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Pathology 1 Block 2 > Neoplasia 2 > Flashcards

Neoplasia 2 Flashcards

1
Q

how do all benign tumors grow?

A

they all grow as a cohesive expansile mass

  • they develop a fibrous tissue capsule composed of compressed connective tissue
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2
Q

can benign tumors infiltrate other tissues?

A

no

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3
Q

how do benign tumors grow?

A

develop a fibrous tissue capsule composed of compressed connective tissue

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4
Q

what is the only benign tumor that does not grow as an expansive cohesive mass and without a capsule?

A

hemangioma

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5
Q

what is this?

A

hemangioma

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6
Q

what is this?

A

hemangioma

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7
Q

what is an example of a benign tumor that is encapsulated?

A

Uterine leiomyoma (fibroid)

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8
Q

what is this?

A

Uterine leiomyoma (fibroid): note the well encapsulated masses

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9
Q

what is this?

A

Benign, unencapsulated tumor (hemangioma)

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10
Q

what is this?

A

Carcinoma uterine cervix with invasion of bladder wall

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11
Q

how do malignant tumors grow?

A

they infiltrate and destroy the surrounding tissue

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12
Q

can malignant tumors be easily demarcated?

A

no, they are poorly outlined

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13
Q

what is this?

A

Carcinoma head of pancreas

note the infiltration of the ampulla, duodenal wall, & common bile duct/pancreatic duct. Absolutely no demarcation, which indicates an ill defined margin.

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14
Q

what does it mean when a tumor metastasizes?

A

when a tumor spreads to another region different from the primary tumor

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15
Q

what tumors metastasize?

A

malignant

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16
Q

what are the only malignant tumors that do not metastasize?

A

gliomas and basal cell carcinomas

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17
Q

what is this?

A

Lung showing multiple metastatic tumor deposits from a primary breast carcinoma

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18
Q

what is this?

A

canon ball appearance, metastatic breast carcinoma

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19
Q

What 3 ways do malignant tumors spread?

A

i) Seeding of body cavities and surfaces
ii) Lymphatic spread
iii) Hematogenous spread

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20
Q

how does the seeding of body cavities and surfaces mechanism of spreading work?

A

malignant cells will exfoliate off the tissue and invade another foreign tissue

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21
Q

What malignant tumors utilize the seeding of body cavities and surfaces in the peritoneal cavity?

A

ovaries, appendix (pseudomyxoma peritonei)

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22
Q

What malignant tumors utilize the seeding of body cavities and surfaces in the subarachnoid space?

A
  • acute lymphoblastic leukemia
  • glioblastoma multiforme
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23
Q

what is Pseudomyxoma peritonei?

A
  • associated with primary mucinous tumor arising from appendix
  • associated with mucinous ovarian tumor
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24
Q

what is a Myxoma?

A

benign neoplasms that comes from primitive multipotent mesenchymal cells

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25
Q

what are the most common 1ry tumor of the adult heart?

A

myxomas

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26
Q

familial syndromes associated with myxomas have activating mutations in what genes?

A

GNAS1 gene which is for Gs alpha

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27
Q

what region in the heart is the preferred area for origin site of myxomas?

A

fossa ovalis

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28
Q

what form of the myxoma tumor of heart may cause intermittent obstruction of the atrioventricular valve opening?

A

pedunculated myxomas

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29
Q

histologically, myxomas are composed of what?

A

stellate or globular myxoma cells embedded within an abundant acid mucopolysaccharide ground substance

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30
Q

what is this?

A

Cardiac Myxoma

note: the myxoid background and stellate cells

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31
Q

what is the lymphatic spreading pathway?

A
  • lymph node involvement
  • follows the natural routes of lymphatic drainage
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32
Q

what is the most common pathway for initial spread for carcinomas and sarcomas?

A

lymphatic spread

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33
Q

what is a Sentinel lymph node?

A

the first lymph node in a regional lymphatic basin that receives lymph flow from the primary tumor

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34
Q

what is an example of a malignant tumor that utilizes the lymphatic spread pathway?

from what side of the area do these tumors arise and to what lymph node do these cells first go?

A

breast cancer

arise from upper, outer quadrant of breas

tumor cells go to axillary nodes

35
Q

what is this an example of?

A

lymphatic spread

  • Observe the presence of glandular elements in the lymph node
  • Metastatic lymph node
  • Primary malignancy from colon
36
Q
A
37
Q

how do we detect malignant tumor cells of breast in lymph nodes?

A

using Technetium-99 (bad cells uptake it better)

38
Q

what are the 2 causes for Lymph node enlargement in cancer?

A
  1. spread and growth of cancer cells
  2. reactive hyperplasia
  • drainage of tumor cell debris or tumor antigen, or both
39
Q

what is this?

A

Reactive Hyperplasia of Lymph nodes

note the follicular architecture is still preserved, however, there is sinusoidal reaction by macrophages (sinus histiocytosis)

40
Q

what is this?

A

Metastatic lymph node

note, no follicular architecture. Glandular elements seen.

41
Q

what cancers use the hematogenous spread pathway?

A

carcinomas and sarcomas

42
Q

what vessels are involved in the hematogenous spread pathway of malignant tumors?

A

veins

43
Q

what organs are mostly involved in the hematogenous spread pathway?

A

liver and lungs

44
Q

what is an example of a malignant tumor that uses the hematogenous spread pathway? What vein is involved?

A

renal cell carcinoma

renal vein

45
Q

what is this?

A

tumor in blood vessel in primary lung cancer

46
Q

what is this?

A

tumor in blood vessel in primary lung cancer

47
Q

what is this?

A

tumor in blood vessel in primary lung cancer

48
Q

what is a unusual pathway of malignant tumor spreading?

A

krukenberg tumor

49
Q

what is a Krukenberg tumor?

A

gastric tumors giving rise to tumor deposits on surface of ovaries (bilateral)

50
Q

what is this?

A

Krukenberg tumor

Note: nodular tumor deposits on surface of both ovaries

51
Q

what is this?

A

Perineural invasion

52
Q

where can a perineural invasion happen?

A

pancreas malignancies

prostate malignancies

salivary gland malignancies

53
Q

what are the 2 non-hereditary predispositions?

A
  1. Chronic inflammation and cancer
  2. Precancerous conditions
54
Q

what are the examples of Nonhereditary predisposition conditions for chronic inflammation and cancer?

A
  1. ulcerative colitis
  2. crohn’s disease
  3. helicobacter pylori
  4. viral hepatitis
  5. chronic pancreatitis
55
Q

what are the examples of Nonhereditary predisposition conditions that are precancerous?

A
  1. pernicious anemia, solar keratosis of skin
  2. Sjorgen syndrome, Hashimoto’s thyroiditis
  3. atypical hyperplasia of ductal epithelium (breast)
  4. leukoplakia of oral cavity, vulva and penis
  5. chronic irritation of sinus orifice (osteomyelitis)
  6. Barrett’s esophagus, dysplastic nevus
  7. myelodysplastic syndrome, regenerative nodules in cirrhosis,
  8. villous adenoma rectum, complete hydatidiform mole: choriocarcinoma
  9. endometrial hyperplasia, scar tissue in lung
56
Q
A
57
Q

pernicious anemia will lead to what cancer?

A

atrophic gastritis of stomach

58
Q

solar keratosis of skin will lead to what cancer?

A

squamous cell carcinoma

59
Q

sjogren syndrome will lead to what cancer?

A

MALT lymphoma

60
Q

hashimoto thyroiditis will lead to what cancer?

A

MALT lymphoma

61
Q

leukoplakia of oral cavity will lead to what cancer?

A

squamous cell carcinoma

62
Q

barrett’s esophagus will lead to what cancer?

A

adenocarcinoma of esophagus

63
Q

dysplastic nevus will lead to what cancer?

A

melanoma

64
Q

myelodysplastic syndrome will lead to what cancer?

A

AML

65
Q

regenerative nodules in cirrhosis will lead to what cancer?

A

hepatocellular carcinoma

66
Q

villous adenoma of rectum will lead to what cancer?

A

adenocarcinoma

67
Q

complete hyaditiform mole will lead to what cancer?

A

choriocarcinoma

68
Q

endometrial hyperplasia will lead to what cancer?

A

adenocarcinoma of endometrium

69
Q

scar tissue in the lung will lead to what cancer?

A

adenocarcinoma

70
Q

what type of patient is at increased risk of developing cancer?

A

those with immunodeficiencies, mostly with T cell deficiencies

71
Q

what is this?

A

atrophic gastritis

note patchy areas of atrophic mucosa

right is normal

72
Q

what is this?

A

epithelial hyperplasia in breast duct

(Atypical ductal hyperplasia breast)

right is normal

73
Q

what is this?

A

solar keratosis

74
Q

what is this?

A

Crohn’s Disease

note non-caseating granuloma in small bowel mucosa.

* there is dense inflammation

75
Q

what is this?

A

helicobacter pylori

note: appear as curved structures. Highlighted by silver stain.

76
Q

why do familial cancers occur?

A

due to germline mutations in a tumor suppressor gene

77
Q

Give 5 examples of autosomal dominant familial cancers

A
  1. retinoblastoma
  2. familial adenomatous polyposis (FAP)
  3. Li-fraumeni syndrome
  4. Hereditary Non polyposis Colon Cancer
  5. BRCA 1 and 2
78
Q

Give 5 examples of autosomal recessive familial cancers

A
  1. Xeroderma Pigmentosum (XP)
  2. Ataxia Telangiectasia
  3. Bloom Syndrome
  4. Fanconi Syndrome
79
Q

what 2 types of non lethal genetic damage may lead to cancer?

A
  1. acquired: environmental (virus, chemicals, radiation)
  2. inherited: germline mutations
80
Q

this term is used to describe a single cell that suffered genetic damage and may keep replicating

A

clonal expansion

81
Q

Genetic damage leading to cancer occurs due to what?

A

damage to normal regulatory oncogenes

82
Q

what regulatory genes get damaged leading to cancer?

A
  1. Growth promoting protooncogenes
  2. Growth inhibiting tumor suppressor genes
  3. Genes that regulate apoptosis
  4. Genes involved in DNA repair
83
Q

what are the steps malignant tumors go through?

(steps of carcinogenesis)

A
  • excessive growth
  • local invasion
  • spread
84
Q

why do we face a therapeutic challenge regarding cancer treatment?

A

mutations that appear in subsequent generation differs vastly.

Pathology 1 Block 2 (8 decks)

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