Introduction

Question 1

Tumor grade

Answer 1

Question 2

Prerequisites for effective cancer screening tests

Answer 2

There must be (1) a well-characterized and identifiable precursor lesion, and (2) enough lead time that it can be removed before it becomes invasive.

The best examples are the colonoscopy and pap smear cytology

Question 3

Grading is the responsibility of ____

Answer 3

Grading is the responsibility of the pathologist

Question 4

“Car on a cliff” metaphor

Answer 4

The grade represents the car’s speed; the stage represents the distance remaining to the cliff edge.

Both are relevant to the likelihood of being able to stop the car before it goes off the cliff.

Question 5

intraoperative consultation

Answer 5

Often pathologists will give intraoperative consultations while the patient is still under anesthesia. Typically this involves frozen sectioning and quickly staining a biopsy sample obtained surgically.

For example, if a frozen section reveals tumor in a lymph node in a patient with an invasive carcinoma, the patient will likely receive more extensive surgery and/or systemic therapy.

Question 6

anaplastic

Answer 6

Tumors of no apparent differentiated cell type

In such cases, it can be difficult even to determine whether an anaplastic tumor is of epithelial, mesenchymal, lymphoid or other origin, even with the use of immunohistochemical stains and electron microscopy.

Question 7

The prefix of a tumor name refers to its ____

Answer 7

The prefix of a tumor name refers to its tissue of origin

Question 8

Tumor stage

Answer 8

a measure of the extent of its spread, and involves three characteristics:

• Size and degree of local invasion (T stage)
• Spread to regional or distant lymph nodes (N stage)
• Presence of absence of distant metastasis (M stage)

Takes into account much more than just microscopic analysis.

Question 9

Answer 9

Lipoma

A benign tumor. Upon histological examination, the lipoma looks almost exactly like regular hyperplastic fat. There is little if any ongoing mitosis, no necrosis, and no hemorrhage.

Question 10

Malignant tumors are given the suffix -____ if they arise from an epithelial cell, and -____ if they arise from a mesenchymal cell.

Answer 10

Malignant tumors are given the suffix -carcinoma if they arise from an epithelial cell, and -sarcoma if they arise from a mesenchymal cell.

Question 11

Most common male and female cancers

Answer 11

Male: Prostate

Female: Breast

Question 12

neoplasm is malignant if:

Answer 12

Question 13

Physiologic hyperplasia

Answer 13

divided into (1) hormonal hyperplasia (e.g. proliferation of the glandular epithelium of the female breast in puberty and pregnancy);

and (2) compensatory hyperplasia (hyperplasia that occurs when a portion of the tissue is removed or diseased).

Question 14

Answer 14

Liposarcoma

It is poorly circumscribed and infiltrates surrounding tissue (at upper left is a normal kidney encased by the tumor) and is heterogeneous, with hemorrhage and necrosis. On histological examination it is difficult to make out cell type, and hemorrhage and necrosis will often be seen (though not in this particular image)

Question 15

Benign tumors usually have the suffix -____.

Answer 15

Benign tumors usually have the suffix -oma

Question 16

Barrett’s esophagus

Answer 16

In chronic gastric reflux, the normal stratified squamous epithelium of the lower esophagus may undergo metaplastic transformation to gastric or intestine-type columnar epithelium.

This is a major risk factor for subsequent esophageal adenocarcinoma.

Question 17

Not all benign lesions are _____.

Answer 17

Not all benign lesions are created equal.

Some technically benign lesions are precursors to cancer or are “premalignant.” They will progress to malignancy if not removed.

Question 18

neoplasm is benign if:

Answer 18

Question 19

Answer 19

Premalignant neoplasm seen on colonoscopy

Question 20

For a single cell to generate a clinically detectable mass (10⁹ cells, or 1 gram), it takes approximately ____ doublings. For this mass to become lethal (1012 cells, or 1 kilogram), it takes ____ additional doublings.

Answer 20

For a single cell to generate a clinically detectable mass (10⁹ cells, or 1 gram), it takes approximately 30 doublings. For this mass to become lethal (1012 cells, or 1 kilogram), it takes only 10 additional doublings.

So, a tumor completes the majority of its life cycle before it is even clinically detected, let alone treated

Question 21

desmoplastic

Answer 21

Tumors that generate a large amount of stroma, particularly fibroblasts and collagen

Question 22

In habitual smokers, the normal pseudostratified ciliated columnar epithelial cells of the trachea and bronchi are replaced by ____.

Answer 22

in habitual smokers, the normal pseudostratified ciliated columnar epithelial cells of the trachea and bronchi are replaced by stratified squamous epithelial cells.

Question 23

The grade of a tumor is a measure of its ____

Answer 23

The grade of a tumor is a measure of its degree of differentiation