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Pathology Pre-Midterm > Module 4 Path-Continued > Flashcards

Module 4 Path-Continued Flashcards

1
Q

Benign tumors have a suffix of oma after tissue type . what are the exceptions to the oma rule?

A

Malignant: melanoma, lymphoma

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2
Q

What is an adenoma?

A

Benign tumor that forms a gland or originates from a gland

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3
Q

What is a cystadenoma?

A

An adenoma with cystic areas (fluid filled)

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4
Q

what is a papilloma?

A

Benign tumors with finger like projections

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5
Q

What is a polyp?

A

Elevated mucosal lesion of tumor; bump in the mucosa

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6
Q

What is a lipoma?

A

Slow growing benign tumor of adipose (mesenchymal origin)
Well differentiated, well demarcated and smooth borders
(no hemorrhage, necrosis or ulcerations)
Lipoma Has a TRUE CAPSULE

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7
Q

What is the etiology of a lipoma?

A

Unknown and painless

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8
Q

What is the most common site for a lipoma?

A

Most common in back
most common in makes
f-breast fibroadenoma

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9
Q

How does a benign lipoma appear on histological slide?

A

Mature white fat cells without pleomorphism

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10
Q

Will a benign become malignant ever?

A

Nope! 0% chance of malignant transformation

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11
Q

What is a hemangioma?

A

Encapsulated aggregates of closely packed thin wall capillaries separated by scant CT
Flattened endothelium

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12
Q

How does a hemangioma appear on histological side?

A

Disorganized blood vessels

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13
Q

What age group of individuals is a hemangioma most common in?

A

Children

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14
Q

What is the classic appearance of a hemangioma?

A

Strawberry raised lesion (usually on buttcheek of newborn)

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15
Q

Would you do a biopsy of a hemangioma?

A

nope!

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16
Q

Is there a change of a hemangioma ever becoming malignant?

A

0% chance of malignant transformation

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17
Q

What is a chorisotoma?

A

Normal tissue in an abnormal palce
aka: ectopic or heterotopic rest
Meckel’s Diverticulum (gastric and pancreatic tissue in the ileum)

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18
Q

What are the two types of hemangioma?

A

Capillary and Cavernous (larger vessels)

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19
Q

What is a leiomyoma (uterine fibroid)

A

Benign smooth muscle uterine muscle

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20
Q

What is the pathogenesis for a leiomyoma?

A

Fast growing benign tumors in myometrium (Smooth muscle-mesenchymal)
no necrosis or hemorrhage; clear demarcation, localized and pseudocapsule

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21
Q

What is the etiology and symptoms for leiomyomas?

A

Unknown
Asymptomatic
No chance of malignancy

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22
Q

What is the most common population for these leiomyomas?

A

Nulliparous African American Women (never had children)

23
Q

What is the presentation for leiomyomas?

A
  • Heavy periods (menorrhagia) –> iron deficiency anemia –> left ventricular hypertrophy –> left ventricular failure–> pulmonary edema –> at 2 weeks hemosiderin laden macrophages in alveolar space with alveolar fibrosis (due to collagen)
  • Uterus grows big and presses on bladder (urinary urgency/frequency) and presses on rectum (constipation)
24
Q

What does the histological slide of a leiomyoma look like?

A

Well differentiated -whorling bundles smooth muscle cells

25
Q

What are some complications of leiomyomas?

A

–Estrogen makes the fibroids grow bigger but does not cause them (pregnancy and oral contraceptives cause the fibroids to grow bigger) (menopause causes the fibroids to grow smaller)

26
Q

What happens if the leiomyomas become too big for the blood supply?

A

They undergo coagulative necrosis and then a red infarct

27
Q

What is a sarcoma?

A

Malignant tumor of mesenchymal origin
retroperitoneal soft tissues: bone, muscle, fat
-disseminate haematogenously in blood
-vimentin (Cytoskeleton protein)

28
Q

What is a carcinoma?

A

Malignant tumor of epithelial origin

  • disseminate via lymph
  • cytokeratin
29
Q

What is a mixed tumor?

A

Can either be benign or malignant (mesenchymal or epithelial origins)
1 germ layer with different types of cells and divergent differentiation

30
Q

A Benign mixed tumor of parotid gland is a pleomorphic (mixed benign) adenoma of salivary gland. What is the etiology and pathogenesis?

A

Etiology -> Unknown

Pathogenesis: arises from 1 germ layer that undergoes divergent differentiation; monoclonal origin

31
Q

How does a benign mixed tumor of the parotid gland present?

A

Painless lumpy mass in the jaw

32
Q

What are the complications of a benign mixed tumor of the parotid glands?

A

Small change of malignant transformation –> metastasize –> compression of the facial nerve –> Bell’s Palsy
High chance of recurrence

33
Q

For investigation of a benign mixed tumor of the parotid gland, what do you see?

A

See both mesenchymal (amorphous fibromyxoid stroma) and epithelial cells (Serous acini)
–both are benign

34
Q

What is a polyp?

A

An outgrowth of mucosal tissue

(can be pednuculated –has visible stalk or sessile–flat with not stalk

35
Q

What is Familial Adenomatous Polyposis (FAP)?

A

Genetic, tubular adenoma, numerous benign polyps (>100) on left side of colon (sigmoid descending) (diameter on left colon is smaller than right –>easier to obstruct)
Benign tumor with dysplastic cells and hence can become cancer

36
Q

What is the gene involved in FAP?

A

APC (tumor suppressor gene) which requires 2 hits –> inherit 1 bad hit and get second hit later in life –> POLYPS –> mutation in KRAS (one hit) and p53 (two hits) –> adenocarcinoma
(hence never born with polyps because your only born with one hit)

37
Q

What are symptoms for FAP?

A

Asymptomatic-screen with sigmoidoscopy (Screen at age 12) if family has a history of left sided colon cancer at a young age

38
Q

What are some complications of FAP?

A

Can bleed and give iron deficiency anemia –> left heart failure

39
Q

What is HNPCC?

A

No benign polyps; cancer on right side of colon

40
Q

HNPCC is due to a DNA mismatch of what repair genes?

A

MLH1, MSH2 and MSH6 and PMS2

41
Q

At what age do you start screening for HNPCC?

A

Microsatellite instability

start at age 25 with colonoscopy

42
Q

What is Lynch syndrome?

A

Family history of cancers in breast, right sided colon, endometrium and ovaries
(mutations in DNA mismatch repair genes)

43
Q

Colon Cancer is mostly what?

A

Sporadic

44
Q

What are predisposing factors to colon cancer?

A

FAP, high fat diet, low fiber, rich in refined carbs, low in vitamins A,C, and E, UC and Crohns

45
Q

What is the etiology for colon cancer?

A

Unknown

46
Q

What are the symptoms for colon cancer?

A

Left side –> bright red blood in stool, mucus, intestinal obstruction and LLQ pain
Right side –> initially no symptoms (b/c occult bleeding) –> iron deficiency anemia due to chronic blood loss

47
Q

If an older male presents with iron deficiency anemia, what is the most likely diagnosis?

A

Right sided colon cancer

48
Q

What is the tumor maker to check for followup after being treated for Colon cancer?

A

Carcino-Embryonic Antigen (CEA) –useful for followup to treatment

49
Q

What immunohistochemical stain is used for colon cancer?

A

Cytokeratin

50
Q

What is the spread of the cancer from colon?

A

Lymph –> liver –> lung

51
Q

So if a patient presents to you with a family history of left sided colon cancer at an early age (before 50), what is the first thing you should thing of?

A

FAP!

present with bright red blood in the stool

52
Q

What kind of polyps do you see in FAP?

A

Pedunculated, they have a stalk and found in the sigmoid colon. totally benign (does not cross basement membrane)

53
Q

What is the chance FAP will become colon cancer?

A

100% chance, all you need is one polyp to turn into cancer. so you are going to get colon cacner

54
Q

What treatment are patients offered by doctors, who are found to have these polyps?

A

Prophylactic colectomy
better to take it out now then before it turns into cancer
take out the left side, the sigmoid colon

Pathology Pre-Midterm (35 decks)

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