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FPP: pre-midterm > Intro to Neoplasia > Flashcards

Intro to Neoplasia Flashcards

1
Q

Define tumor

A

Classically defined as swelling but often used interchangeably with neoplasia

DOES NOT MEAN CANCER

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2
Q

Define neoplasia

A

Abnormal “new growth”

An abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change

DOES NOT MEAN CANCER

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3
Q

Define dysplasia

A

Disorderly proliferation

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4
Q

Define anaplasia

A

Lack of differentiation (cells don’t match their surroundings)

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5
Q

How can you classify a tumor?

A

Based on its:

  • Cell of origin (epithelial, mesenchymal, CNS, lymphoid)
  • Differentiation (well, moderately, poorly)
  • Behavoir (benign/malignant)
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6
Q

What are examples of tumors classified by their cell of origin?

A
  • carcinoma= epithelial (most common)
  • sarcoma= mesenchymal (rare)
  • lymphoma, leukemia= hematolymphoid
  • melanoma= melanocytic
  • glioma/schwanoma= CNS
  • carcinosarcoma= mixed
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7
Q

What characteristic is necessary to classify a cancer as invasive?

A

Cancer needs to break through the basal lamina below the epithelial cells

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8
Q

What is an adenocarcinoma?

A

A cancer of glands (epithelial)

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9
Q

What are features of epithelial cell origin cancers?

A
  • typically arise from ectoderm or endoderm germ layers
  • benign or malignant
  • further classified based on architecture (papillary/bumpy, villous/flat with projections, sessile/flat and deep, cystic)
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10
Q

Contrast a carcinoma and sarcoma

A

Carcinoma= epithelial origin

Sarcoma= mesenchymal/connective tissue origin

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11
Q

What cells are in the mesenchyme and can become cancerous? What is the nomenclature of benign versus malignant mesenchymal cancers?

A

Fibroblasts, adipocytes, smooth/skeletal muscle, bone, cartilage, blood

Benign= -oma
Malignant= -sarcoma
E.g. Osteoma versus osteosarcoma

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12
Q

What are the categories of hematolymphoid origin cancers and examples of each?

A
  1. Lymphoid (cancer resembles lymphocyte; lymphoma)
  2. Myeloid (cancer arises from granulocyte/RBC/platelet progenitor cells; myeloid leukemia)
  3. Histiocytic (proliferative lesions of macrophages and DCs; histiocytoses)
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13
Q

What is a “blast”?

A

A lymphoblast/lymphocyte progenitor cell

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14
Q

What are characteristics of melanocyte origin tumors?

A
  • Neural crest origin
  • May be benign (nevus; defined structure) or malignant (melanoma; varrigated/irregular border)
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15
Q

What are characteristics of a benign tumor?

A
  • “-oma”
  • usually resemble normal tissue
  • slow growth rate
  • non-invasive growth, encapsulated
  • do not metastasize
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16
Q

What are characteristics of a malignant tumor?

A
  • cariconmas or sarcomas
  • variable morphology (normal to extremely different)
  • variable growth rate
  • invasive growth pattern (nonencapsulated/irregular shape)
  • capable of metastasizing (except basal cell carcinoma and gliomas)
17
Q

What 4 criteria are used to determine a benign versus malignant tumor?

A
  1. differentiation and anaplasia (extent to which tumor cells morphologically and functionally resemble the normal tissue counterpart)
  2. rate of growth
  3. local invasion
  4. metastasis
18
Q

What are the histological features assoicated with malignancy?

A
  • cellular/nuclear pleomorphism
  • coarsely clumped chromatin
  • hyperchromatic nuclei
  • high nuclear to cytoplasmic (N/C) ratio
  • large nucleoli
  • atypical, bizarre mitoses (bi/tripolar)
  • loss of tissue polarity (loss of apical/basal layers)
  • tumor giant cells

**these features contribute to the cancer GRADE

19
Q

What are the two ways tumor giant cells can form?

A
  1. Cell doesn’t undergo cytokinesis
  2. Cells fuse together
20
Q

Define mixed tumor

A

A tumor with multiple morphological components (e.g. epithelial and mesenchymal)

21
Q

Define teratoma

A

Composed of tissue derived from multiple germ layers- totipotent cells

**predominately benign tumors

22
Q

Define hamartoma

A

A tumor-like condition;

  • mass of disorganized, mature tissue which is specific to the site of development (surrounded by normal tissue)
  • represent anomalous development (correct cell structure and location, just weird organization/arrangement)
  • e.g. lung hamartoma
23
Q

Define choriostoma

A

A tumor like condition;

  • ectopic tissue in a foreign location
  • e.g. gastric heterotopia= gastric mucosa in the large intestine

**Normal tissue orientation/arrangement in a weird place

24
Q

Contrast in situ and invasive tumors

A

In situ= above basil lamina

Invasive= infiltration of the basil lamina (local is potentially curable while metastatic is unlikely to be cured)

25
Q

How do tumors invade the ECM? (steps)

A
  1. Loss of E-cadherin function (cell-cell adhesion)
  • inactivation of E-cadherin
  • activation of beta catenin
  • SNAIL/TWIST transcription factors
  1. Degradation of basement membrane (matrix metalloproteinases/MMPs)
  2. Change in attachment of tumor cells
  3. Migration
26
Q

Where are common sites of metastases?

A
  • lymph nodes
  • lungs
  • liver (commonly from colon)
  • bone/vertebra
  • brain (commonly from lung)
27
Q

Describe the common hematogenous metastatic spread

A

**common pathway for sarcoma spread (veins>arteries)

  • portal -> liver
  • vena cava -> lung
  • paravertebral plexus -> vertebral mets
28
Q

Describe the common lymphatic metastatic spread

A
  • most common pathway for carcinoma spread (rarer with sarcomas)
  • lymph node involvement is predictable based on drainage (sentinel node= first LN to drain the tumor)
29
Q

Describe the TNM staging system

A

TNM=

  • tumor size
  • nodal involvement
  • metastasis

*each cancer type has its own classification system

_**STAGE IS NOT GRADE_ (management of cancer is determined by stage; I, II, III, IV)

30
Q

What is the common host response to cancer?

A
  • local effects
    • compression of vital structures; pituitary
    • ulceration (bleeding, infection)
  • cachexia (weight loss)
    • cytokine release rather than reduced food intake **TNF
  • hematologic abnormalities
    • anemia
    • hypercoagulability
31
Q

What is the physical effect of cancer?

A

**paraneoplastic syndromes in 10% of patients;

  • Cushing’s (ACTH)
  • Hypercalcemia (PHrP, TGFa, TNF, IL1)
  • Nonbacterial thrombotic endocarditis (hypercoagulability)
  • Carcinoid syndrome (serotonin, bradykinin)

FPP: pre-midterm (19 decks)

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