Micro/Path Neoplams Flashcards
most deadly form of skin cancer (most deaths from skin disease)
melanoma
the development of melanoma is related to
sun exposure
Melanoma has 2 growth stages: radial (initial) and vertical (later phase) which phase has metastatic potential
vertical. = tumor invades (vertically) downward (vs initial radial where it moves horizontally)
in radial phase = horizontal spread of melanoma in epidermis, tumor cells lack the capacity to
metastasize. (think R - radial comes before V = vertical) and also makes sense that at first they haven’t metastasized
superficial spreading melanoma is the most __ type of melanoma. ___ phase predominates
common. radial phase predominates = large flat irregularly pigmented lesion
nodular melanoma is the most __ type of melanoma,__ phase predominates
aggressive.
vertical growth phases = poorest prognosis
lentigo maligna melanoma occurs on ___skin. __- phase predominates. most often develops from pre existing lentigo maligna called
sun exposed, radial growth phase, Hutchinson freckle
Acral- lentiginous melanoma is the __ form of melanoma
least common. arise from pigmented lesions on the palm, sole or under the nail.
pheochromocytomas are neoplasms made of __ cells
pheochromocytomas = chromaffin cells = synthesize catecholamines ( epinephrine (adrenaline), norepinephrine (noradrenaline) and rarely dopamine made from tyrosine)
pheochromocytomas cause surgically correctable hypo/hypertention
hypertention (think catecholamines = epinephrine = SNS)
pheochromocytomas rule of 10:
- 10% of pheochromocytomas are ___
- 10% of sporadic adrenal pheochromocytomas are __
- 10% of adrenal pheochromocytomas are biologicaly ___
- 10% of adrenal pheochromocytomas are not associated with __
- extra adrenal = called parangangliomas
- bilateral
- malignant
- hypertention
so, they are mostly adrenal, non malignant, cause hypertention
___may be associated with MEN (multiple endocrine neoplasia), neurofibromatosis (von Recklinghausen’s disease), or von Hipple-Lindau disease - multiple hemangiomas
pheochromocytomas
most common malignant tumor of childhood
neuroblastoma =catecholamine producing tumor originating from adrenal medulla
First symptoms in this disease is a LARGE ABDOMEN, SENSATION OF FULLNESS AND ABDOMINAL PAIN. FOLLOWED LATER BY AN ABDOMINAL MASS. THIS TUMOR CUASES HYPERTENTION
NEUROBLASTOMA
____Can convert to more differentiated form called ganglioneuroma
neuroblastoma
most malignant neoplasm of lungs
bronchogenic carcinoma
bronchogenic carcinoma spreads first to _ then to
Spreads to lymph nodes then liver/brain/bone (think LLBB) = lymph liver brain bone
___ carcinomas form a mass in the periphery of the lung
adenocarcinoma
epidermoid (squamous cell) carcinoma is a type of bronchogenic carcinoma most common in men/women and closely related to
men and smoking
adenocarcinomas are smaller than bronchogenic carcinomas and located in the __ of the lung. and most common in men/women, smoker/non?
periphery, women non smokers
___ is the most aggressive and highly malignant form of bronchogenic carcinoma.
small cell (oat cell) carcinoma Usually has already metastasized at time of diagnosis
___carcinoma is composed of large undifferentiated malignant cells with variable location
large cell (anaplastic) carcinoma
____ is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that generally arises from cells originating in the endodermal or ectodermal germ layer during embryogenesis. More specifically, a carcinoma is tumor tissue derived from putative epithelial cells
carcinoma
- Most cancers are cancers of the ___. 2. Cancers of the epithelial cells are called ___.
- epithelial cells
- carcinomas
Carcinomas make up about 85 out of every 100 cancers (85%).
different types of epithelial cells can develop into diff kinds of cancer:
where are these:
1. Squamous cell carcinoma (of squamous cells)
2. Adenocarcinoma (of glandular cells)
3. Transitional cell carcinoma (of transitional cells)
- Flat, surface covering cells called squamous cells - for example, the skin or the lining of the throat or food pipe (oesophagus).
- Glandular cells called adenomatous cells - for example, kidney cells or breast cells
- Layers of stretchy cells called transitional cells - for example, the lining of the bladder
Connective tissue is the name for the supporting tissues of the body - the bones, cartilage, tendons and fibrous tissue that support the body organs. Connective tissue cancers are called ___
sarcomas
- Sarcomas are much___common than carcinomas. They are usually grouped into two main types - bone sarcomas (osteosarcoma) and soft tissue sarcomas. Altogether, these make up less than 1 in every 100 (1%) cancers diagnosed.
- Cancer of the cartilage is called __,
- cancer of a muscle is called ___
- less
- chondrosarcoma
- rhabdomyosarcoma
- Cancers of the blood cells - 2. Cancers of the lymphatic system - __
- leukemia
2. lymphomas
Burkitt’s lymphoma involves __ organs and is closely linked to __ virus
abdomenial,
Epstein Barr virus (herpes simplex virus 4)
Non-Hodjkins Lymphoma = malignant tumors of lymph system. Most are B/T cell origin?
B
which cancer is associated with HIV, helicobacter pylori, EBV, herpes virus 8
non-hodjkins lymphoma
first indication of malignant lymphoma is
swelling of the lymph glands
enlarged tonsils and andenoids, painless nodes
as malignant lymphoma progresses symptoms
fatigue, malaise, weight loss, fever, NIGHT SWEATS
Burkitt’s lymphoma is an aggressive B/T cell lymphoma
B cell
the___ form of Burkitt’s lymphoma involves the maxilla or mandible.
african
the __ form of Burkitt’s lymphoma involves the abdominal organs
american
Reed Sternberg cells are found in patients with ___ disease
Hodgkin’s lymphoma
Does malignant lymphoma have Reed Sternberg cells
no
malignant lymphoma show a STARRY SKY appearance of non neoplastic ___
macrophages
how can you differentiate bw malignant lymphoma and hodgkins disease
biopsy
extra-nodal presentation common in hodgkins/non hodgkins lymphoma
non
the ___ form of Burkitt’s lymphoma is most closely associated with EBV (95% of cases) and affects children of ___ regions. Usually begins as a LARGE MASS IN THE JAW
African form
the __ form is less closely associated with EBV and usually begins as AN ABDOMINAL MASS. tumors of the jaw are rare
American form
invasion of dermis by sheets and islands of neoplastic epidermal cells with “KERATIN PEARLS” and related to sun exposure (mostly), chemical carcinogens such as arsenic, and radiation is characteristic of
squamous cell carcinoma
which is ore aggressive tumor:
basal cell carcinoma or squamous cell carcinoma
squamous cell carcinoma bc can metastasize if untreated
squamous cell carcinoma (SCC) is most common on sun exposed sites in later life with ulcerated lesions on the lower/upper lip and ear are most aggressive
lower lip
SCC develops from what pre cancerous condition relating to sun exposure around the lips
actinic cheilitis
SCC = cancerous changes to __ cells
keratinoctyes (middle portion of epidermal skin layer)
SCC is most often __ invasive
locally. but can metastasize into lymph channels
SCC resembles what other cancer in histologic appearance and biological behavior
cervical cancer
to remember think: sCC = CC (cervical cancer)
malignant epithelial cells have an increased number of ___ receptors
Laminin = a glycoprotein in the basement membrane that promotes cell adhesion, migration, growth and differentiation
90% of all malignant cancers of the ORAL CAVITY ARE?
SQUAMOUS CELL CARCINOMA (SCC)
Cirrhosis is most common in men or women
men
most common invasive cancer in humans
basal cell cacinoma
basal cell carcinoma is the most common invasive cancer in humans but do they metastasize
rarely
is basal cell carcinoma ulcerative and indurated ( become firm or hard especially by increase of fibrous elements) and locally destructive
yes
___ carcinoma present as pearly papules containing prominent dilated subepidermal blood vessels (telangiectasias)
basal cell carcinoma
why are basal cell carcinomas (BCC) aka rodent ulcers
bc can ulcerate and locally invade bone or sinuses after many years of neglect
prognosis for BCC is
good = usually cured with surgery
basal cells are normal skin cells that may develop cancerous changes causing a __ that is painful/painless
painless lump. a new skin growth that ulcerates bleeds easily or does not heal well hints it may be BCC
darkly staining PALISADE ARRANGEMENT of nuclei cells at periphery of tumor cell is seen in
BCC
a __ is a stable, heritable change in the nucleotide seq of DNA resulting in an alteration in the products coded for by the gene
mutation
3 kinds of mutations:
- ___ one base is inserted in place of another = results in a missense or non sense mutation
- ___ occurs when one or more base pairs are added or deleted
- ___ insertion sequences or deletions integrated into DNA
- base substitution
- frame shift mutation
- transposons
mutations are caused by
chemicals, ionizing radiation, uv light, viruses
BENZPYRENE = chemical found in __ that binds to DNA bases and causes __ mutations
tobacco smoke = frame shift mutation
___ produce free radicals that can attack DNA bases
ionizing radiation (gamma and xrays)
UV light has lower energy than xray = causes what damage?
cross-linking of the adjacent pyrimidine bases to form dimers Uthymine dimers result in inability of the dna to replicate properly)
____ virus causes frame shift mutations or deletions
bacterial virus Mu (mutator bacteriophage)
cells with high/low proliferation are more sensitive to radiation
high
lymphocytes, bone marrow blood forming cells, reproductive cells and epithelial cells in GI tract are high/low radiosensitive cells
high bc proliferate a lot
nerve cells, mature bone cells, and muscle cells are low/high radiosensitive cells
low, bc don’t regenerate much
what part of GI tract is the most common site of malignancy? least common?
most common is the colon. least common is the small intestine (makes up 75% of overall length of GI tract)
most common malignancy of the colon is sarcoma/adenocarcinoma/lymphoma
adenocarcinoma
most common malignancy of the SI is sarcoma/adenocarcinoma/lymphoma/carcinoid tumor
adenocarcinoma and carcinoid > lymphomas and sarcomas
colorectal adenocarcinoma represents 15% of all cancer related deaths in US and is second to? common in what age? men/women
lung cancer
60-70 y/o males
most colon cancers begin as
benign polyps that after many years develop into cancer. predisposing factor is ulcerative colitis
increased serum concentration of carcinoembryonic antigen (CEA) is related to what cancer
colorectal cancer
up to 4x increase in colorectal cancer if
relatives have the disease
a low fiber diet that is high in __ may predispose you to colorectal cancer
animal fat.
what part of colon is most common site of colorectal cancer
sigmoid colon
colorectal cancer: tumors on the __ side usually cause constipation and destruction while tumors on the __ side usually do not obstruct early
descending (LEFT) = obstruct
ascending (RIGHT) = not obstruct early
Most common cancer in men
prostate
which cancer causes the most deaths in both men and women
lung
how can you confirm prostate cancer
biopsy
Prostate specific antigen (PSA) and acid phosphatase are elevated in
prostate cancer
most prostate cancers are adenocarcinoma/sarcoma?
adenocarcinoma
nodular hyperplasia of prostate:
benign or malignant?
causes?
is it premalignant?
benign enlargement of prostate due to hyperplastic nodules of stroma and glands distorting the prostate.
causes urinary tract obstruction.
It is NOT PREMALIGNANT
most common neoplasm in women?
leiomyomas =
Leiomyosarcoma is the malignant type.
Leiomyoma = __ type
benign
good prognosis. profuse, painful menses and infertility are characteristic of this cancer
leiomyomas
cause of fibroid tumors are unknown. however it is suggested that fibroids may enlarge with
estrogen therapy (oral contraceptives) or pregnancy = shrink after menopause.
most common pelvic tumor
uterine fibroids
___arise from arrector pili muscles found in skin, nipples, scrotum, and labi
leiomyomas
neoplasms of muscles are rare but when encountered they are usually malignant/benign
malignant
rhabdomyosarcoma = malignant/benign neoplasm from SKELETAL (STRIATED) MUSCLE
poor prognosis
malignant
affects throat, bladder, prostate, vagina
the benign variety can arise in ___skeletal muscle of the body.
any
- most common cancer in men
2. most common cancer in women
- prostate
2. breast
strongest association w increased risk for breast cancer is
family history = esp in first degree relatives: mom/sister/daughter
breast cancer occurs more commonly in which breast and in what quadrant
outer upper quadrant of left breast
early menarche late menopause obesity first pregnancy after 30 years of age diet high in animal fat positive family history history of breast cancer in one breast proliferative fibrocystic disease with atypical epithelial hyperplasia are all predisposing factors to
breast cancer
- A painful/painless mass in the breast is usually initial sign of breast cancer.
- retraction of ___
- peau d’orange
- enlarged
- painless
- nipple/skin
- swollen pitted skin
- axillary lymph nodes
most valuable prognostic predictor of breast cancer
lymph node involvement
___ of breast is most common cause of clinically palpable breast mass in women 28-44 years old
fibrocystic disease
5 year survival rate of bronchogenic carcinoma is
10% = leading cause of death from cancer in both men and women
Reed Sternberg cells = neoplastic cells of ___
Hodgkins lymphoma
reed sternberg are binucleated/multinucleated giant cells with eosinophilic inclusion like nucleoli
first sign of Hodgkin lymphoma
enlarged lymph node
Hodgkin lymphoma affects young/old more? women/men
young men
except for nodular sclerosis = more in young women
Non Hodgkin lymphoma is a malignant lymphoma characterized by the absence of
Reed Sternberg cells
benign/malignant: well differentiated slow growth encapsulated/well circumscribed localized movable
benign
benign/malignant:
less well differentiated (anaplastic) rapid growth invasion metastasis immovable
malignant
“punched out” bone lesions
bence jones protein (urine with immunoglobin light chains-kappa or lamda)
B-cell proliferation
multiple myeloma = plasma cell neoplasm
elderly
NON-MALIGNANT cell growth. May proceed to malignant changes in the tissue. Associated w chronic irritation to tissue by a chemical agent, ie cigarette smoke or by chronic inflammatory inflammation. Tissue appears disorganized, atypical cells w/o invasion. Epithelium exhibits acanthosis = abnormal thickening of prickle cell layer.
dysplasia
substitution of one tissue normally found at a site for another. GERD = ex
metaplasia
Most common type of epithelial metaplasia is replacement of __ cells by ___epithelium
columnar
stratified squamous
desmoplasia =
neoplasms that form fibrous stroma that makes tumor feel hard on palpation.
Most common primary MALIGNANT tumor of BONE:
osteogenic sarcoma
choristoma
benign mass of normal tissue MISPLACed WITHIN another organ
ex liver tissue in intestinal wall
hamartoma
benign tumor like overgrowth of cell types that are regularly found within the affected organ. ex. hamangioma = irregular accumulation of bv’s
Ewing sarcoma and primitive neuroectodermal tumor (PNET) are two variants of the same tumor but differ in the degree of neural differentiation:
- tumors that demonstrate neural differentiation are
- tumors that are undifferentiated are
- differentiated = PNET’s
- undifferentiated = Ewing sarcoma
distinction has no clinical signifigance
- most common malignant bone tumor
2. 2nd most common
- osteosarcoma
2. Ewing sarcoma (undifferentiated neural tissue)
majority of Ewing sarcoma are in ages 10-20 and result from
chromosome rearrangement
Ewing sarcoma patients present with
severe bone pain
Schilling test used to detect
pernicious anemia
you need __ and ___ for dna synthesis
vitamin B-12 and folate
you need __ for heme synthesis
iron