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Histopath > Lecture | Neoplasms (part 1) > Flashcards

Lecture | Neoplasms (part 1) Flashcards

1
Q

Uncontrolled proliferation of cells

A

Neoplasia

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2
Q

Neoplasma are reversible. T/F

A

T

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3
Q

Neoplasms’ growth is

A

Autonomous

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4
Q

Neoplasms are ______ even if the stimulus that produce it is removed

A

Persistent

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5
Q

“Neo” means ______ and “plasia” means ______

A

New ; growth

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6
Q

A space occupying lesion

A

Tumor/s

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7
Q

In neoplasms, the growth will now occupy space, it will become a

A

Mass lesion

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8
Q

Overall biological behavior of tumor rather than its morphological characteristics

A

Benign versus malignant

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9
Q

Lesion does not penetrate/invade to adjacent tissues nor spread/metastasize to distant sites; more differentiated

A

Benign

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10
Q

Tumor invade and metastasizes

A

Malignant

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11
Q

“Benign and malignant” refers to the behavior of the lesion not primarily to how this tumor looks like. T/F

A

T

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12
Q

Rate of growth in benign tumors

A

Progressive but slow. Mitoses few & normal

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13
Q

Rate of growth in malignant tumors

A

Variable. Mitoses more frequent & may be abnormal

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14
Q

Differentiation of benign tumors, and malignant tumors

A

Benign: well differentiated
Malignant: some degree of anaplasia

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15
Q

Does not invade to surrounding structures; the growth is cohesive; Capsule & BM not breached, may or may not have a capsule

A

Benign tumor

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16
Q

Poorly cohesive and infiltrative

A

Malignant tumors

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17
Q

____ tumors are not expected to metastasize (ABSENT) while _____ tumors is characteristic to spread to distant organs (MAY OCCUR)

A

Benign ; Malignant

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18
Q

Resemblance of cells to its tissue of origin

A

Differentiation

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19
Q

Resembles mature cells of tissue of origin

A

Well-differentiated neoplasm

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20
Q

Composed or primitive cells with little differentiation

A

Poorly-differentiated neoplasm

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21
Q

In between poorly and well differentiated

A

Moderate differentiation

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22
Q

Composed of cells that are very primitive; a.k.a. Anaplastic tumors because they do not resemble their cells of origin

A

Undifferentiated tumors

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23
Q

The poorly differentiated the tumor, the more better it is, and the better the prognosis. T/F

A

F. … the more aggressive it is, and the poorer the prognosis

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24
Q

Primary descriptor of any tumor

A

Cell or tissue of origin

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25
Q

Benign tumors identified by the suffix

A

Oma

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26
Q

Benign tumor of cartilage

A

Chondroma

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27
Q

Benign tumor of glands

A

Adenoma

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28
Q

Localized disordered differentiation of normal tissues; cells are poorly organized

A

Hamartoma

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29
Q

Ectopic islands of normal tissue; normal tissues found in a different location

A

Choristoma

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30
Q

Hamartoma and choristoma are ____

A

Space occupying lesions but are not neoplasm

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31
Q

Malignant tumors have a suffix if it arises from epithelial cell

A

Carcinoma

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32
Q

Malignant tumors have a suffix if it arises from the mesenchymal origin (e.g., bone, fibrous tissue, cartilage)

A

Sarcoma

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33
Q

Fibrous tissue is called __ for benign or ___ for malignant

A

Fibroma; fibrosarcoma

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34
Q

Leiomyoma ; leiomyosarcoma

A

Benign and malignant tumor in the smooth muscle

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35
Q

Benign and malignant tumor in the striated muscle

A

Rhabdomyoma ; rhabdomyosarcoma

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36
Q

Benign and malignant tumor in fat

A

Lipoma ; liposarcoma

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37
Q

Benign and malignant tumor in the blood vessels

A

Hemangioma ; angioma

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38
Q

Lymphangioma ; lymphangiosarcoma

A

Benign and malignant tumor in the lymphatic vessels

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39
Q

Suffix “__” relationship to blood

A

Emia

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40
Q

Tumors with poorly understood histiogenesis

A

Eponym/s

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41
Q

There are different exceptions to the rule of classifying neoplasms by their identified suffix. T/F

A

T

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42
Q

Hepatoma (historical term)

A

Malignant tumor in the liver

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43
Q

Melanoma (historical term)

A

Type of skin cancer that is malignant

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44
Q

Malignant tumor in the lymph nodes

A

Lymphoma (historical term)

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45
Q

Malignant tumor in the testis

A

Seminoma (historical term)

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46
Q

Reason why some terms ends in “oma” but are not benign

A

Way back when tumor pathologies started out, they mistakenly termed this lesion as “oma” despite its infiltrative nature

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47
Q

Better term for hepatoma and melanoma

A

Hepatoma is hepatocellular carcinoma
Melanoma is malignant melanoma or melanocarcinoma

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48
Q

These historical terms remain their terms despite that is is malignant because

A

Seminoma and lymphoma ; historical ingrained in their literature

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49
Q

Named after the primary investigator; tumors that are poorly understood; cell of origin is not well defined.

Give example

A

Eponym/s ; ex: Hodgkin’s disease/lymphoma or Ewing sarcoma

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50
Q

Secondary descriptors of a tumor

A

Morphological and functional characteristics

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51
Q

___ - frondlike structures
___ - soft cellular tumor with little connective tissue
___ - dense fibrous stroma
___ - secrete abundant mucus
___ - necrotic material expressed from ducts

All are examples of an

A

Papillary carcinoma
Medullary
Scirrhous
Colloid or mucinous carcinoma
Comedocarcinoma

Examples of an eponym

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52
Q

Generally resemble their parent tissues histologically and cytologically; definition resides above all in an inability to invade adjacent tissue and to metastasize

A

Benign tumors

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53
Q

Behavior is apparent in all stages. T/F

A

F.
In the initial phase, the behavior is not apparent that is why the recognition whether its benign or malignant falls back to its morphological features.

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54
Q

Tumor cells that arise from smooth muscles of the uterine well; very common tumor in the uterus

A

Leiomyoma
(tumor [benign] that really looks like a smooth muscle composed of cells that look like smooth muscles)

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55
Q

Depart from parent tissue morphologically and functionally but diagnosis depends on resemblance to normal tissue

A

Malignant tumors

56
Q

Lack of differentiated featured in a cancer cell - degree correlates with aggressiveness.

A

Anaplasia or cellular atypia

57
Q

Anaplasia means that the cells have variation in size and shape called

A

Pleomorphic

58
Q

Cytological evidence include variation in size and shape, enlarged hyperchromatic nuclei with clumped chromatin pattern and prominent nucleoli, atypical mitosis, bizarre cells

A

Anaplasia or cellular atypia

59
Q

Cancer cells tend to be anaplastic and they do not really resemble their cell or tissue of origin. T/F

A

T

60
Q

Pleomorphism

A

Variation in size and shape

61
Q

Abnormal nuclear morphology of anaplasia

A

Hyperchromasia
High nuclear cytoplasmic ratio
Chromatin clumping
Prominent nucleoli

62
Q

Malignant tumor from the smooth muscle cells of the uterus

A

Leiomyosarcoma

63
Q

Malignant tumors’ other features that favor malignancy (4)

A

Mitotic activity
Inavasion-particularly of blood vessels and
Lymphatic
Metastases

64
Q

Distant metastasis?

A

Invasion will have a predilection (i.e., preference) towards blood vessels and lymphatics and once they achieve this, these tumor cells can now go to different organs

65
Q

Features of malignant tumors

A

Cellular feature: anaplasia
Local invasion: capsule and basement membrane
Metastasis: seeding of body cavities, and lymphatic & hematogenous spread

66
Q

Metastasis is not apparent in the beginning but in the natural progression of malignancies. T/F

A

True

67
Q

What is the most important or unequivocal sign that the neoplasm is malignant?

A

Metastasis

68
Q

Benign tumors are apparent because of its rapid in size and its infiltration to surrounding tissues. T/F

A

False

69
Q

In breast cancer, the tumor cells appears to form glands, so this is a sarcoma because it arises from the mesenchyme. T/F

A

False.
Glands are a carcinoma because they are considered epithelial

70
Q

If the tumor in breast carcinoma appear like glands or like ducts, what is its diagnosis?

A

Invasive Ductal Carcinoma

71
Q

If the tumor in breast carcinoma appear like glands or like ducts, what is its diagnosis?

A

Invasive Ductal Carcinoma

72
Q

Usual location of metastasis in breast carcinoma

A

Lymph nodes in the axillary region

73
Q

Hallmark of malignant lesion

A

Capacity for involvement outside the area of origin- Invasion- METASTASIS

74
Q

In breast carcinoma, metastasis in the liver is possible. T/F

A

True.
Metastasis can be distant, not only in the axillary lymph nodes but it can involve other organs in the body

75
Q

No specific determinants of malignancy can be detected by light microscopy. T/F

A

False.
Electron microscopy

76
Q

It has a significant value in diagnosis of poorly differentiated cancers that are problematic by routine microscopy.

A

Electron microscopy

77
Q

Carcinoma is easily distinguishable from sarcoma because the tissue of origin is already apparent. T/F

A

False.
Hard to distinguish because the tissue/cell of origin is not clr

78
Q

In the histological diagnosis of malignancy, Carcinoma exhibits _

A

Desmosomes and junctional complexes (both typically characterizes an epithelial cell),
which are not typical of mesenchymal tumors and absent in lymphomas

79
Q

In carcinoma, these are short and blunt associated with terminal web

A

Microvilli

80
Q

long and slender

A

Mesothelioma

81
Q

Microvilli of lymphoid and mesenchymal tumors do not show. T/F

A

True

82
Q

Theses are bundles of tonofilaments

A

Epithelial tumors

83
Q

Slender microfilaments, terminal web

A

Mesenchymal tumors

84
Q

Electron microscopy are readily accessible as all labs operates it. T/F

A

False.
Only a few laboratories operates an electron microscope as part of its portfolio. Most labs do not incorporate it.

85
Q

Tumor pathology is the presence of tumor markers, thus all markers allow unequivocal distinction between benign and malignant cells. T/F

A

False,
No marker allows unequivocal distinction between benign and malignant cells, thus tumor markers should be interpreted AFTER a morphological assessment of the lesion

86
Q

Uniformly express cytokeratins

A

Carcinomas

87
Q

Tumor marker for prostatic cancers

A

Prostate-associated antigen
(A lineage-associated marker of carcinoma)

88
Q

Carcinoembryonic antigen (a lineage-associated marker of carcinoma) for _

A

Colon cancers

89
Q

Tumor marker for pancreatic and GI cancers

A

CA 19-9
(A Lineage-associated marker of carcinoma)

90
Q

CA 125 (a lineage-associated marker of carcinoma) for _

A

Ovarian cancers

91
Q

Tumor marker for thyroid carcinomas

A

Thyroglobulin
(A lineage-associated marker of carcinoma)

92
Q

Importance of lineage-associated markers

A

To evaluate if there is a metastasis
To help identify where that tumor is coming from

93
Q

Importance of lineage-associated markers

A

To evaluate if there is a metastasis
To help identify where that tumor is coming from

94
Q

Express chromogranin, neuron-specific enolase, synaptophysin, and leu-7 (CD57)

A

Neuroendocrine tumors

95
Q

Positive for vimentin, melanoma-associated antigen, and S-100
Negative for cytokeratin

A

Malignant melanoma

96
Q

Soft tissue sarcomas express

A

Vimentin,
Desmin (for smooth or striated muscle fibers),
Muscle-specific actin (for muscle tissue),
Neurofilament proteins (for neuroblastomas & ganglioneuromas), and
Glial fibrillary acidic protein (for astrocytes)

97
Q

Generally positive for Leucocyte Common Antigen (CD45)

A

Malignant lymphoma

98
Q

A common marker in malignant lymphoma which is true for all leukocytes and lymphocytes and other blood hematolymphoid cell.
This is grouped according to cluster designations.

A

CD45

99
Q

Malignant lymphomas express these markers grouped according to cluster designations
- Blood hematolymphoid cells
- T cell
- B cell
- Langerhan’s histiocytes

A

Blood hematolymphoid cells - CD45

T cell marker- CD3

B cell markers - CD19, CD20 s

Langerhan’s histiocytes - CD1

100
Q

Identified by antibodies against factor VIII-related antigen or binding to certain lectins (CD34 or CD31)

A

Vascular tumors

101
Q

Proliferating cells display marker/s

A

Ki67 and Proliferating Cell Nuclear Antigen (PCNA)

102
Q

Ambivalence to render a specific diagnosis (for a tumor)

A

Malignant poorly differentiated neoplasm

When this happens, tumor markers are helpful

103
Q

A high grade malignant tumor located in the nasopharynx of a patient in which the neoplastic cells show positivity to cytokeratin and negative for LCA (or CD45) is most likely diagnosed as?

A

Undifferentiated carcinoma of the nasopharynx

104
Q

Negative for cytokeratin and Positive for LCA (CD45)

A

Large cell malignant lymphoma

105
Q

Not disease-specific but allow tumor monitoring for recurrence after surgery

A

Serum tumor markers

106
Q

Serum tumor markers:
- CEA
- CA125
- PSA
- Alpha fetoprotein
- Human Chorionic Gonadotropin (HCG)
- Human placental alkaline phosphatase

A
  • CEA > colonic cancer
  • CA125 > ovarian malignancy
  • PSA > prostatic carcinoma
  • Alpha fetoprotein > liver cancer or yolk sac tumor in the ovary or testis
  • Human Chorionic Gonadotropin (HCG) > trophoblastic tumors
  • Human placental alkaline phosphatase > seminomas
107
Q

Characteristics unique to caner cells; the cause of most cancer deaths

A

Invasion and metastasis

108
Q

Before cancer cells invade other organs, the carcinoma may be confined first to the epithelium; No penetration of basement membrane; not defined for connective tissue cells, lymphoid elements, and hepatocytes

A

carcinoma in situ stage

109
Q

Growth within tissue of origin then enlarged and infiltrate normal structures causing impairment of function

A

In situ stage

110
Q
  • Carcinoma found in the cervix
  • full thickness of the mucosal surface (squamous epithelium)
  • all cells are atypical
  • no penetration of the basement membrane
  • no invasion to the underlying stroma

Diagnosis?

A

Carcinoma in-situ (non-invasive stage)

111
Q
  • penetration in the basement membrane
  • invasion to the underlying stroma
  • tumor may have acquired the capacity for distant metastasis

Diagnosis?

A

Invasive squamous cell carcinoma / Invasive carcinoma

112
Q

Refers to the transfer of malignant cells from one site to another not directly connected with it.

A

Metastatic spread

113
Q

The metastatic spread is disseminated through the

A

Vascular and lymphatic channels

114
Q

(Metastatic spread) Capillaries and venules commonly invaded;
Must lodge in the vascular bed of metastatic site for it to become viable.

A

Hematogenous metastasis

115
Q

Appearance of malignant cells in blood is synonymous with metastasis. T/F

A

False, it is not synonymous.

116
Q

Favored sites of hematogenous metastasis.

A

Liver and Lungs

117
Q

Why does hematogenous metastasis favor the liver and lungs?

A

Primarily due to the double circulation found in these two organs because these two organs are very vascular which increases the chance that these tumor cells will lodge into this organ

118
Q

What type of circulation happens in the liver and in the lungs?

A

Liver - portal circulation, hepatic circulation
Lungs - bronchial circulation, pulmonary circulation

119
Q

(Metastatic spread) Basement membranes are lacking in lymphatic capillaries; regional lymphatic pattern of spread

A

Lymphatic metastasis

120
Q

Metastases found in lymph nodes distant from the site of tumor

A

Skip metastasis

121
Q

Steps required for establishment of metastasis

A
  1. Invasion of basement membrane
  2. Movement through the ECM
  3. Penetration of vascular and lymphatic channels
  4. Survival and arrest within the circulating blood or lymph
  5. Exit from circulation into new tissue site (“skip metastasis”)
  6. Survival and growth as metastasis
122
Q

Role of adhesion molecules

A

Invasion

123
Q

An adhesion molecule that confers metastatic potential; play a role in cell migration, proliferation, and in angiogenesis

A

Integrins

124
Q

Expression of adhesion molecule correlates with tumor aggressiveness

A

Intercellular adhesion molecule-1 (ICAM-1)

125
Q

An adhesion molecules that is downregulated in highly metastatic clones; decreased expression allows detachment of tumor cells from parent tumor

A

Vascular cell adhesion molecule-1 (VCAM-1)

126
Q

Cell-cell adhesion molecules that suppress invasion and metastasis; expression lost or reduced in most carcinomas

A

Cadherins and Catenins

127
Q

Tumor cell cytokine that stimulates motility

A

Autocrine motility factor

128
Q

Elaboration of proteases (e.g., matrix metalloproteinases) that degrade basement membrane components

A

Proteolytic enzymes

129
Q

Needed to establish new colony

A

Invasion of circulation

130
Q

Adheres to endothelium causing retraction with exposure of basement membrane and subsequent binding and extravasation

A

Escape from circulation

131
Q

Secretion of substances that stimulate angiogenesis

A

Local growth

132
Q

Stimulate formation new blood vessels

A

Angiogenesis

133
Q

Without a new blood vessel feeding the new colony, these tumors will not grow. T/F

A

True

134
Q

Tumors release/secrete growth factors to enhance formation of new blood vessels. T/F

A

True

135
Q

The success of the metastatic implant to the distant organs depends on two factors

A

Favorable environment and vascular anatomy

136
Q

Depends on surface properties of the cells involved

A

Proclivity or homing to specific organs

Histopath (3 decks)

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