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Basic Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Paraneoplastic syndromes in lung adenocarcinoma

A
  • Hypertrophic pulmonary osteoarthropathy.
  • Trousseau’s syndrome.
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2
Q

In general, what makes a tumour malignant?

A
  • Invasion.
  • Metastases.
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3
Q

What is the pathological process in colonic tubulovillous adenoma?

A

Dysplasia.

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4
Q

What is Dysplasia, what does it signify, and what is it seen in

A
  • Morphological term.
  • Describes disorderly proliferation.
  • Signifies the early steps of progression in carcinogeneisis.
  • Seen in pre-malignant tumours.
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5
Q

What does Carcinoma define

A

Describes malignant cancers arising from epithelial type tissues.

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6
Q

What does Sarcoma define

A

Decribes malignant cancers arising from bone and soft tissue (muscle, blood vessels, fat, CT).

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7
Q

What is the most likely malignant diagnosis in a 29-year-old woman living in Australia?

A

Malignant melanoma

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8
Q

What are the most common cancers excluding skin.

Also most common to metastasise.

A

4 B’s:

  • Breast.
  • Bronchus (Lung).
  • Bowel.
  • Brostate.
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9
Q

What are the most common tumours in Childhood

A
  • Osteosarcoma.
  • Ewings.
  • Primitive neuroectodermal tumours (PNET).
  • Medulloblastoma.
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10
Q

Patient with rectal cancer, previous sebaceous adenoma and loss of MLH1 and / or MSH2 proteins.
What is the diagnosis?

A

Muir-Torre Syndrome.

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11
Q

What are the top 3 cancers in Lynch syndrome MSH2 mutation carriers (or EPCAM)

A
  • Colon (50-80%).
  • Endometrial (25 - 60%).
  • Urinary tract (12% women, 28% men).
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12
Q

Chance of developing breast cancer if have mutated BRCA1

A

6 in 10 (60%).

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13
Q

Chance of developing breast cancer if have mutated BRCA2

A

4 in 10 (40%).

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14
Q

Which tumour marker is likely to be elevated in hepatocellular carcinoma?

A

AFP

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15
Q

What cancers can have an elevated Ca 125 and CEA.

A
  • Breast (can also have elevated Ca 15-3, CA27.29).
  • Pancreatic (can also have elevated Ca 19-9).
  • Ovarian.
  • Lung.
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16
Q

What virus is associated with Cervical Cancer and other female genital cancers

A

HPV subtypes 16 and 18

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17
Q

Which infectious organism is associated with Kaposi sarcoma?

A

HHV8.

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18
Q

What are the histological features of Burkitt’s lymphoma

A
  • “Starry sky” appearance
  • Basophilic lymphoma cells (monotonous background of dark cells which looks like the night “sky”).
  • Pale / clear macrophages (“Stars”).
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19
Q

What is the histological feature of cervical cells from HPV

A

Koilocytosis.

Koilocytes =

  • Squamous epithelial cells.
  • Large, irregular perinuclear cavitation (cleared out area around nucleus).
  • Nuclear enlargement.
  • Dense nuclear chromatin (dark nucleus).
  • Rim of condensed cytoplasm around perinuclear cavitation (gives “halo” appearance to cell)
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20
Q

In a textile factory which uses aniline dyes, which cancer is the workers at higher risk of developing?

Aniline dye = aromatic azo dye

A

Bladder cancer

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21
Q

Chemical-industry workers who use benzene are at risk of which cancer?

A
  • Leukaemia.
  • Hodgkin lymphoma.
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22
Q

What is Aflatoxin B-1 and what is it suspected to cause?

A

What it is:

  • Toxin produced by Aspergillus flavus.
  • Grows on mouldy grains and peanuts.

Cause:

  • Liver cancer in underdeveloped countries.
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23
Q

Individuals with Li-Fraumeni syndrome inherit a mutated copy of which tumour-suppressor gene?

A

Tp53

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24
Q

What is Tumour Grading?

A
  • Microscopic description of tumour.
  • Based on how closely a tumour resembles the tissue of origin.
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25
Q

What contributes to the T stage in TNM staging of a melanoma?

A

Thickness of melanoma (Breslow thickness).

Tell you how far melanoma has spread locally

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26
Q

What is T N M staging?

A

Describes spread of tumour:

  • Tumour = size of tumour and any spread into nearby tissue. Given score from 1 - 4.
  • Nodes = spread to LNs. Given score from 0 - 3.
  • Metastasis = spread to other sites of body. Given score from 0 - 1.
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27
Q
A
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28
Q

A 35-year-old male has noticed slight enlargement of right testis and breast enlargement over the past 6 months.
Which kind of testicular tumour is he likely to have?

A

Seminoma.

Germ-cell tumour

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29
Q

What is SIADH, what are the symptoms, and what cancer is it associated with?

A

What it is:

  • Syndrome of inappropriate antidiuretic hormone secretion.
  • Too much ADH –> retention of H20 –> hyponatraemia.

Symptoms:

  • Confusion / disorientation / delirium.
  • Generalised muscle weakness.
  • Myoclonus.
  • Tremor.
  • Asterixis.
  • Hyporeflexia.
  • Ataxia.
  • Dysarthria.
  • Generalised seizures.
  • Coma.

Cancer:

  • Small cell lung cancer.
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30
Q

hypertrophic pulmonary osteoarthropathy

A

associated with adenocarcinoma of lung

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31
Q

75-year-old male with back pain. Radiological evidence of multiple sclerotic lesions are identified in the vertebrae.
What is the most likely primary malignancy?

NB. Osteosclerotic lesions (AKA osteoblastic) = new bone formation.

A

Prostate.

Prostate cancers typically produce osteoblastic (sclerotic) lesions.

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32
Q

What are the features of carcinoid syndrome, what percent of carcinoid tumours have carcinoid syndrome, and what is the cause?

A

Features:

  • Cardiac - pulmonary / tricuscid thickening / stenosis, endocardial fibrosis.
  • Liver - hepatomegaly.
  • GI - diarrhoea, cramps, N+V, retroperitoneal / pelvic fibrosis.
  • Skin - cutaneous flushes, cyanosis.
  • Respiratory - cough, wheeze, dyspnoea.

Percent:

  • 5%.

Cause:

  • Endogenous secretion of vasoactive substances, mainly serotonin and kallikrein.
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33
Q

Which cancers can metastasise to the kidneys, and what is the typical feature in the kidney to indicate this is metastasis and not primary?

A

Cancers:

  • Lungs.
  • Breast.
  • Colon.

Feature:

  • Multiple renal tumours / masses on gross macroscopy.
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34
Q

CT showing liver with multiple nodules.
Is this likely to be primary cancer or metastases?

A

Metastases.

35
Q

What is the normal PRIMARY role of BRCA1 and BRCA2 genes?

A

Transcriptional regulation and DNA repair.

36
Q

Multiple endocrine neoplasia type 1 (MEN 1):
-Main syndrome features

A
  • Pituitary adenoma.
  • Parathyroid hyperplasia.
  • Pancreatic tumours.
37
Q

Multiple endocrine neoplasia type 2 (MEN 2):
-Main syndrome features

A
  • Parathyroid hyperplasia.
  • Medullary thyroid carcinoma.
  • Pheochromocytoma.
38
Q

Multiple endocrine neoplasia type 2B (MEN 2B):
-Main syndrome features

A
  • Mucosal neuromas.
  • Marfanoid body habitus.
  • Medullary thyroid carcinoma.
  • Pheochromocytoma.
39
Q

Paraneoplastic syndromes in lung squamous cell carcinoma

A
  • Humoral hypercalcaemia of malignancy (PTHrP).
  • Pancoast syndrome.
40
Q

Paraneoplastic syndromes in small (oat) cell lung carcinoma

Microscopy: cells with very little cytoplasm and lots of nuclear moulding i.e. appear small.

A
  • SIADH.
  • Lambert-Eaton myasthenic syndrome.
  • Cerebellar degeneration.
  • Cushings^ (from ACTH)

^Sx: HTN, easy bruising

41
Q

What is the term for benign epithelial tumours vs malignant epithelial tumours

A

Benign = adenoma.

Malignant = carcinoma.

42
Q

What is the term for benign smooth muscle tumours vs malignant smooth muscle tumours

A

Benign = Leiomyoma (AKA fibroid in uterus).
Malignant = Leiomyosarcoma.

43
Q

What is the term for benign blood vessel tumours vs malignant BV tumours

A

Benign = Haemangioma.
Malignant = Angiosarcoma.

44
Q

What is the term for benign nerve tumours vs malignant nerve tumours

A

Benign = Neuroma.
Malignant = Malignant peripheral nerve sheath tumour.

45
Q

What is the term for benign fat tumours vs malignant fat tumours

A

Benign = Lipoma.
Malignant = Liposarcoma.

46
Q

What is the term for benign melanocyte tumours vs malignant melocyte tumours

A

Benign = Naevus.
Malignant = Melanoma.

47
Q

Describe the microscopy of uterine leiomyoma (AKA fibroid)

A

Parallel bundles (fascicles) of spindled (elongated) smooth muscle cells.

48
Q

What gene is associated with familial retinoblastoma

A

RB1

49
Q

Li-Fraumeni:
What is Li-Fraumeni syndrome, what gene mutation is it associated with, what is the inheritance, and what cancers can it lead to?

A

What it is:

  • Very rare cancer predisposition syndrome.

Gene mutation:

  • Germline mutations of TP53 tumour suppressor gene (produced p53 protein).

Inheritance:

  • Autosomal dominant.

Cancers:

  • Osteosarcoma.
  • Soft-tissue sarcomas.
  • Breast cancer.
  • Brain tumours.
  • Adrenocortical carcinoma.
  • Leukaemia.
  • Lung ca.
  • Pancreatic ca.
50
Q

What gene is associated with Familial adenomatous polyposis

A

APC

51
Q

What genes are associated with Hereditary nonpolyposis colorectal cancer

A
  • MLH1
  • MSH2
  • MSH6
  • PMS1
  • PMS2
52
Q

What gene is associated with Wilms’ tumour

A

WT1

53
Q

What gene is related to von Hippel-Lindau

A

VHL

54
Q

What gene is related to Cowden

A

PTEN

55
Q

What cancers can have an elevated CEA and Ca 19-9

A

GI:

  • Stomach.
  • Colon.
  • Pancreas.
56
Q

What tumour markers are elevated in prostate cancer

A

PSA

57
Q

What tumour markers are elevated in Testicular cancer

A
  • AFP.
  • HCG.
58
Q

What cancers have been associated with EBV and how has it been linked

A

Cancers:

  • Burkitt lymphoma (“starry sky” histology).
  • Nasopharyngeal carcinoma.
  • Hodgkin’s disease (“owl-eye” cells [Reed sternberg]).
  • B-cell lymphoma in the immunocompromised.

How:

  1. Latent infection with EBV.
  2. EBV binds CD21 on B cells.
  3. Polyclonal B cell expansion with expression of EBV antigen.
  4. Some B-cells killed by EBV-specific cytotoxic T cells.
  5. Some B-cells undergo mutation (MYC tranlocation between Ch 8 and 14).
  6. Proliferation of neoplastic clone cells.
59
Q

What cancers have been associated with Hep B and C chronic liver disease

A

Hepatocellular carcinoma

60
Q

What cancer has been associated with Herpes virus 8 (HHV8)

A

Kaposi sarcoma

61
Q

What cancer has been associated with H.pylori

A

Gastric lymphoma

62
Q

What cancer has been associated with RNA retroviruses (HTLV-1)

A

T-cell leukaemia / lymphoma

63
Q

What chemical carcinogen are mine workers exposed to and what cancer can this cause.

A

Chemical:

  • Nickel.

Cancer:

  • Nasal cavity cancer.
  • Lung cancer.
64
Q

What chemical carcinogen are vineyard workers exposed to, where can this chemical be found, and what can this chemical cause

A

Chemical:

  • Arsenic.

Found in:

  • Fungicides.
  • Alloys.
  • Electrical devices.
  • Medication.

Cause:

  • Skin cancer.
  • Lung cancer.
  • Haemangiosarcoma.
65
Q

What is asbestos, what are some properties, what is its structure, where can it be found, and what can this chemical cause

A

What it is:

  • General term for number of fibrous magnesium silicates.

Properties:

  • Fire-resistant.
  • Good acoustic insulator.
  • Good thermal insulator.

Structure:

  • Long, thin fibres.

Found in:

  • Existing consruction.
  • Fire-resistant textiles.
  • Friction materials.
  • Roofing papers.
  • Floor tiles.

Cause:

  • Lung mesothelioma.
  • Asbestosis.
  • Pleural fibrous plaques.
  • GI cancers.
66
Q

Where can Radon be found, and what cancers can this chemical cause

A

Found in:

  • Quarries.
  • Mines.

Cancer:

  • Lung.
67
Q

Where can vinyl chloride be found, and what cancers can this chemical cause

A

Found in:

  • Refrigerant.
  • Plastic adhesives.

Cancer:

  • Hepatic angiosarcoma.
68
Q

Where can beryllium be found, and what cancers can this chemical cause

A

Found in:

  • Aerospace applications.
  • Nuclear reactors.

Cancer:

  • Lung.
69
Q

Where can Cadmium be found, and what cancers can this chemical cause

A

Found in:

  • Batteries.
  • Alloy.
  • Metal plating and coating.

Cancer:

  • Prostate.
70
Q

Where can chromium be found, and what cancers can this chemical cause

A

Found in:

  • Metal alloys.
  • Paints.
  • Pigments.

Cancer:

  • Lung.
71
Q

Where can ethylene oxide be found, and what cancers can this chemical cause

A

Found in:

  • Fruit / nut ripening agents.
  • Rocket propellant.
  • Fumigants.
  • Sterilants.

Cancer:

  • Leukaemia.
72
Q

What is the protein produced by gene TP53 and what is it’s role.

A

Protein:

  • p53.

Role:

  • Monitors cell stress.
  • Prevents cancer by inducing transient cell cycle arrest to allow repair of damaged DNA.
  • If damaged DNA unable to be repaired induces cell senescence OR apoptosis.
73
Q

What is familial adenomatous polyposis coli and what can it transform into?

A

What it is:

  • Condition of large intestine.
  • Multiple adenomatous polyps.

Transform into:

  • Colonic adenocarcinomas.
74
Q

What cancer is neurofibromatosis type 1 associated with

A

Neurofibrosarcoma

75
Q

What are the features of von Hippel-Lindau syndrome and what is it a risk factor for?

A

Features:

  • Retinal angiomas.
  • Cerebellum haemangioblastomas.
  • Cysts in kidney, liver, pancreas, epididymis.
  • Renal haemangioblastoma.

At risk of:

  • Renal carcinoma.
76
Q

What is Tumour Staging?

A
  • How much cancer there is in the body and how far it has spread.
  • TNM staging.
77
Q

What cancer is most commonly associated with hypercalcaemia?

A

Squamous cell carcinoma.

78
Q

What are paraneoplastic syndromes and what are some examples.

A
  • Disease manifestations that occur with but NOT due to cancer in the tissues / organs concerned.
  • Can be due to secretion of soluble, specific factors by the tumour.
  • Symptoms of disease manifestations can occur before underlying cancer detected.
  • Removal of primary cancer MAY cause syndrome to subside.

Examples:
* General - anorexia, weight loss, low-grade fever (due to TNF and IL-6), weakness / fatigue.
* Endocrine-related e.g. Cushings (usually seen with small cell carcinomas).
* SIADH.
* Lambert-Eaton Myasthenic syndrome.
* Hypertrophic pulmonary osteoarthropathy.

79
Q

What is Lambert-Eaton Myasthenic Syndrome (LEMS), what are the symptoms, and what cancer is it associated with?

A

What it is:

  • Rare, autoimmune disorder in < 10 yo or > 40 yo.
  • Autoimmunity against voltage-gated calcium channels on presynaptic motor nerve terminals –> loss of functional channels on motor nerve terminal.
  • Can be a paraneoplastic syndrome (50%).

Symptoms:

  • Muscles - weakness, fatigue, pain.
  • Difficulty walking.
  • Hyporeflexia.
  • Speech impairment.
  • Swallowing problems.

Cancer:

  • Small cell lung cancer.
80
Q

What cancer is hypertrophic pulmonary osteoarthropathy and digital clubbing commonly associted with?

A

Non-small cell lung cancers (usually adenocarcinoma).

81
Q

What is Cushing’s syndrome, what are the features, what cancer is it associated with and why?

A

What it is:

  • Excess adrenal glucocorticoids.

Features:

  • Central obesity.
  • Diabetes.
  • Fatigue.
  • HTN.
  • Osteoporosis.
  • Acne.
  • Stretch marks.
  • Muscle weakness.
  • Anxiety / depression.
  • Moon face.
  • Peripheral muslce wasting

Cancer:

  • Small cell lung cancer.

Why:

  • Excess ACTH secretion from small cells of lung
82
Q

What cancers are osteolytic bone lesions commonly associated with

A
  • Multiple myeloma.
  • Breast cancer.
83
Q

What cancer is commonly associated with cryptorchidism (undescended testis) and if untreated what other conditions can it cause?

A

Cancer:

  • Seminoma (germ cell tumour).

Other conditions:

  • Torsion.
  • Infertility.

Basic Pathology (14 decks)

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