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Introduction to Neoplasia Flashcards

1
Q

Neoplasia

A

New tissue growth that is unregulated, irreversible, and monoclonal

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2
Q

What determines the clonality of B lymphocytes?

A

Immunoglobulin light chain phenotype

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3
Q

Benign vs malignant tumors of the epithelium

A

Benign

  • Adenoma
  • Papilloma

Malignant

  • Adenocarcinoma
  • Papillary carcinoma
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4
Q

Benign vs malignant tumors of mesenchyme

A

Benign

  • Lipoma

Malignant

  • ​Liposarcoma
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5
Q

Benign vs malignant lymphocyte

A

Benign

  • Does not exist

Malignant

  • Lymphoma/Leukemia
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6
Q

Benign vs malignant tumor of melanocyte

A

Benign

  • Nevus (mole)

Malignant

  • Melanoma
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7
Q

What is the purpose of the hemoccult test?

A

Tests for occult blood in stool. It along with a colonoscopy can be used to detect colonic adenoma before it becomes colonic carcinoma or carcinoma before it spreads

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8
Q

Ras can be considered a possible oncogene. By what mechanism?

A
  • Mutated ras inhibits the activity of GTPase activating protein. This prolongs the activated state of ras, resulting in increased growth signals
    • ras bound to GDP is inactive, ras bound to GTP is active
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9
Q

Carcingogenic agent: Aflatoxins

A

hepatocellular carcinoma

  • Derived from Aspergillus, which can contaminate stored rice and grains
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10
Q

Carcingogenic agent: Alkylating agents

A

Leukemia/Lymphoma

  • ​Side effect of chemotherapy
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11
Q

Carcingogenic agent: Alcohol

A

​Squamous cell carcinoma of oropharynx and upper esophagus, and hepatocellular carcinoma

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12
Q

Carcingogenic agent: Arsenic

A

Squamous cell carcinoma of skin, lung cancer, and angiosarcoma of liver

NOTE: Arsenic is present in cigarette smoke

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13
Q

Carcingogenic agent: Asbestos

A

Lung carcinoma and mesothelioma

  • ​Exposure to asbestos is more likely to lead to lung cancer than mesothelioma
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14
Q

Carcingogenic agent: Cigarette smoke

A

Carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas

  • Most common carcinogen worldwide; polycyclic hydrocarbons are particularyl carcinogenic
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15
Q

Carcingogenic agent: Nitrosamines

A

Stomach carcinoma

  • Found in smoked foods; responsible for high rate of stomach carcinoma in Japan
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16
Q

Carcingogenic agent: Naphtylamine

A

Urothelial carcinoma of cladder

  • Derived from cigarette smoke
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17
Q

Carcingogenic agent: Vinyl chloride

A

Angiosarcoma of liver

  • ​Occupational exposure; used to make polyvinyl chloride for use in pipes
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18
Q

Carcingogenic agent: Nickel, chromium, beryllium, or silica

A

Lung carcinoma

  • Occupational exposure
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19
Q

Carcingogenic agent: EBV

A
  • Nasopharyngeal carcinoma, Burkitt lymphoma, and CNS lymphoma in AIDS
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20
Q

Carcingogenic agent: HHV-8

A

Kaposi sarcoma

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21
Q

Carcingogenic agent: HBV and HCV

A

Hepatocellular carcinoma

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22
Q

Carcingogenic agent: HTLV-1

A

Adult T- cell leukemia/lymphoma

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23
Q

Carcingogenic agent:High risk HPV(16,18,31,33)

A

Squamous cell carcinoma of vulva, vagina, anus, and cervix; adenocarcinoma of cervix

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24
Q

Overexpression of which growth factor is associated with astrocytoma?

A

PDGFB

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25
Q

Amplification of which growth factor receptor is associated with a subset of breast carcinomas?

A

ERBB2 (HER2/neu)

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26
Q

A point mutation of which growth factor receptor is associated with MEN 2A, MEN2B, and sporadic medullary carcinomas of thyroid?

A

RET

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27
Q

A point mutation of which growth factor receptor is associated with gastrointestinal stromal tumor?

A

KIT

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28
Q

Point mutation of which signal trasnducer is associated with carcinomas, melanoma, and lymphoma?

A

RAS gene family

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29
Q

A translocation of (9,12) with BCR of which signal transducer is associated with CML and some types of ALL?

A

ABL

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30
Q

A translocation at (8,14) involving IgH and what nuclear regulator is associated with Burkitt lymphoma?

A

c-MYC

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31
Q

An amplifiction of which nuclear regulator is associated with neuroblastoma?

A

N-MYC

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32
Q

An amplification of which nuclear regulator is associated with lung carcinoma (small cell)?

A

L-MYC

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33
Q

Translocation at (11;14) involvign IgH and which cell cycle regulator is associated with mantle cell lymphoma?

A

CCND1 (cyclin D1)

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34
Q

Amplification of which cell cycle regulator is associated with melanoma?

A

CDK4

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35
Q

How does p53 induce apoptosis?

A
  • p53 upregulates BAX which disrupts Bcl2.
    • Cytochrome c leaks from the mitochondria activating apoptosis

NOTE: Both copies of the p53 gene must be knocked out for tumor formation

36
Q

Li-Fraumeni syndrome

A
  • Link to germline mutations in the p53 gene
  • Characterized by a propensity to develop multiple types of carcinomas and sarcomas
37
Q

How does Rb regulate the progression from G1 to S phase?

A
  • Rb holds the E2F transcription factor, which necessary for transition to the S phase
  • E2F is released when Rb is phosphorylated by CDK4

NOTE: Rb mutation results in constritutively free E2F, allowing progression through the cell cycle and uncontrolled growth of cells

38
Q

Germline vs sporaadic mutation of Rb

A

Germline

  • Familial retinoblastoma
  • Bilateral retinoblastoma and osteosarcoma

Sporadic

  • Unilateral retinoblastoma
39
Q

Bcl2 is overexpressed in follicular carcinoma. By what mechanism does this take place?

A
  • t(14,18) moves Bcl2 (chromosome 18) to the IgH (chromosome 14), resulting in increased Bcl2
  • Because upregulation Bcl2 increases stability of the mitochondrial membrane. B cells that are supposed to apoptosed during somatic hypermutation in the lymh node germinal center accumulate, leading to lymphome
40
Q

What is the mechanism by which tumor cells invade and spread?

A
  • tumor cells are normally attached to each other by E-cadherin
  • Downregulation of E-cadherin leads to dissociation
  • Cells attach to laminin and destroy the basement membrane (collagen IV) via collagenase
  • Cells attach to fibronectin in the extracellular matrix and spread locally
  • Entrance into vascular or lymphatic spaces allows for metastisis
41
Q

Lymphatic spread is characteristic of __________.

A

Carcinomas

42
Q

Hematogenous spread is characteristic of ________. What are the exceptions?

A

Sarcomas

Exceptions:

  • Renal cell carcinoma (often invades renal vein)
  • Hepatocellular carcinoma (often invades hepatic vein)
  • Follicular carcinoma of the thyroid
  • Choriocarcinoma (tumorous trophoblast cells)
43
Q

Seeding of body cavities is characteristic of ___________.

A

Ovarian carcinoma, which often involvs the peritoneum

44
Q

Benign vs malignant tumors (characteristics)

A

Benign

  • Slow growing
  • Well circumscribed
  • Distinct
  • Mobile

Malignant

  • ​Rapidly growing
  • Poorly circumscribed
  • Infiltrative
  • Fixed

NOTE: A biopsy or excision is generally required before a tumor can be classified as benign or malignant

45
Q

What immunohistochemical stain is used to target prostatic epithelium?

46
Q

What immunohistochemical stain is used to target breast epithelium?

47
Q

What immunohistochemical stain is used to target thyroid follicular cells?

A

Thyroglobulin

48
Q

What immunohistochemical stain is used to target neuroendocrine cells?

A

Chromogranin

49
Q

What immunohistochemical stain is used to target melanoma, Schwannoma and Langerhans cell histiocytosis?

50
Q

Grading of cancer

A
  • Well-differentiated (low grade)- resmebles normal parent tissue
  • Poorly differentied (high grade)- does not resemble parent tissue

Important for determining prognosis

51
Q

Staging of cancer

A
  • Assessment of size and spread of a cancer
  • Key prognostic fact; more important than grade
  • System:
    • T- tumor (size and /or depth of invasion)
    • N- spread to regional lymph nodes
    • M-metastasis; single most important prognostic factor
52
Q

Mutation of signal transducer JAK2 causes__________.

A

Polycythemia Vera (a slow-growing blood cancer in which your bone marrow makes too many red blood cells)

53
Q

Mutation of DNA mismatch repaire genes MLH and MSH cause ______________.

A

Sporadic colon cancer

Hereditary- HNPCC (Lynch syndrome)

54
Q

A DNA breaks in BRCA1 and BRCA2 can cause__________.

A

Hereditary breat/ovarian cancer

55
Q

Tumors from what sites are likely to metastisis in the liiver and lungs

A

All portal and vena cava blood pass through

56
Q

Steps to Invasion and metastasis

A
  1. Detachement (E-cadherin)
  2. Degradation of basement membrane
    * Matrix metaloproteinase, collagenase
  3. Attach to ECM, migrate
  4. Vascular dissemination and homing
  • Enter and leave blood vessels- break basement membrene-adhere to endothelium
  • Homing vascular bed/lymphatic drainage
57
Q

What are the frequent sites of hematogenous spread?

A

Liver, lungs, bone

58
Q

Tumors from what sites are likely to metastisis in the bone?

A

From prosate, breast, kidney, thyroid, and lung

59
Q

Where do metastisis in the brain come from?

A

Lung, breast, melanoma

60
Q

Where do metastisis in the adrenal gland come from?

A

Lung and breast

61
Q

Virchow node

A

Supraclavicular lymph node- from gastric carcinoma

62
Q

Krukenberg tumor

A

Metastasis to ovary from gastric

63
Q

Analine dyes (naphytlamine) are associated with what type of cancer?

A

Urothelial carcinoma (bladder)

*Found in dye and rubber

64
Q

What neoplasias are associated with hypercarcemia?

A

Lung squamous cell carcinoma, breast carcinoma

65
Q

What neoplasias are associated with Cushing’s syndrome?

A

Lung small cell carcinoma

66
Q

What neoplasias are associated with syndrome of inappropriate ADH secretion?

A

Lung small cell carcinoma

Symptoms: Headache, confusion, gait disturbance, nausea, cramps, hyponatremia, increased urine osmolality

67
Q

What neoplasias are associated with polycythemia?

A

Renal cell carcinoma, pheochromcytoma, hepatocellular carcinoma, hemagioblastoma

Symptoms: Increased erythropoietin, elevated hemoglobin and hematocrit, facial redness, headache

68
Q

What neoplasias are associated with acanthosis nigrans?

A

Gastric carcinoma

69
Q

What neoplasias are associated with dermatomyositis?

A

Breast, ovary, lung

70
Q

What neoplasias are associated with Leser-Trelat syndrome?

A

GI malignancy

71
Q

What neoplasias are associated with hypertrophic osteoarthropathy?

A

Lung cell carcinoma

Symptom: Finger clubbing

72
Q

What neoplasias are associated with myasthenia gravis?

73
Q

What neoplasias are associated with Lambert-Eaton?

A

Small cell lung cancer

74
Q

What neoplasias are associated with migratory thromboplebitis?

A

Pancreatic carcinoma

75
Q

What neoplasias are associated with DIC?

A

Acute promyeloctyic leukemia

76
Q

What neoplasias are associated with pure red cell aplasia?

77
Q

What neoplasias are associated with nonbacterial thrombotic endocarditis?

A

Pacreatic adenocarcinoma

78
Q

a- fetoprotein (serum marker)

A
  • High levels associared with neural tube and abdominal wall defects
  • Low levels associated with Down syndrome
  • Hepatocellular carcinoma
  • Endodermal sinus tumor
79
Q

hCG

A
  • Hydatidiform moles
  • Choriocarcinomas
80
Q

CA 19-9

A

Pancreatic adenocarcinoma

81
Q

CA 125

A

Ovarian cancer

82
Q

CEA

A

Major associations

  • Colorectal and pancreatic cancers

Minor associations

  • Gastric, breast, and medullary thyroid carcinomas
83
Q

Target therapy for breast carcinoma

A
  • Anti-estrogen- Tamoxifen
  • Anti-HER2NEU receptor- Herceptin
84
Q

Targeted therapy for chronic myeloid leukemia

A

Tyrosine kinase inhibitor- Imatinib

85
Q

Targeted therapy for lung carcinoma

A

Anti-EGFR

Checkpoint inhibitors (PD1)

86
Q

Targeted therapy for melanoma

87
Q

Targeted therapy for lymphoma

A

Anti CD20 (Rituximab)

OSI (CAMELITA) (38 decks)

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