the number of mitoses within the tumor.

Answer 15

Grading

Question 16

Malignant tumors are classified as: acc to grading

Answer 16

• Grade I : well differentiated • Grade II : moderately differentiated • Grade III :poorly differentiated • Grade IV : undifferentiated (anaplastic)

Question 17

based on the size of
the primary lesion, its extent of spread to
regional lymph nodes , and the presence or
absence of metastases.

Answer 17

Staging

Question 18

Two method of staging are currently in use:

Answer 18

1. The TNM system: • T,primary tumor; N,regional lymph node involvement; M,metasta­ses. • T1, T2, T3, and T4 describe the increasing size of the primary lesion. • N0, N1, N2, and N3 indicate progressively advancing node
   involvement. • M0 and M1 reflect the absence and presence, respectively, of distant
   metastases. 2. The AJC (American Joint Committee) system.

Question 19

cancers are divided into stages?

Answer 19

0 to IV,

Question 20

Laboratory diagnosis of cancer can be achieved by: ?

Answer 20

Morphologic methods • Biochemical assays • Molecular tests

Question 21

include microscopic tissue or cellular diagnosis: ?

Answer 21

Morphologic

Question 22

is a gold standard for cancer diagnosis

?

Answer 22

Morphologic Methods

Question 23

Several sampling approach are available: Morphologic?

Answer 23

1. Biopsy, excision & frozen section 2. Fine ­needle aspiration 3. cytologic smears 4. Immunocytochemistry stains 5. Flow cytometry

Question 24

useful for measuring the level of tumor associated

enzymes, hormones and tumor markers in serum. ?

Answer 24

Biochemical assays:

Question 25

They are useful in screening, determining the

effectiveness of therapy & detecting tumor recurrences ?

Answer 25

Biochemical assays

Question 26

Only few tumor markers are proven to be useful ?

Answer 26

CEA &

AFP

Question 27

used for the diagnosis of tumors and for predicting their

behavior.

Answer 27

Molecular Diagnosis

Question 28

used for
detecting chromosomal translocations characteristic of many
tumors.

Answer 28

fluo­rescence in situ hybridization (FISH)

Question 29

Molecular Diagnosis:

Answer 29

PCR analysis.