neoplasia Flashcards
1
Q
what is the most common characteristic of neoplasia
A
autonomous cell proliferation
2
Q
what is a neoplasm in general terms
A
a new growth
3
Q
what is a neoplasm in technical terms
A
an abnormal mass of tissue, that grows more & differently than normal tissue
4
Q
2 basic components that all tumors have (benign or malignant)
A
-parenchyma
-supportive stroma
5
Q
what is parenchyma
A
neoplastic proliferating cells
6
Q
what is supportive stroma
A
reactive / non-neoplastic component (connective tissue, blood vessels, etc.)
7
Q
2 types of supportive stroma
A
-desmoplasia
-scirrhous
8
Q
what is desmoplasia stroma
A
abundant collagenous stroma
9
Q
what is scirrhous stroma
A
dense, fibrous stroma (stony hard)
10
Q
prefix for glandular epithelium neoplasms
A
adeno-
11
Q
prefix for fibroblast neoplasms
A
fibro-
12
Q
prefix for skeletal muscle neoplasms
A
rhabdomyo-
13
Q
prefix for smooth muscle neoplasms
A
leiomyo-
14
Q
prefix for fat cell neoplasms
A
lipo-
15
Q
prefix for cartilage neoplasms
A
chondro-
16
Q
prefix for bone neoplasms
A
osteo-
17
Q
prefixes for vascular neoplasms
A
angio-, lymphangio-
18
Q
prefixes for hematopoietic cell neoplasms
A
lympho-, myelo-
19
Q
prefix for endothelium neoplasms
A
hemangioendothelio-
20
Q
suffix of benign neoplasms
A
-oma
21
Q
suffixes of malignant neoplasms
A
-carcinoma
-sarcoma
22
Q
tumor from somatic cell is derived from what tissue layers
A
ONE of 3 germ layers (endoderm, mesoderm, ectoderm)
23
Q
tumor from gonadal or embryonic cell is derived from what tissue layers
A
ALL 3 germ layers
24
Q
5 main characteristics of benign tumors
A
-encapsulation
-smooth borders
-remain localized
-differentiated
-slow growth/proliferation
25
benign tumor cells closely resemble _____
the normal cell in morphology & function
26
cycstic teratoma arises from _____ cells, and can give rise to tissue originating from _____
arise from totipotential germ cells
originate from all 3 germ layers
27
what is a papillary cystadenoma
papillary epithelial proliferation protruding into cystic spaces
28
6 main characteristics of malignant tumors
-poorly circumscribed (no capsule)
-firm, fixed (not freely moveable)
-enlarged, prominent nuclei, maybe more # nuclei in cytoplasm
-hyperchromasia- darkly staining (bc more DNA)
-coarsely clumped chromatin
-increased # of mitoses, some abnormal
29
7 additional characteristics of malignant neoplasm
-nuclear pleomorphism
-loss of polarity
-necrosis
-immune response
-differentiation
-rapid rate of growth
-local invasion
30
what is the most important criteria of malignancy
distant metastasis
31
malignant tumors are _____ & have _____ potential
invasive
&
have metastatic potential
32
what factors influence tumor growth
-hormone dependence
-adequacy of blood supply
-genetics
33
metastasis unequivocally implies _____
malignancy
34
what % of newly diagnosed solid tumors (excluding most skin cancers) have metastases
30%
35
most common pathway of metastasis
lymphatics
36
most common pathway of hematogenous spread
venous ->
drains to liver & lung
37
is it true that neoplasia is most often sporadic
YES
38
8 hallmarks of cancer
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 & metastasize
8) ability to evade the host immune response
39
self-sufficiency in growth GOF mutations convert _____ to _____
proto-oncogenes to oncogenes
40
major proto-oncoprotein signaling pathways
RTK
GPCR
JAK/STAT
WNT
Notch
Hedgehog
TGFB/SMAD
NK-kB
41
2 methods for diagnosing overexpression of growth factors
IHC
FISH
42
some growth factors can synthesize their own receptors that they respond to, which creates a _____
autocrine loop
43
2 examples of growth factor mutations that create an autocrine loop
-PDGF-B in glioblastoma
-TGF-a in some sarcomas
44
2 examples of growth factor mutations that constitutively activate tyrosine kinases
ERBB1 (EGFR) -point mutation in lung adenocarcinoma
ERBB2 (HER2) -amplification in breast & gastric adenocarcinomas
45
Alk (a tyrosine kinase) is activated by _____ & seen in _____
gene rearrangement
lung cancers
46
mutations that cause oncogenic activity often occur in what 2 locations of the cell
cytoplasm
nucleus
47
2 examples of non-receptor tyrosine kinase mechanism of oncogenesis
ABL tyrosine kinase (BCR-ABL gene) -> chronic myelogenous leukemia (CML)
JAK2 tyrosine kinase (JAK/STAT gene) -> chronic myeloproliferative disorders
48
2 examples of signal-transducing proteins expressed in cancers
KRAS (colon, lung, pancreatic cancers)
BRAF (melanomas)
49
1 example of nuclear regulatory protein expressed in cancers
MYC (Burkitt lymphoma)
50
1 example of cell cycle protein expressed in cancers
cyclin D1 (mantle cell lymphoma)
51
2 examples of mechanisms of oncogene activation (by MYC)
-amplification
-chromosomal translocation
52
_____ mutation in CDK causes cancer
GOF
53
_____ mutation in CDK1 causes cancer
LOF
54
what does CDK1 do
CDK inhibitor (inhibits G1 / S phase of cell cycle)
55
examples of LOF CDK1 mutations
-germline p16 mutations
-acquired p16 mutations
-retinoblastoma (RI) mutations
-p53 mutations
56
what is p53
tumor suppressor gene
57
major tumor suppressor genes
p53
APC
E-cadherin
58
which tumor suppressor gene is still effective if only one gene is present
APC
59
what cancer results if BOTH APC genes are absent
familial adenomatous polyposis syndrome
60
2 major mechanisms of apoptosis evasion in cancer
-loss of p53 -> inactive pro-apoptotic factors (ex. BAX)
-amplification of BCL-2 family (anti-apoptotic genes) -> protects against apoptosis (ex. BCL2 overexpression)
61
example of cell with self-renewing capacity
hematopoietic stem cells in CML
62
example of mutated differentiated cell without stem cell quality, but still leading to self-renewing
granulocytic progenitors in APML
63
angiogenesis is essential for _____
tumor growth
64
normally angiogenesis is regulated by _____
pro- & anti-angiogenic factors
65
example of pro-angiogenic factor, which is upregulated by what factors
VEGF
upregulated by:
hypoxia
RAS
MYC
66
example of anti-angiogenic factors
p53
67
p53 normal functions
stimulates thrombospondin-1 (anti-angiogenic factor)
&
inhibits pro-angiogenic factors
68
2 phases of metastatic cascade pathway
1) invasion of ECM
2) vascular dissemination, homing of tumor cells, & colonization
69
_____ determine the target tissues for metastasis
chemokines
70
tumors can evade host immune response by _____ & _____
-decreasing expression of antigens, MHCs
-producing immunosuppressive cytokines (ex. PDL-1)
71
example of antibody that is used to treat cancer
antibody against PDL-1 (inactivates PDL-1 -> now unable to inhibit tumor cell death)
= tumor cell death
72
PDL-1 specifically inhibits _____
T-cell activation
73
example of gene whose loss of heterozygosity results in cancer
RB (ocular retinoblastoma)
74
ability of cells to metastasize requires _____
multiple driver mutation steps
75
what are microsatellites (MS's)
1 to 6 tandem normally constant nucleotide repeats in the genome
76
in HNPCC, MS's are _____
unstable (they increase / decrease)
77
_____ normally correct unstable MS's
4 mismatch repair (MMR) genes
78
deficiencies in any of the 4 MMR genes can cause _____
increase in MS's
=
promotes carcinogenesis
=
activate immune response
79
what are chemical carcinogens
have highly reactive electrophile groups that damage DNA -> leading to mutations & eventually cancer
80
direct vs indirect acting agents (in chemical carcinogenesis)
direct: do not need metabolic conversion to become carcinogenic
indirect: are active once converted to a carcinogen by a metabolic pathway
81
what is the process of radiation carcinogenesis with ionizing radiation
ionizing radiation = chromosome breakage / translocation / point mutations
->
genetic damage & carcinogenesis
82
what is the process of radiation carcinogenesis with UV rays
UV rays = formation of pyrimidine dimers within DNA
->
mutations & carcinogenesis
83
what is the risk of radiation carcinogenesis with imaging such as CT
very small
84
5 examples of viral & bacterial agents of oncogenesis
HTLV-1
HPV
EBV
hep B & C
h. pylori
85
3 factors taken into account when grading tumors
-degree of differentiation of tumor cells
-cellular pleomorphism
-# of mitoses within tumor
86
low grade tumor = _____ aggressive
less
87
high grade tumor = _____ aggressive
more
88
3 things that tumor staging is based on
(T) primary tumor size
(N) extent of spread to regional lymph nodes
(M) if distant (blood-borne) metastasis is present
89
which checkpoint in cell cycle is affected by ionizing radiation
G2 / M
