Major types of Carcinoma Flashcards
Malignant tumors of epithelium arise from?
malignant stem cell -
What distinguishes metastatic from benign
invasion and metastasis
Cancer grade =
refers to extent of differentiation
low grade - well differentiated
high grade - poorly differentiate
Cancer Stage =
refers to extent tumor spread at time of diagnosis
for many types of carcinoma: stage is the best predictor of prognosis
TNM classification
T - size of tumor 1-4
N - lymph node involvement
M - metastasis - yes or no
major types of carcinoma (4)
lung 16%
pancreas 5%
colorectal 65%
prostate 99%
percents are 5 year survival
lung cancer deaths per year
124,000
lung cancer survival correlated with
stage
lung cancer cure requires
complete surgical excision
% of preventable lung cancer cases
85-90% caused by smoking
peak incidence lung cancer
70
risk factors for lung cancer
smoking (pack years)
family history, exposure to industrial shit
what percent of heavy smokers will develop lung cancer?
10
how is small cell lung CA treated?
not surgically - only by chemotx
4 major types of lung cancer
squamous cell
adenocarcinoma - includes bronchioloalveolar
large cell
small cell (oat)
keratin pearls are diagnostic of
squamous cell carcinoma
squamous carcinoma of lung % risk features endocrine?
25-40%
strongly linked to smoking
typically arise centrally, in major bronchi
cancer often exhibits central necrosis, as cancer growth exceeds blood supply
cancer cells appear squamous with keratin, formation of keratin pearls is common
rare cases can produce a parathyroid related protein and lead to hyper-calcemia
acinar predominant papillary predominant micropapillary predominant solid predominant invasive mucinous
these are all subtypes of?
adenocarcinoma of lung
adenocarcinoma of lung % risk features signals?
25-40% of cases
many cases linked to smoking
can occur centrally or periphery (in areas of scarring)
cancer cells attempt to form glands and produce mucin
sometimes occur in never smokers / some harbor mutations in EGFR and respond to gefitinib
bronchioloalveolar carcinoma variant of? risk? features prognosis?
variant of adenocarcinoma
not linked with smoking
the tumor cells grow along the alveolar septae, and lung structures. Typically there is very little stroma produced by the tumor… can occur anywhere in the lung
prognosis is better than with other types of lung cancer
large cell carcinoma of lung
%
grade?
features
10-15%
high grade cancer
cancer cells do not produce keratin, or mucin, or form glands
highly undifferentiated, anaplastic
very pleomorphic, bizarre looking cells with large nuclei, and bizarre mitotic figures
small cell lung cancer % risk features endocrine?
25%
strongly linked to smoking
terrible prognosis - treat with chemo / no surgery
mets to brain are common
cancer cells appear small and dark staining, form clusters of cells
stain positive for neuroendocrine markers
can produce a paraneoplastic syndrome
pancreatic cancer symptoms (4)
back pain
unexplained, painless jaundice due to growth of cancer blocking bile duct
migratory thromophlebitis
cachexia
pancreatic cancer prog feature origin mutations? mets best case?
terrible 5 year
pancreatic cancer risk?
unknown age family slight association with smoking + alcohol and pancreatitis diabetes peutz-heghers/brca2
colon adenocarcinoma = ?% of carcinomas arising in colon
98%
colon adenocarcinoma risk?
most cases are sporadic
what are adenomatous polyps
benign overgrowths of glandular tissue - less differentiated than normal
T4 in adenocarcinoma?
perforated through visceral pleura and/or invasion of organs
most common non-skin cancer in adult males?
prostate
prostate cancer new cases/yr
180,000
is prostate cancer more common in us?
yes appears to be most common in us
prostate cancer risk factors
age
race
genetics
prostatic carcinoma
zone effected?
effects peripheral > transition zone
gold standard for dx in prostate cancer?
blind random biopsy
only 50% sensitive
prostate cancer by race
black most frequent then white hispanic indian asian
what is prostatic intraepithelial neoplasia?
believed to represent noninvasive precursor to some cancers
genetic changes are similar
increases with age - peak prevalence 5-10yr b4 PCa
30-50% prostates with PIN harbor PCa
prostatic adenocarcinoma dx criteria?
uniform round glands infiltrative pattern single cell layer (loss of basal) nuclear enlargement - prominent nucleoli perineural invasion
prostatic carcinoma - prognostic factors (4)
grade
stage
tumor volume (PSA)
molecular markers
Gleason grading in PCa
based on morphologic resemblance to normal prostate / degree of invasiveness
score 1-5
score = most + 2nd most common
prostate cancer risk of progression 5 year (5 places)
pelvic lymph nodes 95% seminal vesicles 85% established capsular penetration 48% focal capsular penetration 33% organ confined 10%
PCa deaths in 2016
26000
what % men >50 have PCa
30% autopsy
