Neoplasia 1 Flashcards
1
Q
What is neoplasia?
A
an abnormal mass of tissue, that proliferates faster than the rest of the tissue, even without the stimuli
2
Q
what is this?
A
carcinoma of the pancreas
3
Q
what is the fourth leading cause of cancer deaths in the United States?
A
Pancreatic cancer - Infiltrating ductal adenocarcinoma of the pancreas
4
Q
what are the 2 components that define neoplasia?
A
- proliferating neoplastic cells (parenchyma)
- supporting tissue (stroma)
- desmoplasia is seen: abundant collagenous stroma
5
Q
what is this?
what are the arrows pointing at?
A
neoplasia
Tumor cells in nests and surrounding fibro-collagenous stroma.
6
Q
what is this picture an example of?
A
Desmoplastic round cell tumor:
7
Q
what is this picture an example of?
A
Desmoplastic round cell tumor:
8
Q
What is this picture an example of?
A
Desmoplastic round cell tumor:
9
Q
who usually gets desmoplastic round cell tumor?
A
adolescent, young adults, male
10
Q
where does dermoplastic round cell tumor grow usually?
A
Intra abdominal tumor
11
Q
how aggressive is a desmoplastic round cell tumor? can it be removed?
A
very aggressive
complete removal is not possible due to infiltration of abdominal structures
12
Q
benign tumors have what suffix?
A
-oma
13
Q
what are 2 types of benign tumors?
A
- mesenchymal tumors
- epithelial tumors
14
Q
what are 3 examples of benign mesenchymal tumors?
A
- fibroma
- osteoma
- chondroma
15
Q
what are 3 examples of benign epithelial tumors?
A
- adenoma
- papilloma
- cystadenoma
16
Q
what is this?
A
osteoma
17
Q
what is this?
A
adenoma or polyp
18
Q
what is a adenoma?
A
a tumor composed of solid glandular tissue with structures closely arranged
19
Q
what is important to remember of adenomas of the endocrine glands?
A
they may not show glands, but show cells resembling the respective tissue.
20
Q
what is important to remember of adenomas arising in glands that grow into lumen?
A
they become pedunculated to form ‘polyps’.
21
Q
what is a cystadenoma?
A
adenomas exhibiting cystic spaces into which papillary ingrowths of neoplastic epithelium protrude.
22
Q
what is an example of cystadenoma?
A
papillary’ cystadenoma of ovary (can be mucous or serous)
23
Q
what is a Fibroadenoma?
A
benign tumor seen in breast.
24
Q
what is a fibroma?
A
common benign tumor arising mostly in oral cavity.
25
when a fibroma is viewed under the microscope, what is seen?
Microscopy shows proliferation of fibrous tissue (collagen)
26
what is this?
fibroma
27
what is this?
fibroma
28
what is this?
fibroadenoma of breast
29
what is the most common benign breast tumor?
Fibroadenoma Breast
30
when do we usually see fibroadenoma of the breast?
any time during the active reproductive life, yet most common at 30 y/o
31
what is curious about the epithelial component of the fibroadenoma of the breast?
the epithelial component is hormonally responsive and there is typically an increase in size due to lactational changes during pregnancy
32
what is this?
a laryngeal pappilloma
33
what is this?
laryngeal papilloma
34
what is a papilloma?
benign tumors of surface epithelia that appear warty or papillary outgrowths.
35
what is a Polyp?
arise from mucosal (most) surface and can be sessile or pedunculated.
36
what is a Villous papilloma?
contains many delicate finger-like processes, ‘frond-like’. These are supported by a core of connective tissue stroma containing blood vessels (fibrovascular core).
37
what is important to remember in villous papilloma?
the stroma is part of the tumor.
The epithelium lining this structure is the most important for diagnosis. Varying degrees of dyplasia or even invasion may be noted.
38
what is this?
papilloma with verruca vulgaris
39
what is this?
papilloma with verruca
40
what is this?
Intraductal papilloma breast
41
what is this?
Intraductal papilloma breast
42
what is an Intraductal papilloma of breast?
papilloma that grow within a dilated duct and are composed of multiple branching fibrovascular cores
43
what will be found present in intraductal papillom of breast?
epithelial hyperplasia
44
what is this?
cystadenoma of ovary
note cystically dilated space, loculation (comaprtments), and fimbria.
45
what is the malignant counterpart of a cystadenoma?
cystadenocarcinoma
46
Malignant tumors can be of 2 types...
1. Mesenchymal
2. Epithelial
47
48
malignant mesenchymal tumors are referred to how?
sarcomas
49
what are 3 examples of sarcomas?
1. fibrosarcoma
2. chondrosarcoma
3. osteosarcoma
50
what is this?
osteosarcoma
51
what is this?
an osteosarcoma
52
in what ages do we find sarcomas?
in all ages
53
sarcomas spread less or more rapidly?
more rapidly
54
what is the best way to get rid of a sarcoma?
through surgery
55
what stains can be used for sarcomas?
vimentin
desmin
56
what is this?
Spindle cell sarcoma: note cells with dark brown stain (positive for desmin)
57
what is characteristic of osteosarcoma?
formation of bone or osteoid by tumor cells
58
from what cell does an osteosarcoma derive itself from?
mesenchymal cells
59
what genetic defect's or diseases can lead to osteosarcoma?
fibrous dysplasia
pagets disease
retinoblastoma
li fraumeni
60
in what part of the body do we most commonly find osteosarcoma?
distal femur
proximal tibia
proximal humerus
61
what is this?
osteosarcoma
62
what is this?
osteosarcoma
63
what is this?
osteosarcoma
64
malignant epithelial tumors are called...
carcinomas
65
what are 2 examples of carcinomas?
1. adenocarcinoma
2. squamous cell carcinoma
66
what is this?
adenocarcinoma of stomach
67
what is this?
adenocarcinoma of stomach
68
when adenocarcioma of stomach is viewed under the microscope, what is expected to be seen?
Microscopy reveals irregular glands lined by cells with atypical features
69
what is this?
squamous cell carcinoma of esophagus
70
squamous cell carcinoma of esophagus can be related to what?
smoking and alcohol usage
71
what is this?
esophageal small cell carcinoma
72
what is lymphoma?
malignant tumor involving lymphoid cells.
73
what can be seen in a section of a lymph node with lymphoma?
On section the enlarged lymph node shows homogenous white color.
74
most common lymphomas are of what type?
B cell
75
what is Leukemia?
malignancy of blood cells derived from bone marrow.
76
what is this?
leukemia
77
what is this?
lymphoma, dissected lymph node
78
what are 3 examples of a special type of neoplasia?
1. pleomorphic adenoma
2. Teratomas
3. choristoma
79
what is a pleomorphic adenoma?
* mixed tissue tumor
* benign mix of epithelial and stromal cells
80
from where do pleomorphic adenomas come from?
from myoepithelial/ductal reserve cells
81
pleomorphic adenomas usually arise from where?
parotid gland
82
what is shown in the picture?
shows epithelial elements forming ducts/acini/sheets of cells
83
what is this?
what should be noted about this picture?
pleomorphic adenoma
## Footnote
Note: nests of glandular elements (top), myxoid areas (lower right), & cartilage (left).
84
what is this?
normal salivary gland
85
what is this?
pleomorphic adenoma of salivary gland
## Footnote
A: Shows tumor compressing the normal salivary gland tissue. Note the boundary between the the two. There is a clear demarction between the normal and tumor. This is a feature of benign tumor.
86
is a pleomorphic adenoma mostly benign or malignant?
benign
87
what is the most common site of occurence with pleomorphic adenomas?
the parotid gland
88
what age group is mostly affected with plomorphic adenomas?
middle age, almost never in young
89
what is this?
pleomorphic adenoma of parotid
90
what is a teratoma?
Tumors representing more than one germ layer
91
what are the 3 types of teratomas?
1. Mature teratoma
2. Immature teratoma
3. Monodermal (highly specialized)
92
how aggresive is a mature teratoma?
it is benign
93
what are 2 other names for mature teratomas?
1) dermoid cyst
2) cystic teratoma
94
how aggresive is a immature teratoma?
it is very aggresive (malignant)
95
what is this?
Mature (benign) teratoma from ovary
96
what is this?
mature teratoma of epidermis
97
what is this?
In what layer do we find this?
mature teratoma of gutlike epithelium
found in endoderm
98
What is this?
In what layer do we find this?
mature teratoma of neural tissue
found in the ectoderm
99
what is this?
In what layer do we find this?
mature teratoma of the endocrine glands
found in endoderm
100
what is this?
in what layer do we find it?
mature teratoma of the muscle
found in the mesoderm layer
101
what is this?
in what layer do we find it?
mature teratoma of cartilage
found in mesoderm
102
what is this?
mature teratoma
103
what is this?
mature teratoma
104
how do we identify mature or benign teratomas?
most are cystic and almost always lined by skin-like structures
105
where are mature teratomas very common?
young women during the active reproductive years
106
if a mature teratoma goes malignant, what is the most common malignant form it takes?
squamous cell carcinoma
107
what are the most common monodermal teratomas?
struma ovarii teratoma
carcinoid teratoma
108
monodermal teratomas are bilateral or unilateral?
unilateral
109
of what tissue is struma ovarii teratoma usually composed of?
what may it cause?
mature thyroid tissue, which can be functional
hyperthyroidism
110
ovarian carcinoid teratoma arises from what tissue?
intestinal epithelium
111
what can ovarian carinoid teratoma produce and what can it lead to?
it can be functional and produce 5-hydroxytryptamine
it may lead to carcinoid syndrome
112
where do we find immature teratomas most commonly?
in prepubertal adolescents and young women
113
what tissue do immature teratomas look like?
embryonal or immature fetal tissue
114
what is a choristoma?
Ectopic pouch of normal tissue
115
what are 2 examples of choristoma?
1. pancreatic tissue in stomach wall
2. gastric mucosa in Meckel diverticulum
116
what is this?
choristoma of gastric mucosa
117
what is this?
choristoma
118
what is this?
choristoma
119
where are choristomas the most common tumor?
epibulbaly and orbitally in children
120
what is a hamartoma?
tumor-like malformation
mass of disorganized, but mature specialized cells or tissue indigenous to that site
121
hamartomas are composed of which tissue?
* the tissue specific to the part from which it arises
122
how do we anticipate the growth of a hamartoma?
the hamartoma will only grow as much as its surrounding tissue
(growth not seen usually after adolesence)
123
what is this?
hamartoma
124
where are hamartoma commonly seen in what organ?
lungs
125
what is this?
hamartoma of lung
126
what is this?
pulmonary hamartoma (nodule)
127
what is this?
pulmonary hamartoma (nodule)
128
what are the embryonic tumors that can occur during infancy
1. Wilm's tumor
2. Neuroblastoma
3. Medulloblastoma
4. Retinoblastoma
5. Hepatoblastoma
6. Embryonic sarcoma
129
Neuroblastomas in children occur in what organ?
kidneys
130
neuroblastomas in adults or older occur where?
along the sympathetic chain
131
what hormones get produced in neuroblastomas that are derived from the sympathetic chain?
catecholamines
132
what are these tumor called?
what happens in the future with these tumors?
silent
they spontaneously regress and leave only fibrosis or calcification
133
What is Ewing's Sarcoma?
a malignant bone tumor characterized by primitive round cells without differentiation
134
Ewing's Sarcoma and what other tumor are categorized under the Ewing Sarcoma family tumors?
neuroectodermal tumor
135
what is the second most common bone sarcoma in children?
Ewing sarcoma
136
Where does ewing sarcoma develop?
in the diaphysis of long tubular bones (femur, pelvis)
137
what is characteristic about Ewing's Sarcoma?
periosteal reaction produces layers of reactive bone deposited in an onion-skin fashion
138
What is the genetic basis of Ewing's sarcoma?
translocation generating in-frame fusion of the EWS gene on chromosome 22 to the FLI1 gene
139
what is differentiation of neoplastic cells?
how much neoplastic cells look like normal cells on morphology and function
140
what is anaplasia?
no differentiation
141
what is this an example of?
differentiation
## Footnote
Note: ‘glands’ formed by tumor cells …differentiation
142
How can we differentiate Anaplastic tumors in order to catogorize them as epithelial derived or mesenchymal derived?
immunohistochemistry
143
do benign tumors spread?
how differentiated are benign tumors?
no
well differentiated
144
how differentiated are malignant tumors?
do malignant tumors metastasize?
less differentiated than benign tumors
yes
145
what is this?
normal colon histology
146
what is this?
adenocarcinoma of colon
## Footnote
note: the abnormal and irregularly shaped glandular elements bordering normal mucosa.
147
what is this?
Well differentiated adenocarcinoma
* shows glandular pattern,
* cells exhibit features of **malignancy**
148
what is this?
Poorly differentiated adenocarcinoma (anaplastic):
* shows poor differentiation and bears no resemblance to parent tissue
149
what is this?
Squamous cell carcinoma: well-differentiated
150
what is this?
Squamous cell carcinoma: poorly- differentiated
151
what can we infer about the cell shape of a malignant tumor?
there is variation in size and shape of the cells and its nuclei
152
what can we infer about the cell shape of a benign tumor?
they show minimal pleomorphism
153
which tumor (malignant or benign) show hyperchromatism (dense staining of nuclei)?
What is important to remember about hyperchromatism?
malignant tumors
## Footnote
\*\*\*IT does not help to differentiate malignant tumors from benign, or from those which are undergoing hyperplasia or repair.\*\*\*\*
154
what is the normal nuclear to cytoplasmic ratio?
what it the malignant tumor nuclear to cytoplasmic ratio?
what it the benign tumor nuclear to cytoplasmic ratio?
1: 4 or 1:6
1: 1
1: 1
155
what aspect can be seen here?
pleomorphism is seen
156
what is characteristic about mitosis in malignant cells?
* there is abnormal/bizarre mitosis
* can have: tripolar, quadripolar, stellate spindles
157
what is characteristic about this picture?
malignant cell
quadripolar spindle
158
what is characteristic about this picture?
tripolar spindle
malignant cell
159
how is the spindle of mitosis in benign tumors?
normal (bipolar)
160
what is this?
stellate spindle in malignant cell mitosis
161
what is this?
Bipolar spindle type of mitosis in Normal or Benign tumors
162
what can be noticed about the polarity of cells in a malignant tumor?
In what epithelium can this change in polarity be seen?
polarity is lost so orientation is disordered
In: cervix, tracheobronchial, stomach
163
what is this?
tumor giant cell
164
what is a tumor giant cell?
tumor cells having 2 or more nuclei
165
where are tumor giant cells more common?
in sarcomas
166
what is important to remember about tumor giant cells?
they are not related or similar to the ones found in TB
167
What is this?
Rhabdomyosarcoma Tumor Giant cell
168
What is this?
Alveolar soft tissue sarcoma
| (with presense of tumor giant cells)
169
what is an example of a tumor giant cell?
Malignant Fibrous Histiocytoma (MFH)
170
what is a Malignant Fibrous Histiocytoma (MFH)?
contains cells similar to fibroblasts & histiocytes
171
from where or what part of the body do most malignant fibrous histiocytoma come from?
at what age?
from the extremities or from the retroperitoneum
50-60's
172
what is this?
tumor necrosis
173
where does tumor necrosis happen?
in rapidly growing tumors
174
what is Tumor lysis syndrome?
on who does it happen?
with what illnesses is tumor lysis syndrom associated?
- constellation of metabolic disturbances that may be seen after initiation of cancer treatment
- patients with bulky, rapidly proliferating, treatment-responsive tumors
- associated with
* acute leukemias
* high-grade non-Hodgkin lymphomas,
* Burkitt lymphoma
175
what is this?
adenoma of thyroid showing numerous follicles of varying sizes encapsulated within the thyroid
(Picture: shows crowded follicles with normal thyroid in the periphery)
176
what is this?
normal thyroid follicles
177
what is this?
follicular adenoma
178
Is there a cytological difference between follicular adenoma and minimally invasive follicular carcinoma?
no
179
follicular carcinomas activate what signaling pathway?
Ras
180
what is this?
follicular adenoma of thyroid
181
how do you differentiate between a adenoma and a well differentiated adenocarcinoma?
you check for:
1. capsular invasion
2. vascular invasion
182
what is this?
thyroid adenoma or adenocarcinoma
183
what is dysplasia?
disordered growth
184
where is dysplasia seen?
seen in epithelial lined structures (example: cervix)
185
where does dysplasia happen often?
occurs in metaplastic epithelium (Barrett’s, respiratory tract in smokers)
186
how is dysplasia known when entire thickness of the epithelium is involved?
carcinoma in situ
187
what type of leasion is carcinoma in-situ?
pre-invasive lesion
188
what is this?
dysplasia
## Footnote
Note: loss of polarity, and atypical cellular/nuclear features involving the entire thickness of epithelium
189
what is this?
mild dysplasia
note loss of polarity, atypical cellular/nuclear features limited to lower one-third of the epithelial thickness, mitosis (arrows).
190
what is this?
severe dysplasia
Near full thickness architectural disorder with marked nuclear pleomorphism and hyperchromatism, dyskeratosis (white arrows), and upper layer mitoses (black arrows).
191
what is this?
dysplasia of cervix
192
what are these (ABC)?
cervical intraepithelial neoplasia
A) Mild dysplasia
B) Moderate dysplasia
C) Severe dysplasia (carcinoma in-situ)
193
what are the 4 phases of tumor growth?
1. Malignant change in the target cell (transformation)
2. Growth of the transformed cells
3. local invasion
4. Distant metastases
194
195
