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Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Which carcinomas are special in that their main mode of metastasis is via hematogenous spread?

A
  1. Follicular Thyroid CA
  2. Choriocarcinoma
  3. Renal cell CA
  4. Hepatocellular CA
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2
Q

Too much exposure to aniline dyes can lead to which cancer?

A

Bladder urothelial CA

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3
Q

What proto-oncogene (when mutated) can lead to neuroblastoma?

A

N-MYC

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4
Q

An abnormal mass of tissue with excessive and uncoordinated growth compared to that of a normal tissues ; its growth persists after cessation of the stimuli that evoked the growth ; literally means new growth.

A

Neoplasm

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5
Q

Localized neoplasms with names usually ending with -oma, except lymphoma, seminoma, dysgerminoma, hepatoma and melanoma ( these are malignant neoplasm)

A

Benign neoplasm

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6
Q

Neoplasms that invade and destroy adjacent tissues?

A

Malignant neoplasms

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7
Q

Malignant neoplasms of epithelial origin usually spread by Lymphatic route eg. Colorectal adenocarcinoma

A

Carcinomas

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8
Q

Malignant neoplasms of mesenchymal origin, usually spread by hematogenous route, eg. Uterine leiomyosarcoma?

A

Sarcomas

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9
Q

Benign but disorganized appearance of tissue indigenous to a particular organ eg. Peutz -Jegher Polyp

A

Hamartoma

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10
Q

Cytologically and architecturally normal tissue in an ectopic location. Eg Ectopic gastric tissue in Meckel Diverticulum.

A

Choristoma ( Basically, Ectopia)

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11
Q

Extent to which neoplastic cells resemble their normal forebears morphologically and functionally.

A

Differentiation

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12
Q

Considered hallmark of malignancy , which literally means “ to form backward” , term used to describe cells with little or no differentiation.

A

Anaplasia

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13
Q

Disorderly cellular proliferation described as a loss in uniformity of individual cells and of their architectural orientation?

A

Dysplasia

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14
Q

Fibrous tissue formation in response to neoplasm.

A

Desmoplasia

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15
Q

Dysplastic changes that involve the entire thickness of the epithelium , without violation of the basement membrane?

A

Carcinoma in situ

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16
Q

Development of secondary implants discontinuous with the primary tumor in remote tissues, more than any other attribute , this identifies a neoplasm as malignant.

A

Metastasis

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17
Q

Next to metastasis , this is the most reliable feature that distinguishes malignant from benign tumors?

A

Local invasion

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18
Q

Top 3 common cancers in males?

A
  1. Prostate
  2. Lung
  3. Colorectal
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19
Q

Top 3 common cancers in females?

A
  1. Breast
  2. Lung
  3. Colorectal = Uterine corpus
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20
Q

Top 3 common cancers mortality in males?

A
  1. Lung
  2. Prostate
  3. Colorectal
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21
Q

Top 3 common cancer mortalities in females?

A
  1. Lung
  2. Breast
  3. Colorectal = Pancreas
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22
Q

Hallmarks of Cancer? (8)

A
  1. Self- sufficiency in growth signals
  2. Insensitivity to growth inhibitory signals
  3. Altered cellular metabolism
  4. Evasion of apoptosis
  5. Limitless replicative potential (immortality)
  6. Sustained angiogenesis
  7. Ability to invade and metastasize
  8. Ability to evade the host immune response
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23
Q

Normal cellular genes whose products promote cell proliferation; examples : RAS (most commonly mutated proto-oncogene in human cancers) and ABL (in MCL)

A

Proto-oncogenes

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24
Q

Mutant or over expressed versions of proto-oncogenes that function autonomously without a requirement for normal growth-promoting signals .

A

Oncogenes

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25
Q

Genes whose products apply brakes to the cell proliferation, abnormalities in such leads to carcinogenesis.

A

Tumor suppressor genes

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26
Q

Governor of proliferation, a tumor suppressor gene that exerts anti-proliferative effects by controlling G1-S checkpoint in the cell cycle.

A

Rb

governoRb

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27
Q

Guardian of the genome, a tumor suppressor gene that regulates cell cycle progression, DNA repair, Cellular senescence, and apoptosis , the most frequently mutated tumor-suppressor gene in human cancers, mutated in Li-Fraumeni Syndrome.

A

p53

( Police 53)

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28
Q

Fermentative glucose metabolism by cancer cells , even in the presence of oxygen , which provides metabolic ingredients of synthesis of cellular constituents.

A

Warburg Metabolism

Ferment Wine : Warburg

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29
Q

Progressive loss of body fat and lean body mass accompanied by profound weakness , anorexia, and anemia in cancer patients, mediated by cytokines (TNF, IL-1, IL-6, Lipid mobilizing factor)

A

Cancer cachexia

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30
Q

Signs and symptoms not referable to the anatomic distribution , usually due to an ectopic hormone production by tumor cells eg. Ectopic ACTH Production (Cushing Syndrome) in small cell lung cancer, Hypercalcemia in squamous cell carcinoma Lung ( due to PTHrp expression).

A

Paraneoplastic Syndrome

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31
Q

Term used to describe the degree of differentiation based on histologic appearance of tumor eg. Gleason scoring in Prostatic adenocarcinoma?

A

Tumor grade

( high grade - malignant, low grade - less likely)

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32
Q

Term used to describe the degree of localization/ spread of the tumor, usual criteria: location and size of the primary tumor, nodal status, and presence of distant metastasis, has more prognostic value than tumor grade. Eg AJCC cancer staging system TNM.

A

Tumor stage

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33
Q

Conditions secondary to release of products of dying cancer cells during chemotherapy, characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia.

A

Tumor lysis syndrome

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34
Q

Which of the following malignancies has propensity for hematogenous spread?
a. Breast carcinoma
b. Prostatic CA
c. Sarcoma
d. Lymphoma

A

Sarcoma

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35
Q

Mutation that leads to acquisition of cancer hallmarks?

A

Driver mutation

36
Q

Virus responsible for Burkitt’s lymphoma ?

A

Epstein Barr Virus

Epstein BUR virus

37
Q

Cancer correlated to urinary schistosomiasis, Schistosoma haematobium.

A

Squamous Cell Carcinoma of the Urinary Bladder

38
Q

Percentage of alcoholics that will develop cirrhosis ?

A

10-15%

39
Q

Feature seen in prostatic adenocarcinoma?

A

Perineural spread of the tumor

40
Q

In meningomyeloceles , the route of infection to the nervous system is through ?

A

Direct implantation

41
Q

In performing biopsies on palpable lesions, which microscopic finding is more likely indicative that the lesion is malignant?

A

Invasion to adjacent tissues

42
Q

Metastasis of tumors of the kidney and liver can reach the heart ang pericardium through?

A

Hematogenous seeding

43
Q

Features of MEN 1.

A
  1. Primary tumors ( prolactin or GH)
  2. Pancreatic endocrine tumors
    - Zollinger-Ellison Syndrome
    - Insulinomas
    - VIPomas
    -Glucagonomas (rare)
  3. Parathyroid adenomas
  4. Associated mutation of MEN 1
    -Tumor suppressor gene
    -Codes for menin
    -Chromosome 1 angiofibromas
    -Collagenomas
    -Meningiomas

Mnemonic: Disease in Pituitary, Parathyroid, Pancreas

44
Q

Features of MEN 2A .

A
  1. Parathyroid hyperplasia
  2. Medullary thyroid carcinoma - neoplasm of para follicular C cells, Secretes calcitonin, prophylactic thyroidectomy required
  3. Pheochromocytoma- secretes cathecolamines
  4. Associated with mutation in RET
    - Protooncogene
    -Codes for receptor tyrosine
    -Chromosome 10

Mnemonic: only type Affects Adrenal glands

45
Q

Features of MEN2B

A
  1. Medullary thyroid carcinoma
  2. Pheochromocytoma
  3. Mucosal neuromas A ( oral, intestinal, ganglioneuromatosis)
  4. Associated with *Marfanoid habitus** mutation in RET genes

Mnemonic: only type that has ORAL manifestations (MEN 2B Kissed)

46
Q

Diffuse Gastric Adenocarcinoma Features

A
  1. Not associated with H.pylori
  2. E-cadherin mutation
  3. Signet ring cells ( mucin filled cells with peripheral nuclei)
  4. Stomach wall is grossly thickened and leathery ( lintis plastica)
47
Q

Medullary Thyroid CA morphology?

A

Chief cell hyperplasia and (+) Amyloid

48
Q

More sensitive tumor marker of Medullary Thyroid CA?

A

Calcitonin

49
Q

Better predictor of prognosis in Medullary Thyroid CA?

A

CEA

50
Q

Patent urachus is a risk factor for which type of carcinoma of the bladder?

A

Adenocarcinoma

51
Q

Smoking is a risk factor for which type of carcinoma of the bladder?

A

Transitional Cell Carcinoma

Smoking Trans

52
Q

Chronic irritation and S. haematobium are risk factors for which type of carcinoma of the bladder?

A

Squamous cell carcinoma

Mnemonics: Schistosoma x Squamous

53
Q

Cancers that has point mutations of RAS family genes? (6)

A

Pancreatic adenocarcinoma 90%
Colon 50%
Thyroid 30%
Lung adenocarcinoma
Myeloid Leukemia
Cholangiocarcinoma

54
Q

Cancer that has point mutations of BRAF family genes? (2)

A

Hairy Cell Leukemias 100%
Melanoma 60%

55
Q

Cancers that has point mutations of BCR-ABL genes?

A

Chronic Myelogenous Leukemia
( Philadelphia Chromosome)

56
Q

Cancers that has point mutations of NMYC and LMYC genes?

A

Neuroblastoma

MYC - Burkitt Lymphoma

57
Q

Cancers that has point mutations of Platelet Derived Growth Factor (PDGF and PDGFR) Receptor genes?

A

Glioblastoma

58
Q

What cancer has mutations in ERBB1 receptor encoding EGFR ?

A

Lung Adenocarcinoma

59
Q

What cancer has mutations in ERBB2 receptor encoding HER 2 ?

A

Breast Carcinomas

60
Q

What cancer has mutations in EML4-ALK fusion gene ?

A

Lung adenocarcinoma

Mutations in receptor tyrosine kinases:
- EML4-ALK
-ERBB1
-EGFR

61
Q

Cancer involved in overexpression of PDGF-B ?

A

Astrocytoma

62
Q

Cancer involved in overexpression of Fibroblast growth factor HSTI ?

A

Osteosarcoma

63
Q

Cancer involved in amplification of Fibroblast growth factor 3 (FGF3) ? (4)

A

Stomach
Bladder
Breast
Melanoma

64
Q

Cancer involved in overexpression of TGF-a ?

A

Astrocytoma

Overexpression of growth factors:
PDGF-B
TGF-a

65
Q

Cancer involved in overexpression of HGF? (2)

A

Hepatocellular Carcinoma
Thyroid Cancer

66
Q

Cancer involved in point mutation and translocation of JAK/STAT signal transduction ? (2)

A

Myeloproliferative Disorders
Acute Lymphoblastic Leukemia

67
Q

Cancer involved in the translocation of CCNDI 1 ( Cyclin D1 ) ? (2)

A

Mantle Cell Lymphoma
Multiple Myeloma

68
Q

Cancer involved in the amplification of CCNDI 1 ( Cyclin D1 ) ? (2)

A

Breast & Esophageal Carcinoma

69
Q

Cancer involved in the amplification & point mutationof CDK4 ? (3)

A

Glioblastoma
Melanoma
Sarcoma

70
Q

Oncogenes involved in Melanoma with their mode of activation? (4)

A
  1. Fibroblast Growth Factor (FGF 3) - amplification
  2. GTP binding protein NRAS- point mutation
  3. RAS signal transduction BRAF- point mutation
  4. Cyclin Dependent kinase CDK4 - amplification & point mutation
71
Q

Tumor antigens - help tumor eradication. (6)

A
  1. CEA
  2. AFP
  3. CA-125 & CA 19-9 : Ovarian Carcinoma
  4. MUC-1 : Ovarian & Breast CA
  5. CD 20 : Mature B cell Lymphomas & Leukemias
  6. CD 30: T cell lymphomas and most Hodgkin Lymphomas
72
Q

CML translocation and affected genes?

A

Translocation :
9,22
Affected Genes:
ABL , BCR

Grandmother 92 yo has CML not ABL to go to Bath at CR

73
Q

AML translocation and affected genes?

A

Translocation
8;21 & 15;17
Affected genes
AML
ETO
PML
RARA

74
Q

Burkitt Lymphoma translocation and affected genes?

A

Translocation
8;14
Affected genes
MYC
IGH

75
Q

Mantle Cell Lymphoma translocation and affected genes?

A

Translocation
11;14
Gene affected
CCNDI
IGH

76
Q

Ewing Sarcoma translocation and affected genes?

A

Translocation
11;22
Affected gene
FLI 1
EWSRI

77
Q

Prostatic Adenocarcinoma translocation and affected genes?

A

Translocation
7;21
17;21
Gene affected
TMPRSS2
ETV I

78
Q

HNPCC / Lynch Syndrome develop carcinomas of cecum and proximal colon due to mutations of one or more of its polyps. What are the genes involves in its DNA mismatch repair? (2)

A

MSH2
MLH1

79
Q

Paraneoplastic syndrome of Squamous Cell carcinoma of the Lungs?

A

Hypercalcemia

80
Q

Paraneoplastic syndrome of small cell carcinoma of the lungs?

A

Endocrinopathies : Cushing Syndrome

81
Q

Paraneoplastic syndrome of gastric, lung and endocrine carcinomas?

A

Acanthosis nigricans : Leser trelat sign

Note: Due to secretion of epidermal growth factors

82
Q

Paraneoplastic syndrome of pancreatic or lung cancer?

A

Migratory Thrombophlebitis : Trousseau Syndrome

83
Q

Paraneoplastic syndrome of acutepromyelocytic leukemia and prostatic adenocarcinoma?

A

DIC ( Disseminated Intravascular Coagulation )

84
Q

Cancers that shows Myasthenia as paraneoplastic syndrome?

A

Bronchogenic carcinoma
Thymic carcinoma

Note: check thymus & lungs in myasthenic patients

85
Q

Paraneoplastic syndromes caused by thymic & bronchogenic carcinomas? (3)

A

Myasthenia
Hypertrophic osteopathy & Clubbing of fingers

Pathology (23 decks)

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