Module 4 Path Continued Flashcards
What is a blastoma?
Tumor thought to arise in embryonic tissue
Blastomas are most common in what age group?
children
Blastomas are malignant in what three areas of the body?
- Retinoblastoma-retina
- Heptaoblastoma-liver
- Neuroblastoma- neural origin
When do patient normally develop retinoblastoma?
around age 2
What is the pathogenesis of retinoblastoma?
Mutation in Rb tumor suppressor genes needs 2 hits
- Sporadic (unilateral) and Familial (bilateral)
- Familial type leads to osteosarcoma later in life
What is the presentation of retinoblastoma?
Visual impairment (running into walls) Leukocoria (cats eye reflex) causes pupil to look white with pupillary light reflex
On histological stain of a retinoblastoma what classic things are you going to find?
True Rosettes (malignant cells arrange around a central lumen)
What is the treatment for retinoblastoma?
Take eye out and chemotherapy called enucleuation
if you dont take out the eye it will spread
What condition are pseudorosettes: not arranged around central lumen seen in ?
seen in neuroblastoma
which tumors have NO chance of malignancy?
Lipoma
Capillary Hemangioma
Leiomyoma
What tumors have small chance of malignancy?
Salivary gland adenoma (mixed tumor)
Benign dermoid cyst (teratoma)
What tumors have 100% change of malignancy?
FAP HNPCC Osteosarcoma Wilm's Tumor Retinoblastoma
NOTE –> MORE INFO IN CHARTS ON CARCINOGENS
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HNPCC is due to what?
DNA mismatch repair genes: MLH1, MSH2 and MSH6 and PMS2
micro-satellite instability
What is the presentation for HNPCC?
Family history of right sided colon cancer at an early age
normally asymptomatic
What should you do as a physician to screen for HNPCC?
Start screening with a colonoscopy at age 25 that again has a family history of right sided colon cancer at an early age
How many polps do you see in HNPCC?
1 or 2 polyps on the right side
What do you find in the stool of a patient with HNPCC?
Stool is getting formed and blood mixed with stool and patient never see it.
patients are going to have iron deficiency anemia because they never see the blood.
What is the appearance of the polys in HNPCC?
Sessile polys (flat with no stalk)
Colon cancer, what side in the most common?
Left side and sporadic
What are the predisposing factors and etiology of colon cancer?
Predisposing factors: FAP, high fat diet, low fiber, rich in refined carbs, low in vitamins A,C,E and UC/Crohn’s
Etiology: unknown
What are the signs of left sided colon cancer?
Napkin ring constriction
stools come out like a pencil
bright red blood in stool
mucus and more likely to obstruct because diameter of left side is way smaller then right
What are the signs of right sided colon cancer?
Symptoms: occult bleeding and fatigue from iron deficiency anemia
older male with iron deficiency is right sided so you do colonoscopy
If you have anemia = LV failure and heart failure cells
At what age do you start screening people for colon cancer that do not have a family history of colon cancer?
age 50
What do you see on histology of colon cancer?
Dysplastic glands invading (Adeno)
How do you monitor response to treatment?
CEA
remember P CLUBS
How do you differentiate on gross specimen cancerous ulcer vs peptic ulcer?
Look for margins that are heaped up or raised and thats huge for cancer ulcer
Site of Metastasis = brain, what is the site of primary cancer?
Lung Breast Skin (melanoma) Kidney (renal cell carcinoma) GI Lots of Bad Stuff Kills Girls
Site of Metastasis=LIVER, what is the site of primary cancer?
Colon Stomach Pancreas Breast Lung P CLuBS
Site of metastasis=bone, what is the site of primary cancer?
Prostate
Breast
