Neoplasia - 2 Flashcards
Hallmark of malignancy
Anaplasia - lack of differentiation
Morphological changes associated with anaplasia (5 broad categories)
- Pleomorphism - variation in size and shape
- Abnormal nuclear morphology
- Mitoses
- Loss of polarity
- Other (too much for this card lol)
Which malignant tumors cannot metastasize
gliomas
basal cell carcinomas of the skin
Morphological changes associated with anaplasia:
Abnormal nuclear morphology (5)
abundant chromatin and are dark staining (hyperchromatic)
nuclei disproportionately large, nuclear-to-cytoplasm ratio may approach 1 : 1 (normal 1 : 4 or 1 : 6)
nuclear shape - variable , irregular
the chromatin - coarsely clumped and distributed along the nuclear membrane.
Large nucleoli
Morphological changes associated with anaplasia:
Mitoses (3)
Undifferentiated tumors - large # of mitoses; highly proliferative
Mitoses doesn’t necessarily indicate malignancy (bone marrow; tissue undergoing hyperplasia)
Morphologic feature of malignancy: Atypical, bizarre mitotic figures (tripolar, quadripolar, or multipolar spindles)
Morphological changes associated with anaplasia:
Loss of polarity (2)
Orientation of anaplastic cells is disturbed aka loss of normal polarity
Sheets or large masses of tumor cells grow in an anarchic, disorganized fashion.
Morphological changes associated with anaplasia:
Other
a. formation of what cells occurs (describe nuclei)
b. describe vascular stroma
c. What kind of necrosis do the large central areas undergo
a. tumor giant cells - can have single huge polymorphic nucleus or have two or more large, hyperchromatic nuclei
b. Vascular stroma is scant
c. Ischemic necrosis
Define carcinoma in situ
a. where does it stay confined
b. what kind of neoplasm is it considered
c. Examples
Carcinoma in situ - dysplastic changes are marked and involve the entire thickness of the epithelium but the lesion remains confined
a. confined in the basement membrane
b. pre-invasive neoplasm
c. skin, breast, cervix
Which benign tumor invades tissue but does not metastasize?
Dermatofibroma
Describe the fibrous capsule of a benign tumor?
Exception
rim of compressed fibrous tissue that separates the tumor from the host tissue
Exception: Hemangioma
Define metastasis
3 methods of spreading
Metastasis - spread of a tumor to sites that are physically discontinuous with the primary tumor
Methods of spreading
- direct seeding of body cavities or surfaces
- lymphatic spread
- hematogeneous spread
Seeding of body cavities and surfaces:
a. what body cavity is most often involved
b. location of particularly common carcinoma that occurs with this
a. peritoneal cavity
b. Carcinoma arising in the ovaries
gelatinous neoplastic mass formed when mucus-secreting appendiceal carcinomas fill the peritoneal cavity
pseudomyxoma peritonei
What is the most common pathway for the initial dissemination of carcinomas (or sarcomas - less typical)?
What route do they follow?
Lymphatic spread
Follow the natural route of lymphatic drainage
Where do carcinomas of the breast usually arise? where do they usually first disseminate?
Where do carcinomas of the lung usually first disseminate?
Breast: arise in the upper outer quadrants; first spread to axillary lymph nodes
Lung: usually first spread to perihilar tracheobronchial and mediastinal nodes
Metastasis in which local lymph nodes can be bypassed due to either:
- Venous - lymphatic anastamoses
- Inflammation or radiation has obliterated lymphatic channels
skip metastasis
Define sentinel lymph node
the first node in a regional lymphatic basin that receives lymph flow from the primary tumor
Hematogeneous spread T/F
Veins are less readily penetrated than arteries
What is this more typical of sarcomas or carcinomas
False; Arteries are less readily penetrated than are veins
Typical of sarcomas
What organs are most frequently involved with hematogeneous dissemination
Liver and lungs
Which cancers most frequently embolize through the paravertebral plexus? (2)
Which cancers have a propensity for invasion of veins? (2)
Paravertebral plexus: carcinomas of the thyroid and prostate
Invasion of veins:
- Renal cell carcinoma
- Hepatocellular carcinoma
Cancer incidence (Frequency): arrange most to least freq.
Male: colorectal, prostate, lung
Female: lung, colorectal, breast
Children: CNS (cerebellar), ALL, neuroblastoma
Male: Prostate > lung > colorectal
Female: Breast > lung > colorectal
Children: ALL > CNS (cerebellar) > neuroblastoma
Cancer incidence (Mortality): arrange high to low
Male: colorectal, prostate, lung
Female: lung, colorectal, breast
Gynecologic malignancies: endometrium, ovary, cervix
Male: Lung > prostate > colorectal
Female: Lung > breast > colorectal
Gynecologic malignancies: Ovary >Endometrium > Cervix
Arsenic
Cancers associated
Typical use or occurrence
Cancer: Lung and skin carcinomas
Typical use: smelting (byproduct), alloys (component), electrical and semiconductor devices, medications and herbicides, fungicides, and animal dip
Asbestos
Cancers associated
Typical use or occurrence
Cancer: Mesothelioma, lung adenocarcinoma
Typical use: fire/heat retardants, existing construction, underlayment and roofing papers, and floor tiles
