Neoplasia 1 And 2 Flashcards by Iseoluwa Ojo

Metaplasia in the Cervix:

Normal epithelium
Metaplastic epithelium
Factors that Initiate Metaplasia

Simple columnar
Squamous
Low PH, HPV infection

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Metaplasia in the urinary bladder:

Normal epithelium
Metaplastic epithelium
Factors that Initiate Metaplasia

Urothelium
Squamous
Stones, schistosoma infection

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Metaplasia in the stomach:

Normal epithelium
Metaplastic epithelium
Factors that Initiate Metaplasia

Simple columnar
Intestinal type with goblet cells
H.pylori

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Premalignant lesion: Bronchial dysplasia

Malignancy :

Sites:

Carcinoma

Bronchus

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Premalignant lesion: liver cirrhosis

Malignancy :

Sites:

Hepatocellular carcinoma

Liver

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Premalignant lesion: cervical dysplasia

Malignancy :

Sites:

Squamous cell dysplasia

Cervix

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Premalignant lesion: endometrial hyperplasia

Malignancy :

Sites:

Endometrial carcinoma

Endometrium

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Premalignant lesion: solar keratosis

Malignancy :

Sites:

Squamous cell carcinoma of the skin

Skin

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Premalignant lesion: chronic ulcerative colitis villous adenoma of the colon

Malignancy :

Sites:

Adenocarcinoma

Colon

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Premalignant lesion: atrophic gastritis with intestinal metaplasia and dysplasia

Malignancy :

Sites:

Gastric carcinoma

Stomach

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A neoplasm is ____________ , the growth of which _______________ with that of the normal tissues and persists in the same excessive manner after ______________________ .”

an abnormal mass of tissue

exceeds and is uncoordinated

cessation of the stimuli which evoked the change

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Cancer:

Is the _________________________ that grow beyond __________ and which can then ______________ of the body and spread to other organs” (WHO 2012)

Rapid creation of abnormal cells

their usual boundaries

invade adjoining parts

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Nowell’s law:

Cancer can be defined as _____________ that have acquired ____________ which confers __________ over normal cells

an overgrowth of cells

cumulative genetic damage

growth advantage

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Three important characteristics of malignant cells are:??

Immortalization
Invasion
Metastasis

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Immortalization- Uncontrolled _______

Invasion of _________

Metastasis via _________

proliferation

adjacent structures

lymphatics or blood

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Differences between Normal and Malignant cells

Contact inhibition
Growth factor secretion
Oncogene expression
Tumor suppression gene

Intact; lost

Coordinated; random increase

Rare; increased

Presence; loss

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Tumours may be classified based on clinical or morphology characteristics

Clinical classification : based on its morbid anatomy & clinical behaviour
_____
_______

Morphologic classification is based on its cell of origin (using histologic features)
_________
________

Benign; Malignant

Epithelial; mesenchyme

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Diff. btw benign & malignant Tumour

Spread
Growth rate
Boundaries
Relations
Effects

Localized; metastasize

Usually slow; usually rapid

Encapsulated; irregular, no capsule

Compress; invade and destroy

Pressure effect ; destroys leading to death

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Benign cells are cancer cells

T/F

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Malignant cells are cancer cells

T/F

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Benign tumor cells can spread by invasion

T/F

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A tumour is made of the _____ and the ____________

stroma; neoplastic cells (parenchyma).

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Stroma refers to the __________ within which the tumour cells are dispersed

connective tissue

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The nomenclature of a tumor is based mainly on the _____ component which are the actual tumour cells (cell of origin)

parenchymal

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Benign mesenchymaL tumours are named by ______________

Attaching Oma to their cell of origin

Benign mesenchymaL tumours Fibroblast → ______. Bone → ________ . Fat → ______.

fibroma osteoma lipoma

Benign mesenchymaL tumours Blood vessel - > ________. Peripheral Nerve→_______ Lymph vessel →_____________.

haemangioma Neuroma lymphangioma

Benign mesenchymaL tumours Cartilage → ________ Meninges → ________ Smooth muscle → ______ Skeletal muscle → __________

chondroma meningioma leiomyoma rhabdomyoma

For benign epithelial tumours, Papilloma –tumour _____________ Adenoma-tumour forming_______________ or ___________

raised above an epithelial surface e.g squamous, transitional glandular structures or arising from parenchyma organs

For benign epithelial tumours, Cystadenoma-forming ________________ Papillary cystadenoma- __________

glands & cystic spaces e.g ovary above with papillary

Benign epithelial tumour nomenclature Nevus- benign tumour of ___________ Trophoblastic tumour – ___________ Polyps- lesion in __________________

melanocytes (in the skin) hydatidiform mole(placenta) hollow organs raised above mucosa

Intestinal Polyp of the intestine (adenomatous polyp) is not premalignant T/F

F It is

Malignant mesenchymal tumours are called ________

Sarcomas

Cell type —— Malignant mesenchymal Fibroblast Lipoblast Blood vessels Smooth muscle

Fibrosarcoma Liposarcoma Hemangiosarcoma Leimyosarcoma

Cell type —— Malignant mesenchymal Skeletal muscle Cartilage Bone

Rhabdomyosarcoma Chondrosarcoma Osteosarcoma

Malignant epithelial tumours Adenocarcinomas- form _____________________ Squamous cell carcinoma-arising from a ____________ Melanocarcinoma-from ___________ Choriocarcinoma-malignant tumour of ________

glands/arise from a parenchyma organ squamous epithelium melanocytes placenta

Mixed tumours-have _____________________

more than one type of neoplastic cells

Mixed tumors Pleomorphic adenoma – of ________ composed of both ______ and _____ elements Fibroadenoma –benign tumour of ______ composed of both ______ and _______ components Wilm’s tumour-malignant tumour of ______ affecting ______

salivary gland; epithelial and mesenchymal breast ; glandular epithelial and fibrous kidney; children

Differences between carcinoma and sarcoma Cell type Stroma Spread Metastasis Hemorrhage and necrosis Fatality

Epithelial; mesenchyma Abundant; scanty, fleshy To lymphatics; to blood Occurs late; occurs early Less frequent; more frequent Less fatal; more fatal

Wilm’s tumor : __________________

Nephroblastoma

Misnomer terms- Choriostoma –_______ of _____ tissue in ______ location e.g normal pancreatic tissue in the _______

ectopic rest normal abnormal intestinal wall

Misnomer terms- Harmatoma –mass of ______ but ————— cells _______ to the site

disorganized mature specialized indigenous

Harmatoma is a true tumor T/F

Chroriostoma is a true tumor T/F

Misnomer terms- ▪ Seminoma- (benign or malignant?) tumour of the ________ ▪ Melanoma-(benign or malignant?) tumour of the _________

Malignant ; Testes malignant; melanocytes

Seminoma Benign or malignant?

Malignant

melanoma Benign or malignant

Malignant

Teratomas are tumours which contain —————- derived from ________

>1 neoplatic cell > 1germ cell layer

Origin of teratomas: _________cells in the gonads or in _______ cell rests

Toti potential embryonic

All teratomas are malignant T/F

F Can be classified as matured (benign] and immature[malignant]

Common sites of teratomas - ______,  ______, _________, ____________

ovary; testes; mediastinum sacrococcygium

Special type of teratoma – _________ in the ovary contains _________ tissue

struma ovarii only thyroid

Differences btw benign and malignant teratomas Components are mature or immature Gross appearance Prognosis

Mature; immature Cystic; solid Good; fatal

Cancer is a communicable disease T/F

F non-communicable

Cancer also affects the young T/F

Cancer is the ____ common cause of death in developed countries and among the ______ leading causes of death in developing countries.

2nd three

Cancer occurs in (males or females ?) 2xs more than in (males or females?)

Females Males

WHO defined Epidemiology as the study of the ______ and ________ of health-related states or events (including disease), and the _______ of this study to the ______ of diseases and other health problem

distribution determinants application control

Complex diseases are caused by the interaction of ______________

genes and environmental factors

Complex diseases are also called ______

multifactorial

Risk factors of cancer- Hereditary (____ %)-mutation of _____ that are _____ in family Familial (____%)- _______ and ____factors Sporadic or acquired (____%)- cancer occurring by chance in general population due to _______ and _____ factors

5-10 ; genes; inherited 10-20 ; multiple genes and environmental 70-80 ; lifestyle & environmental

Heredity in Cancer: inherited cancer syndromes Certain cancer genes are inherited as autosomal dominant predisposing individuals to cancer e.g  ___________,  ______________,  _____________,  __________________ syndrome.

retinoblastoma familial adenomatous polyposis neurofibromatosis Multiple endocrine neoplasm(MEN)

Heredity in cancer incidence _____________ _____________ Autosomal ________ of defective DNA repair

Inherited cancer syndrome Familial cancers recessive syndromes

Transmission pattern of familial cancers are clear T/F

Familial cancers have a specific marker T/F

Heredity in Cancer : Familial cancers Multiple genetic mutations, that runs in family ______, ______,  ______,  _____  _____ etc

Breast colon Ovary Brain Stomach

Heredity in Cancer: Autosomal recessive syndromes of defective DNA repair Individuals with the following conditions have _______________ and thus ______________

defect in ability to repair DNA damage predisposed to mutation that increase cancer risk

Heredity in Cancer: Autosomal recessive syndromes of defective DNA repair  ___________ ————— ___________ ————— ___________ —————— _____________ ————

Xeroderma pigmentosum Bloom’s syndrome, Fanconi anemia. Ataxia telengiectasia

Difference between hereditary and acquired Cancer Risk factors Modifiable or not? Preventable or not? 2 examples each

Not; modifiable Not; preventable Rb gene, BRCA gene; diet, microorganisms

Cancer risk ___eases with increasing age

incr

certain tumours are seen exclusively in children while others are commonly found in adults T/F

List 5 Common childhood cancers

Retinoblastoma Burkitt’s lymphoma Nephroblastoma Leukemias Neuroblastomas

Environmental Risk factors Ultraviolet and X-ray can cause __________ cancer

Skin, breast, thyroid

Environmental Risk factors Pollution from burning fuels can cause _______ cancer

Lungs

Environmental Risk factors Benzene: ______________ Dyes: __________

Blood cancer Bladder cancer

Social Risk factors of cancer Tobacco→cancer of the __________________________ Alcohol→cancer of the _____ ,_______,_______ Obesity or overweight→ ____,_____,_______

lungs, mouth, stomach, pancreas, breast, cervix liver, stomach and breast breast, colon, womb

Social risk factors of cancer Early exposure to sex→cancer of the ______ Multiple sexual partners→cancer of the ____,______ (through ____ and ______ virus)

cervix cervix, liver HPV; hepatitis B

Inactivity is a social risk factor to cancer! T/F

Tobacco Kills ___% of its users

Westernized food which is high in animal protein and fat are major risk factors for _______ cancer.

colorectal

Eating of smoked and salted food in form of ‘barbecue meat’, ‘suya’ or ‘kilishi’ or ‘eran oniyo’, ‘smoked fish’ may also predispose to cancer of the _______.

stomach

Lack/inadequate intake of fresh fruits and vegetables → _______ cancer

colon

Aflatoxin from ________ such as _______ is associated with _____ cancer particularly in the presence of ______ virus

improperly preserved grains groundnut liver hepatitis B

Micro-organisms and Associated Malignant Tumours Hepatitis B/C virus— Human Papillomavirus- Epstein Barr virus- HIV-

Liver cancer Cervical cancer Burkitt’s lymphoma; nasopharyngeal cancer High grade Bcell lymphoma

Micro-organisms and Associated Malignant Tumours Parasite Schistosoma haematobium

Squamous cell carcinoma of the urinary bladder

The risk factors of breast cancer ______ gender ___easing age _______ relative with breast cancer abnormal genes (____,_____genes) ____parity (Early or late?) age at first pregnancy and (shorter or longer?) reproductive span

Female incr maternal BRCA 1, BRCA2 nulli Late Longer

Risk factors of breast cancer (early or late?) menarche __yrs (Early or late?) menopause ___yrs

Early; <12 Late; >50

Obesity is a risk factor for breast cancer T/F

Breastfeeding your babies is a way to reduce risk for breast cancer T/F

Getting enough sleep is a way to reduce risk for breast cancer T/F

Predisposing/risk factors to cervical cancer  Genital tract ___ infection in >___% of cases  Early exposure to _______.  History of ________.  Cigarette smoking  Poverty  Poor nutrition and lack of micronutrients.  Immune deficiencies (e.g HIV)

HPV; 90 sexual intercourse multiple sexual partners

no HPV, no ________’

cervical cancer

Prostate cancer –risk factors  _____ race,  age above ___ years,  positive ________,  Obesity  high fat diet  high serum _____ levels; the latter being most consistent.

Black 40 family history androgens

Cigarette smoking can lead to buerger’s disease T/F

Willis Definition: “A neoplasm is _____________ .”

an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change

tumors are dependent on the host for their nutrition and blood supply T/F

Glioma – (Benign or Malignant?) tumor of _____ It (does or does not?) metastasize

Malignant CNS Does not

Sarcomas are fleshy T/F

List 5 malignant tumors with suffix ‘oma’

Hepatoma- liver Melanoma- melanocytes Seminoma- testes Lymphoma- lymph nodes Mesothelioma- pleural, peritoneal

Polyps It may have a stalk (__________ polyp) or may be without a stalk (_______ polyp).

pedunculated sessile

Eponymously named tumors and their cells of origin Burkitt’s lymphoma Ewing sarcoma Grawitz tumor Kaposi’s sarcoma Hodgkin’s lymphoma Brenner tumor

B cell lymphoma Bone Renal tubules epithelium Vascular endothelium Post-germinal B cells Epithelium of ovary

Embryonal Tumors Mention 4

Retino Neuro Nephro Hepato

Common chemical carcinogens Beta naphthylamine[rubber industry]- _______ Ca Asbestos-_________ Nitrosamine[beverage,beer] - ____ cancer Benz pyrene[cigar]- ____ Ca Aflatoxin B1 [promoter]-_____ Ca Vinyl chloride- liver haemangiosarcoma Nickel, chromium-____ Ca Arsenic-_____ cancer

bladder mesothelioma GIT lung liver lung skin

Diseases caused by H. pylori are: (1) peptic ulcers, (2) gastric _______, and (3) gastric ______.

adenocarcinomas lymphomas

Mention a parasite that can cause cholangiocarcinoma

Clonorchis sinensis

Human herpes virus -8 causes _____ cancer Merkel cell polyoma virus causes ______

Kaposi sarcoma Merkel cell carcinoma

tumor suppressor genes When loss of gene function is caused by damage to a single allele, it is called ———-.

haploinsufficiency

In Burkitt lymphoma, most common translocation t (__:___)

8:14

. For example, Philadelphia (Ph) chromosome in _______. Balanced reciprocal translocation between long arm of chromosomes _____ and _____ ,

chronic myelogenous leukemia 9 and 22

Deletion is common with ______ genes Example: Deletion of ____ gene (involving chromosome 13q14) is associated with retinoblastoma.

tumor suppressor RB

Which is more important, the stage or grade of a tumor

Stage

Stage— T1 T2 T3 T4

Limited to mucosa and submucosa Extension into but not through muscularis propria Invasion of perirectal fat Invasion of adjacent structures

Based on world wide stats, which continents have the most cancer cases

Asia, then europe, then north ameriac, then AFRica!!

Most common cancer in Nigeria is ??

Breast

In Africa,___ % of cancer deaths are due to diet, tobacco and infections