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Pathology 1 Block 2 > Neoplasia 1 > Flashcards

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

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2
Q

what is this?

A

carcinoma of the pancreas

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3
Q

what is the fourth leading cause of cancer deaths in the United States?

A

Pancreatic cancer - Infiltrating ductal adenocarcinoma of the pancreas

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4
Q

what are the 2 components that define neoplasia?

A
  1. proliferating neoplastic cells (parenchyma)
  2. supporting tissue (stroma)
  • desmoplasia is seen: abundant collagenous stroma
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5
Q

what is this?

what are the arrows pointing at?

A

neoplasia

Tumor cells in nests and surrounding fibro-collagenous stroma.

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6
Q

what is this picture an example of?

A

Desmoplastic round cell tumor:

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7
Q

what is this picture an example of?

A

Desmoplastic round cell tumor:

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8
Q

What is this picture an example of?

A

Desmoplastic round cell tumor:

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9
Q

who usually gets desmoplastic round cell tumor?

A

adolescent, young adults, male

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10
Q

where does dermoplastic round cell tumor grow usually?

A

Intra abdominal tumor

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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

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12
Q

benign tumors have what suffix?

A

-oma

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13
Q

what are 2 types of benign tumors?

A
  1. mesenchymal tumors
  2. epithelial tumors
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14
Q

what are 3 examples of benign mesenchymal tumors?

A
  1. fibroma
  2. osteoma
  3. chondroma
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15
Q

what are 3 examples of benign epithelial tumors?

A
  1. adenoma
  2. papilloma
  3. cystadenoma
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16
Q

what is this?

A

osteoma

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17
Q

what is this?

A

adenoma or polyp

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18
Q

what is a adenoma?

A

a tumor composed of solid glandular tissue with structures closely arranged

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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.

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20
Q

what is important to remember of adenomas arising in glands that grow into lumen?

A

they become pedunculated to form ‘polyps’.

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21
Q

what is a cystadenoma?

A

adenomas exhibiting cystic spaces into which papillary ingrowths of neoplastic epithelium protrude.

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22
Q

what is an example of cystadenoma?

A

papillary’ cystadenoma of ovary (can be mucous or serous)

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23
Q

what is a Fibroadenoma?

A

benign tumor seen in breast.

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24
Q

what is a fibroma?

A

common benign tumor arising mostly in oral cavity.

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25
Q

when a fibroma is viewed under the microscope, what is seen?

A

Microscopy shows proliferation of fibrous tissue (collagen)

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26
Q

what is this?

A

fibroma

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27
Q

what is this?

A

fibroma

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28
Q

what is this?

A

fibroadenoma of breast

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29
Q

what is the most common benign breast tumor?

A

Fibroadenoma Breast

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30
Q

when do we usually see fibroadenoma of the breast?

A

any time during the active reproductive life, yet most common at 30 y/o

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31
Q

what is curious about the epithelial component of the fibroadenoma of the breast?

A

the epithelial component is hormonally responsive and there is typically an increase in size due to lactational changes during pregnancy

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32
Q

what is this?

A

a laryngeal pappilloma

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33
Q

what is this?

A

laryngeal papilloma

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34
Q

what is a papilloma?

A

benign tumors of surface epithelia that appear warty or papillary outgrowths.

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35
Q

what is a Polyp?

A

arise from mucosal (most) surface and can be sessile or pedunculated.

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36
Q

what is a Villous papilloma?

A

contains many delicate finger-like processes, ‘frond-like’. These are supported by a core of connective tissue stroma containing blood vessels (fibrovascular core).

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37
Q

what is important to remember in villous papilloma?

A

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.

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38
Q

what is this?

A

papilloma with verruca vulgaris

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39
Q

what is this?

A

papilloma with verruca

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40
Q

what is this?

A

Intraductal papilloma breast

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41
Q

what is this?

A

Intraductal papilloma breast

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42
Q

what is an Intraductal papilloma of breast?

A

papilloma that grow within a dilated duct and are composed of multiple branching fibrovascular cores

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43
Q

what will be found present in intraductal papillom of breast?

A

epithelial hyperplasia

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44
Q

what is this?

A

cystadenoma of ovary

note cystically dilated space, loculation (comaprtments), and fimbria.

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45
Q

what is the malignant counterpart of a cystadenoma?

A

cystadenocarcinoma

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46
Q

Malignant tumors can be of 2 types…

A
  1. Mesenchymal
  2. Epithelial
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47
Q
A
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48
Q

malignant mesenchymal tumors are referred to how?

A

sarcomas

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49
Q

what are 3 examples of sarcomas?

A
  1. fibrosarcoma
  2. chondrosarcoma
  3. osteosarcoma
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50
Q

what is this?

A

osteosarcoma

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51
Q

what is this?

A

an osteosarcoma

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52
Q

in what ages do we find sarcomas?

A

in all ages

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53
Q

sarcomas spread less or more rapidly?

A

more rapidly

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54
Q

what is the best way to get rid of a sarcoma?

A

through surgery

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55
Q

what stains can be used for sarcomas?

A

vimentin

desmin

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56
Q

what is this?

A

Spindle cell sarcoma: note cells with dark brown stain (positive for desmin)

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57
Q

what is characteristic of osteosarcoma?

A

formation of bone or osteoid by tumor cells

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58
Q

from what cell does an osteosarcoma derive itself from?

A

mesenchymal cells

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59
Q

what genetic defect’s or diseases can lead to osteosarcoma?

A

fibrous dysplasia

pagets disease

retinoblastoma

li fraumeni

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60
Q

in what part of the body do we most commonly find osteosarcoma?

A

distal femur

proximal tibia

proximal humerus

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61
Q

what is this?

A

osteosarcoma

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62
Q

what is this?

A

osteosarcoma

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63
Q

what is this?

A

osteosarcoma

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64
Q

malignant epithelial tumors are called…

A

carcinomas

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65
Q

what are 2 examples of carcinomas?

A
  1. adenocarcinoma
  2. squamous cell carcinoma
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66
Q

what is this?

A

adenocarcinoma of stomach

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67
Q

what is this?

A

adenocarcinoma of stomach

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68
Q

when adenocarcioma of stomach is viewed under the microscope, what is expected to be seen?

A

Microscopy reveals irregular glands lined by cells with atypical features

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69
Q

what is this?

A

squamous cell carcinoma of esophagus

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70
Q

squamous cell carcinoma of esophagus can be related to what?

A

smoking and alcohol usage

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71
Q

what is this?

A

esophageal small cell carcinoma

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72
Q

what is lymphoma?

A

malignant tumor involving lymphoid cells.

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73
Q

what can be seen in a section of a lymph node with lymphoma?

A

On section the enlarged lymph node shows homogenous white color.

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74
Q

most common lymphomas are of what type?

A

B cell

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75
Q

what is Leukemia?

A

malignancy of blood cells derived from bone marrow.

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76
Q

what is this?

A

leukemia

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77
Q

what is this?

A

lymphoma, dissected lymph node

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78
Q

what are 3 examples of a special type of neoplasia?

A
  1. pleomorphic adenoma
  2. Teratomas
  3. choristoma
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79
Q

what is a pleomorphic adenoma?

A
  • mixed tissue tumor
  • benign mix of epithelial and stromal cells
80
Q

from where do pleomorphic adenomas come from?

A

from myoepithelial/ductal reserve cells

81
Q

pleomorphic adenomas usually arise from where?

A

parotid gland

82
Q

what is shown in the picture?

A

shows epithelial elements forming ducts/acini/sheets of cells

83
Q

what is this?

what should be noted about this picture?

A

pleomorphic adenoma

Note: nests of glandular elements (top), myxoid areas (lower right), & cartilage (left).

84
Q

what is this?

A

normal salivary gland

85
Q

what is this?

A

pleomorphic adenoma of salivary gland

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
Q

is a pleomorphic adenoma mostly benign or malignant?

A

benign

87
Q

what is the most common site of occurence with pleomorphic adenomas?

A

the parotid gland

88
Q

what age group is mostly affected with plomorphic adenomas?

A

middle age, almost never in young

89
Q

what is this?

A

pleomorphic adenoma of parotid

90
Q

what is a teratoma?

A

Tumors representing more than one germ layer

91
Q

what are the 3 types of teratomas?

A
  1. Mature teratoma
  2. Immature teratoma
  3. Monodermal (highly specialized)
92
Q

how aggresive is a mature teratoma?

A

it is benign

93
Q

what are 2 other names for mature teratomas?

A

1) dermoid cyst
2) cystic teratoma

94
Q

how aggresive is a immature teratoma?

A

it is very aggresive (malignant)

95
Q

what is this?

A

Mature (benign) teratoma from ovary

96
Q

what is this?

A

mature teratoma of epidermis

97
Q

what is this?

In what layer do we find this?

A

mature teratoma of gutlike epithelium

found in endoderm

98
Q

What is this?

In what layer do we find this?

A

mature teratoma of neural tissue

found in the ectoderm

99
Q

what is this?

In what layer do we find this?

A

mature teratoma of the endocrine glands

found in endoderm

100
Q

what is this?

in what layer do we find it?

A

mature teratoma of the muscle

found in the mesoderm layer

101
Q

what is this?

in what layer do we find it?

A

mature teratoma of cartilage

found in mesoderm

102
Q

what is this?

A

mature teratoma

103
Q

what is this?

A

mature teratoma

104
Q

how do we identify mature or benign teratomas?

A

most are cystic and almost always lined by skin-like structures

105
Q

where are mature teratomas very common?

A

young women during the active reproductive years

106
Q

if a mature teratoma goes malignant, what is the most common malignant form it takes?

A

squamous cell carcinoma

107
Q

what are the most common monodermal teratomas?

A

struma ovarii teratoma

carcinoid teratoma

108
Q

monodermal teratomas are bilateral or unilateral?

A

unilateral

109
Q

of what tissue is struma ovarii teratoma usually composed of?

what may it cause?

A

mature thyroid tissue, which can be functional

hyperthyroidism

110
Q

ovarian carcinoid teratoma arises from what tissue?

A

intestinal epithelium

111
Q

what can ovarian carinoid teratoma produce and what can it lead to?

A

it can be functional and produce 5-hydroxytryptamine

it may lead to carcinoid syndrome

112
Q

where do we find immature teratomas most commonly?

A

in prepubertal adolescents and young women

113
Q

what tissue do immature teratomas look like?

A

embryonal or immature fetal tissue

114
Q

what is a choristoma?

A

Ectopic pouch of normal tissue

115
Q

what are 2 examples of choristoma?

A
  1. pancreatic tissue in stomach wall
  2. gastric mucosa in Meckel diverticulum
116
Q

what is this?

A

choristoma of gastric mucosa

117
Q

what is this?

A

choristoma

118
Q

what is this?

A

choristoma

119
Q

where are choristomas the most common tumor?

A

epibulbaly and orbitally in children

120
Q

what is a hamartoma?

A

tumor-like malformation

mass of disorganized, but mature specialized cells or tissue indigenous to that site

121
Q

hamartomas are composed of which tissue?

A
  • the tissue specific to the part from which it arises
122
Q

how do we anticipate the growth of a hamartoma?

A

the hamartoma will only grow as much as its surrounding tissue

(growth not seen usually after adolesence)

123
Q

what is this?

A

hamartoma

124
Q

where are hamartoma commonly seen in what organ?

A

lungs

125
Q

what is this?

A

hamartoma of lung

126
Q

what is this?

A

pulmonary hamartoma (nodule)

127
Q

what is this?

A

pulmonary hamartoma (nodule)

128
Q

what are the embryonic tumors that can occur during infancy

A
  1. Wilm’s tumor
  2. Neuroblastoma
  3. Medulloblastoma
  4. Retinoblastoma
  5. Hepatoblastoma
  6. Embryonic sarcoma
129
Q

Neuroblastomas in children occur in what organ?

A

kidneys

130
Q

neuroblastomas in adults or older occur where?

A

along the sympathetic chain

131
Q

what hormones get produced in neuroblastomas that are derived from the sympathetic chain?

A

catecholamines

132
Q

what are these tumor called?

what happens in the future with these tumors?

A

silent

they spontaneously regress and leave only fibrosis or calcification

133
Q

What is Ewing’s Sarcoma?

A

a malignant bone tumor characterized by primitive round cells without differentiation

134
Q

Ewing’s Sarcoma and what other tumor are categorized under the Ewing Sarcoma family tumors?

A

neuroectodermal tumor

135
Q

what is the second most common bone sarcoma in children?

A

Ewing sarcoma

136
Q

Where does ewing sarcoma develop?

A

in the diaphysis of long tubular bones (femur, pelvis)

137
Q

what is characteristic about Ewing’s Sarcoma?

A

periosteal reaction produces layers of reactive bone deposited in an onion-skin fashion

138
Q

What is the genetic basis of Ewing’s sarcoma?

A

translocation generating in-frame fusion of the EWS gene on chromosome 22 to the FLI1 gene

139
Q

what is differentiation of neoplastic cells?

A

how much neoplastic cells look like normal cells on morphology and function

140
Q

what is anaplasia?

A

no differentiation

141
Q

what is this an example of?

A

differentiation

Note: ‘glands’ formed by tumor cells …differentiation

142
Q

How can we differentiate Anaplastic tumors in order to catogorize them as epithelial derived or mesenchymal derived?

A

immunohistochemistry

143
Q

do benign tumors spread?

how differentiated are benign tumors?

A

no

well differentiated

144
Q

how differentiated are malignant tumors?

do malignant tumors metastasize?

A

less differentiated than benign tumors

yes

145
Q

what is this?

A

normal colon histology

146
Q

what is this?

A

adenocarcinoma of colon

note: the abnormal and irregularly shaped glandular elements bordering normal mucosa.

147
Q

what is this?

A

Well differentiated adenocarcinoma

  • shows glandular pattern,
  • cells exhibit features of malignancy
148
Q

what is this?

A

Poorly differentiated adenocarcinoma (anaplastic):

  • shows poor differentiation and bears no resemblance to parent tissue
149
Q

what is this?

A

Squamous cell carcinoma: well-differentiated

150
Q

what is this?

A

Squamous cell carcinoma: poorly- differentiated

151
Q

what can we infer about the cell shape of a malignant tumor?

A

there is variation in size and shape of the cells and its nuclei

152
Q

what can we infer about the cell shape of a benign tumor?

A

they show minimal pleomorphism

153
Q

which tumor (malignant or benign) show hyperchromatism (dense staining of nuclei)?

What is important to remember about hyperchromatism?

A

malignant tumors

***IT does not help to differentiate malignant tumors from benign, or from those which are undergoing hyperplasia or repair.****

154
Q

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?

A

1: 4 or 1:6
1: 1
1: 1

155
Q

what aspect can be seen here?

A

pleomorphism is seen

156
Q

what is characteristic about mitosis in malignant cells?

A
  • there is abnormal/bizarre mitosis
  • can have: tripolar, quadripolar, stellate spindles
157
Q

what is characteristic about this picture?

A

malignant cell

quadripolar spindle

158
Q

what is characteristic about this picture?

A

tripolar spindle

malignant cell

159
Q

how is the spindle of mitosis in benign tumors?

A

normal (bipolar)

160
Q

what is this?

A

stellate spindle in malignant cell mitosis

161
Q

what is this?

A

Bipolar spindle type of mitosis in Normal or Benign tumors

162
Q

what can be noticed about the polarity of cells in a malignant tumor?

In what epithelium can this change in polarity be seen?

A

polarity is lost so orientation is disordered

In: cervix, tracheobronchial, stomach

163
Q

what is this?

A

tumor giant cell

164
Q

what is a tumor giant cell?

A

tumor cells having 2 or more nuclei

165
Q

where are tumor giant cells more common?

A

in sarcomas

166
Q

what is important to remember about tumor giant cells?

A

they are not related or similar to the ones found in TB

167
Q

What is this?

A

Rhabdomyosarcoma Tumor Giant cell

168
Q

What is this?

A

Alveolar soft tissue sarcoma

(with presense of tumor giant cells)

169
Q

what is an example of a tumor giant cell?

A

Malignant Fibrous Histiocytoma (MFH)

170
Q

what is a Malignant Fibrous Histiocytoma (MFH)?

A

contains cells similar to fibroblasts & histiocytes

171
Q

from where or what part of the body do most malignant fibrous histiocytoma come from?

at what age?

A

from the extremities or from the retroperitoneum

50-60’s

172
Q

what is this?

A

tumor necrosis

173
Q

where does tumor necrosis happen?

A

in rapidly growing tumors

174
Q

what is Tumor lysis syndrome?

on who does it happen?

with what illnesses is tumor lysis syndrom associated?

A
  • 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
Q

what is this?

A

adenoma of thyroid showing numerous follicles of varying sizes encapsulated within the thyroid

(Picture: shows crowded follicles with normal thyroid in the periphery)

176
Q

what is this?

A

normal thyroid follicles

177
Q

what is this?

A

follicular adenoma

178
Q

Is there a cytological difference between follicular adenoma and minimally invasive follicular carcinoma?

A

no

179
Q

follicular carcinomas activate what signaling pathway?

A

Ras

180
Q

what is this?

A

follicular adenoma of thyroid

181
Q

how do you differentiate between a adenoma and a well differentiated adenocarcinoma?

A

you check for:

  1. capsular invasion
  2. vascular invasion
182
Q

what is this?

A

thyroid adenoma or adenocarcinoma

183
Q

what is dysplasia?

A

disordered growth

184
Q

where is dysplasia seen?

A

seen in epithelial lined structures (example: cervix)

185
Q

where does dysplasia happen often?

A

occurs in metaplastic epithelium (Barrett’s, respiratory tract in smokers)

186
Q

how is dysplasia known when entire thickness of the epithelium is involved?

A

carcinoma in situ

187
Q

what type of leasion is carcinoma in-situ?

A

pre-invasive lesion

188
Q

what is this?

A

dysplasia

Note: loss of polarity, and atypical cellular/nuclear features involving the entire thickness of epithelium

189
Q

what is this?

A

mild dysplasia

note loss of polarity, atypical cellular/nuclear features limited to lower one-third of the epithelial thickness, mitosis (arrows).

190
Q

what is this?

A

severe dysplasia

Near full thickness architectural disorder with marked nuclear pleomorphism and hyperchromatism, dyskeratosis (white arrows), and upper layer mitoses (black arrows).

191
Q

what is this?

A

dysplasia of cervix

192
Q

what are these (ABC)?

A

cervical intraepithelial neoplasia

A) Mild dysplasia

B) Moderate dysplasia

C) Severe dysplasia (carcinoma in-situ)

193
Q

what are the 4 phases of tumor growth?

A
  1. Malignant change in the target cell (transformation)
  2. Growth of the transformed cells
  3. local invasion
  4. Distant metastases
194
Q
A
195
Q
A

Pathology 1 Block 2 (8 decks)

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