Neoplasia 1 Flashcards
What are the 4 most common cancers in men?
- Prostate (28%)
- Lung and Bronchus (15%)
- Colon and Rectum (9%)
- Urinary Bladder (7%)
What are the 4 most common cancers in women?
- Breast (28%)
- Lung and Bronchus (14%)
- Colon and Rectum (10%)
- Uterine Corpus (6%)
What are the 4 most deadly cancers in men?
- LUNG AND BRONCHUS (29%)
- Prostate (11%)
- Colon and Rectum (9%)
- Pancreas (6%)
What are the 4 most deadly cancers in women?
- LUNG AND BRONCHUS (26%)
- Breast (15%)
- Colon and Rectum (9%)
- Pancreas (7%)
What can be said about the clonality of a Benign vs. a Malignant tumor?
Monoclonal Tumors = Malignant or Benign
- Neoplasia by definition is monoclonal
- Originated from a single cell line
Differentiate the Gross morphologic Characteristics of a Benign vs. Malignant tumor.
- growth
- shape
- edges
- location
Benign:
- SLOW growth
- Well circumscribed Regularly Shaped
- Defined edges
- NO INVASIVE EDGES - VERY important
- NO METASTASIS - Very important
Malignant:
- The opposite, its fast growing (once its detected), CRAB shaped, INVASIVE edges and METASTASIS possible
What two tissue components make up tumors whether they are malignant or benign?
Parenchyma:
- Functional Tissue of the Organ
- THESE ARE THE NEOPLASTIC CELLS
Stroma:
- Connective Tissue, Blood Vessels, and Host-derived Inflammatory Cells.
What Key feature are you looking for in breast tissue to ensure that its not malignant?
Lobules Should not Invade the Fat
What are some cancers that deviate from the normal cancer nominclature?
- Lymphoma
- Mesothelioma
- Seminoma
**all malignant but named as though they are benign
Differentiate a Haratoma and Choristoma.
- define these as benign or malignant.
***Both are benign
Hamartomas:
- Correct Tissues are present for the location but growth is not organized as it should be (e.g. getting a huge lob of cartilage where there should only be a small amt.)
Choristoma:
- Benign (correctly structured tissue) its just growing in the wrong location (e.g. pancreatic tissue in the stomach)
Where are Choristomas most common?
- in what syndrome are they often seen with?
Choristomas:
- Common in the G.I. Tract
Syndrome:
- Meckel’s Diverticulum (failure of Vitelline duct to close correctly)
Differentiate Sarcomas and Carcinomas.
Sarcomas:
- Derived from SOLID Mesenchymal Tissues (CT, Bone, BVs, Fat, etc.) or its derivatives
Carcinomas:
- malignant neoplasms of Epithelium regardless of origin (can arise from any germ layer)
Between Parenchyma and Stroma, which is most important to the Behavior of the neoplasm?
Parenchyma is important for Behavior
Stroma is important for Growth
What type of malignancy typically spreads through the Lymphatics?
- Bloodstream?
- what kind of tissues are these derived from?
Lymphatics:
Carcinomas - EPITHELIUM derived from any germ layer
Bloodstream:
Sarcomas - Mesenchymal Tissue
What is seeding?
- what cancers are known to do this?
Seeding:
- Growth of a Tumor within a body Cavity
Cancers known to do this:
- Mesotheliomas
- Ovarian Cancers
- Brain tumors
Women with late stage ovarian cancer that were asymptomatic because the cancer just seeded on their peritoneum often present with what symptom?
Ascites
Once cancer enters the blood, what two tissues should you suspect it might enter into?
why?
Liver or Lungs
Liver - the site of PORTAL drainage into a capillary bed where cancer gets caught
Lungs - the site of CAVAL drainage into a capillary bed where cancer gets caught
What is vesicular chromatin?
- is this associated with healthy or malignant cells?
Vesicular Chromatin is very clumpy
**Associated with CANCER (malignant cells)
What features are you looking for in:
- Adenoma?
- Squamous Cell carinoma?
Adenoma:
- Glandular in appearance
Squamous:
- Large squamous cells appearance
- Often Keratin Present in Swirls
What cancers in male and females often form adenocarcinomas?
- Breast
- Prostate - known to wrap around nn.
What are the gross and histological Features of Sarcomas?
Gross:
- Often appear very Fleshy
Histo:
- Spindle Shaped
- Hard to cell their cell of origin
What do we call a carcinoma if we can’t tell what kind of tissue it’s trying to be?
Poorly Differentiated
What are 4 general Features we can use to determine whether a tumor is benign or malignant?
- Differentiation
- Rate of Growth
- Local Invasion
- Metastasis
T or F: if a cancer is well differentiated it will continue to carry out its original tissue function.
True, this is why prostate cancer can be monitored by PSA
Similarly well differentiated Hepatocellular Cancers will produce bile, and squamous cells will make keritin
*These cells just carry on with what they were doing in the 1st place
What features Determine Anaplasia?
- Atypical Mitosis
- Hyperchromatic, Vesicular Nuclei
- High N/C ratio (way above 1:1)
- Pleomorphia (different size and shape)
- Giant Cells (mutlinucleate)
How do you differentiate a late stage dysplasia from cancer?
Basement Membrane - if its still in tact then the tissue is just dysplastic
What is a major factor that determines whether or not a cancer is growing fast?
Ischemic Necrosis - this indicates a cancer that is outgrowing its blood supply
Next to Development of Metastasis, what is the most important factor in determining a malignancy?
Local Invasion
T or F: the larger and more anaplastic a tumor is, the more likely it is to have metastasized
True
Where do brain cancers often Seed into?
The ventricles
What non-neurological cancer types often metastasize onto the spinal chord?
- how?
Thyroid
Prostate
- this is done via the paravertebral plexus
Why do we see cancers metastasize into veins more often than arteries?
Veins are more Penetrable
**What are the 8 Hallmarks of Cancer?
- Self-Sufficiency in Growth
- Lack of Response to growth inhibitory Signals (evasion of death)
- Immortality
- Development of Angiogenesis
- Invasion of local tissues and spread to distant sites
- Reprogramming of Metabolic Pathways
- Evasion of Immune system
What is a major way that most cancers alter their metabolic pathways?
- Warburg Effect
- The Switch to Glycolysis (EVEN under aerobic conditions)
What is a Biphasic Tumor?
- are these malignant or benign?
BOTH the parenchyma and Stroma have undergone clonal proliferation
- These can be either malignant or Benign
How do you differentiate a malignant and Benign Biphasic Tumor?
Benign - Stroma and Parenchyma are both enlarged but are well differentiated without enlarged hyperchomratic nuclei or aytipical mitosis
Malignant - Tissue deviates from above standards
What are you looking for in Anaplasia?
- Nuclear Pleomorphism
- Hyperchromatic Nuclei
- Tumor Giant Cells
**tissue just doesn’t appear homogenous
- *What is Ki-67 used for?
- specifically?
**Marker of Cell Growth (not mitosis necessarily)
**Especially important in cancers involving the Brain
How can we tell how fast a cell is growing?
Amount of Mitotic Figures and growth markers like Ki-67
What does it mean to say a neoplastic growth in in situ?
It hasn’t yet penetrated the basement membrane.
What is the 1st lymph node that a cancer can metastasize to called?
The Sentinel Node
How do most childhood malignancies appear on H and E?
Small Round Blue Cell Tumors
Where is a Wilms tumor located?
- Cell type?
Kidney
Small Round Blue Cell
Where is a Ewing Sarcoma located?
- Cell type?
Bone
Small Round Blue Cell
What secondary cancer is often associated with Retinoblastoma?
Osteosarcoma
