Lab 5 Flashcards
What is neoplasia?
New cellular growth that is autonomous (self-controlled) or beyond normal physiological restraints
What causes neoplasia?
What are the two types of mutations?
Specific types of genetic mutations that lead to uncontrolled cell growth
Mutations that impair the normal on/off switches for cellular replication and growth
Mutations that inhibit or impair apoptosis
What are factors that can increase an individual’s risk for developing a specific type of neoplasia?
Environmental Factors: UV Exposure
Pre-existing genetic factors
What are the two categories of tumors
Benign
Malignant
What are the characteristics of benign tumors?
Localized overgrowth of tissue
Does NOT INVADE or metastasize
Closely resembles the tissue of origin (well-differentiated)
Well-circumscribed (Encapsulated), clearly-defined borders
What are characteristics of malignant tumors?
Morphologically and functionally different from parent tissue (cell line)
Poorly differentiated
INVASIVE (borders unclear or irregular)
Can metastasize
What is differentiated and how is it described?
Differentiation is the degree of resemblance of cells to the mature normal cell of the tissue origin
Described along a specture
What information does the differentiation provide?
Malignancy of cancer and the prognosis of treatment
Benign vs Malignant:
Irregular; poorly-defined borders
Malignant
Benign or Malignant:
Good Prognosis
Benign
Suffix “oma”
Benign growth
Suffix “carcinoma”
Malignant growth of epithelial origin
Suffix “sacroma”
Malignant growth of mesenchymal origin
Prefix “adeno-“
neoplastic growth of glandular epithelium
Adenoma: Benign or Malignant
Benign
Adenocarcinoma: Benign or Malignant
Malignant
What is anaplasia
Cellular atypia, lack of differentiation)lead to a lack of normal tissue architecture)
Where on the differentiation spectrum in anaplasia
Malignant
Poorly differentiated
What are the 4 characteristics of anaplasia in histological tissue sections
Pleomorphism
Hyperchromatism
Atypical Mitosis
Tumor Giants Cells
What is pleomorphism?
abnormal variation in size or shape of cell and cell nuclei
What is hyperchromatism?
enlarged, darkened nuclei (chromatin clumping, large prominent nucleoli)
What is atypical mitosis?
Mitotic figures, other cellular abnormalities
What are tumor giant cells?
Large bizarre shaped cells, may be multi-nucleated
What is the histologic evidence of malignant tumors
Invasion - spread from primary site to adjacent tissues
How do neoplasias spread?
- Invasion - spread within the primary site or the organ/tissue or origin (local spread)
- Metastasis - spread to another site/ tissue/ organ (distant spread)
3 routes of metastatic spread?
- Hematogenous (blood vessels)
- Lymphatic (lymphatic system)
- Direct seeding / extension (direct contact)
What are neoplasms?
solid new growths which occur the blood
What is parenchyma?
Proliferating neoplastic cells
What is stroma?
Supportive structures
Connective tissue and blood vessels
What is angiogenesis?
Formation of new blood vessels
What is desmoplasia?
Formation of abundant dense connective tissue stroma
What does local neoplasia mean?
Swelling
Irritation
Vascular Damage
Organ damage and compromised function
Systemic Neoplasia
Paraneoplastic syndromes
Hypercalcemia
Anorexia, weight loss, and cachexia
Tumor hormones secretions
Characteristics of Chronic Inflammation?
Lymphocytes and macrophages
Tumor immunosurveillance
Immunotherapy
What is tumor immunosurveillance
recognition and destruction of cancer cells by immune system
What cells are apart of tumor immunosurveillance?
- T-lymphocytes (CD8+ cytotoxic) - recognize TSA and lyse tumor cells
- Natural Killer Cells - can lyse tumor cells without TSA
- Macrophages and B lymphocytes play minor role
What is organ tropism?
Tendency for malignant neoplasias to spread to or target organs; favored soil for growth
Examples of Organ Tropism
Breast Cancer –> bone, brain, lung, liver
Lung Cancer –> adrenal gland, bone, brain, liver
Prostate Cancer –> adrenal gland, bone, brain, liver
What is carcinoma in situ?
Marked dysplastic epithelial changes, still confined to the basement membrane (pre-invasive)
What are the progressions from dysplasia?
Dysplasia –> Carcinoma in situ –> invasive (malignant) neoplasia
What does grading do?
measure degree of differentation of proliferating cells compared to normal tissue
Why do we grade cancers?
to help predict the clinical behavior of a malignancy and to establish criteria for therapy and treatment
What is staging?
Assessing the extent of cancer spread
Why do we stage cancers?
To aid in prognosis, treatment/therapy options
What are the factors in scoring system of staging cancers?
Tumor size
Presence of lymph node metastasis
Presence of distance metastasis
TNM system
T: size of primary tumor (T1-T4); T0 = carcinoma in situ
N: Regional lymph node spread (N0-N3)
M: Presence of distance metastasis (M0-M1)
Most common primary malignant bone tumor?
Osteosacroma
What is the primary site of osteosarcoma?
Bone
Osteosarcoma are most common in
adolescents
boys twice as likely than girls
elderly
What types of bones is osteosarcoma most common in?
Long bones
What are the mutations of tumor suppressor genes for osteosarcoma
Rb and p53
Where do osteosarcoma commonly metastasize to? Via?
Lung via hematogenous
What is chondrosarcoma?
Chondroblastic malignancy
Chrondrosarcoma is most common in what age group individuals?
30-60 year olds
Are males or females more likely to develop chrondrosarcoma?
Males ( two times more likely)
Where do chondrosarcoma metastasize to? via?
Lung (hematogenous)
liver, kidney, brain
What causes/drives neoplasia?
- Mutations in normal regulatory genes which turn on/off normal cell growth or mutations that impair/inhibit apoptosis
- the net result of these types of mutations is increased cell growth and regeneration
What are protooncogenes?
Normal genes which promote normal cell growth
What are oncogenes?
Altered versions of normal protooncogenes that promote autonomous growth in cancer cells
Promote cell growth in absence of normal mitogenic signals
What are examples of oncogenes?
erb, ret, myc, ras, sis
What are tumor suppressor genes (anti-oncogenes)
produces proteins which stop/slow cellular proliferation (cell growth and divides to 2 daughter cells)
Deletions or mutations of tumor suppressor genes allow for…
excessive cellular proliferation
What are examples of tumor suppressor genes?
p53, Rb, BRCA1, BRCA2, APC
What are apoptotic genes?
genes that regulate apoptosis, normal apoptotic balance achieved by balance of anti apoptotic and pro-apoptotic genes
What is tumor necrosis?
Death of tumor tissue
Common in aggressive, fast-growing cancers where cells rapidly outgrow their blood supply resulting in cell death
What is the most prevalent cancer in US men?
Prostate Cancer - prostate adenocarcinoma
What is the most common benign neoplasm of the breast?
Fibroadenoma
What is the most common malignancy in US women?
Breast Cancer
What is the most common histological type of breast cancer?
Invasive Ductal Carcinoma
What is the most common cause of cancer death in the US
Lung Cancer
What are the 4 most common histological subtypes of lung cancer?
Squamous cell, Gland forming adenocarcinoma, Small cell carcinoma, Large cell carcinoma
Which lung cancers are linked to cigarette smoking?
Squamous cell and small cell carcinomas
What is the most common lung cancer among women and non-smokers?
Adenocarcinoma of the lung
Approximately 1/3 of all cancer death show metastasis to what area?
Lungs
3 most common types of skin cancer?
- Basal Cell Carcinoma
- Squamous Cell Carcinoma
- Malignant Melanoma
What is the most prevalent skin cancer
Basal Cell Carcinoma
Are basal cell carcinoma’s metastatic
not highly
What type of people is basal cell carcinoma most common in?
fair-skinned people
What is the second most prevalent skin cancer?
Squamous Cell Carcinoma
Is squamous cell carcinoma metastatic?
not highly
Are Malignant melanoma metastatic?
Highest metastatic potential
What is leukemia?
neoplastic disorders of uncontrolled proliferation of hematopoietic stems cells
Where does leukemia originate from?
bone marrow, malignant cells spill into peripheral circulation
How are leukemia’s classified on
based on malignant cell maturity and cell type
What are the two types of cell maturity
- Acute leukemias
- Chronic Leukemias
What are acute leukemias
involve more blast, immature cells, more poorly differentiated
What are chronic leukemias
more mature cells involved, more well differentiated
What are the two cell types of leukemia
- Lymphocytic leukemias (T and B lymphocytes)
- Myelogenous leukemias (granulocytes and monocytes)
What is the most common adulthood leukemia
Chronic Lymphocytic Leukemia (CLL)
What is an indication of leukemia on a histological slide?
Smudge cells
What are potential consequences of all leukemias
- Severe anemias
- Bleeding disorders
- Leukopenia (decreased WBC)
What is a lymphoma?
malignant neoplasm of cells native to lymphoid tissue, predominantly lymph nodes most involve B lymphocytes
How are lymphomas classified?
based on pattern of spread
What are the two patterns of spread of lymphomas
- Spreads contiguously
- Spreads non-contiguously
Is Hodgkin Lymphoma and contiguously or non-contiguously spread
Contiguously
Is non- hodgkin Lymphoma and contiguously or non-contiguously spread
non-contiguously
What is the malignant cell in contiguous lymphoma
Reed-Sternberg cell
What is the malignant cell in non-contiguous lmyphoma
malignant lymphoid cell other than Reed-Sternberg
What is the most common malignancy in young adults?
Hodgkin Lymphoma
What are the potential consequences of lymphomas?
Lymphadenopathy (lymph node enlargement)
Elevated WBC count
Infection
Weight loss
Fever
Malaise
