Integumentary System Pathology 1 - Basic Pathology, General Carcinogenesis Flashcards
What is a papilloma?
Benign tumor of epithelial cells projecting outward either micro- or macroscopically
What is a polyp?
Benign tumor projecting macroscopically into a lumen
What premalignant situation exists if dysplastic or neoplastic cells have not breached the basement membrane?
Carcinoma in situ
What are the four most common types of malignant tumors?
(1) Sarcoma: malignant tumor of mesenchymal tissue
(2) Carcinoma: malignant tumor of epithelial tissue
(3) Adenocarcinoma: carcinoma with a glandular pattern
(4) Squamous cell carcinoma: carcinoma arising from stratified squamous epithelium
Which cells are most susceptible to becoming neoplastic?
Epithelial cells (because they regenerate often).
What is the “two-hit hypothesis” of cancer development?
It takes more than one genetic mutation for a cell to become cancerous
What are some of the major sources of mutagenic and carcinogenic compounds?
(1) Tobacco products
(2) Food
(3) Water
(4) Chemical exposures
(5) Radiation exposures
(6) Drugs
What must occur for a cell to go through full neoplastic transformation and become a malignant tumor?
Multiple genetic abnormalities
What two types of genes are involved in carcinogenesis?
(1) Oncogenes
(2) Tumor suppressor genes
What is a proto-oncogene called after it mutates?
Oncogene. “Pro” suffix usually refers to precursors.
When tumor suppressor genes mutate, what may potentially occur in the cell?
The cell may potentially divide forever
As tumors enlarge, what do they promote around them?
(1) Neo-angiogenesis
(2) Lymphangiogenesis
How do cancer cells evade detection by the immune system?
They develop mutations altering cell surface markers and secrete immunosuppressive compounds
How do neoplastic cells facilitate local invasion into adjacent tissues?
(1) Loss of contact inhibition
(2) Secretion of enzymes, such as matrix metalloproteases, that dissolve connective tissue
What are two cancers that tend to metastasize by venous drainage and settle in specific sites in th ebody?
(1) Prostate cancer: pelvis and lumbar spine
(2) Lung cancer: brain
What are two areas of the body with fine capillary beds that are common sites of metastasis in the body?
Lung and liver
How long does it take a single malignant cell to become clinically detectible?
Thirty population doublings
What is the primary reason tumors grow in size?
Cells produced are immortal and accumulate
What are some examples of complications and systemic effects caused by malignant tumors?
(1) Immune suppression
(2) Metastasis
(3) Micrometastasis
(4) Indirect malignancy
(5) Cachexia
(6) Hemorrhage
(7) Paraneoplastic syndromes
(8) Pathological fractures
(9) Hypercoagulability
(10) Resistance to therapy
What is one of the most common reasons people actually die from cancer?
Many tumors secrete compounds that induce cachexia, causing wasting
What are some examples of tumors that are curable by surgery alone if caught early?
(1) Malignant melanoma
(2) Breast cancer
When a tumor is being graded, what is an important factor to be assessed?
Degree of differentiation of cells, with less differentiated cells termed anaplastic cells
How is the mitotic index used when assessing malignant tumors?
It is used to identify cells with rapid mitosis and determine grade and prognosis
How does receptor analysis help determine prognosis with various cancers, such as breast cancer?
Receptor analysis helps identify those cancers susceptible to hormonal controls and guides therapeutic choices, such as the use of hormonal therapies, e.g., tamoxifen use in estrogen-receptor positive patients with breast cancer
How are most malignant tumors staged?
Tumors are staged by determining:
T: size and extent of local invasion of tumor
N: lymph node involvement
M: whether there is distant metastasis
What are some tumor markers that are sometimes used for cancer screening, though most are too non-specific for general use?
(1) Alpha Feto-Protein (afp) - testicular cancer and heptocellular cancer
(2) Human Ghorionic Gonadotropin (hCG) - testicular cancer
(3) Prostate-specific antigen (psa) - prostate cancer
(4) Carbohydrate Antigen 125 (CA-125) - ovarian and other cancers
(5) Carcinoembryonic Antigen (cea) - colorectal cancer
(6) Carbohydrate Antigen 19-9 CA19-9 - pancreatic cancer
