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Hugh's MD1 Respiratory > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What percentage of Australians die from maligancy? What about cardiovascular disease?

A

30% and 33% respectively

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1
Q

What does transcoelomic metastasis refer to?

A

Metatasis into pleural, peritoneal or mediastinal cavity

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1
Q

What cell lineage does adeno refer to?

A

Glandular

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1
Q

What does carcinoma refer to?

A

Malignant epithelial cell

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2
Q

Is a benign tumour a cancer?

A

NO, Cancers are malignant lesions

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2
Q

What histological features do tumours of glandular origins sometimes exhibit?

A

Glandular lumen

Formation of mucin

Signet ring cells

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2
Q

What histological features do tumours of squamous origins sometimes exhibit?

A

Keratinisation

Intercalated bridges

Eosinophilic cytoplasm

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2
Q

What types of proteins can carcinogenic mutations effect?

A

Growth factors

Growth factor receptors

Protein involved in signal transduction

Nucleur-regulatory proteins

Cell cycle regulators

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2
Q

What is the difference between a proto-oncogene and an oncogene?

A

A oncogene is a mutated form of an proto-oncogene that no longer requires normal growth-promoting signals

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5
Q

What are some common features of malignant tumours?

A

Locally invasive, destructive growth

Often not well circumsized growth

Frequently induce desmoplasia in stroma they invade

Sometimes have necrosis

Variable differentiation - poor, moderate and well

Potential to metatasize

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5
Q

Define dysplasia

A

Dysplasia is a general term for abnormal growth (alteration in size, growth or organisation of cells), can is used not only in the context of tumours

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5
Q

How is epigenetic control exerted on TSGs?

A

DNA is methylated so that the TSG can not be expressed

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5
Q

What are two important factors in angiogenesis?

A

VEGFs and VEGF-Rs

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7
Q

What is a adenocarcinoma?

A

Neoplasia of a epithelium of glandular origin

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8
Q

What features do well differentiated cell have?

A

Resemble their cell of origin well

Low cytological atpyia

Low architectural disorganisation

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9
Q

What cytotic features do neoplasic cells demonstrate?

A

Larger nuclei

Hyperchromatic nuclei

Pleomorphic nuclei

Prominent necleoli

Coarser nuclear chromatin

More mitosis, abnormal mitotic figures

Architectural disorganisation

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9
Q

What type of genes are BRCA1 and BRCA2?

A

Genes involved in DNA repair and that are associated with increased risk of breast cancer

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10
Q

What are some common TSGs?

A

P53, Rb, APC, PTEN

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11
Q

What are some histological features of adenocarcinomas?

A

They tend to form lumens and attempt to secrete mucus

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12
Q

What are some common features of benign tumours?

A

Local expansile,

Slow growthing,

Often well circumscribed

Unable to metastasize

Rarely life threatening (unless they’re in a critial position)

Well differentiated cells (ie look like mature cells)

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13
Q

What is a surgical resection

A

When part or all of an organ is removed to prevent spread of a cancer

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14
Q

Define paraneoplastic effects?

A

Unusual effects that a tumour produces for unknown reasons and that aren’t normally associated with their cell type.

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15
Q

What is the supposed mechanism of weight loss in cancer patients?

A

TNF-alpha and IL-1 produced by tumour cells or within their local environment causes an increase in the basal metabolic rate.

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16
Q

What is a lymphona?

A

Cancer of T or B cells

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17
Q

What are the top 5 most common cancers in Australian women?

A

Brest

Bowel

Melanoma

Lung

Lymphoma

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18
Q

What types of DNA mutation can occur?

A

Point mutations

Replication in the number of genes

Chromosomal rearrangements

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19
Q

What features do poorly differentiated cell have?

A

Do not resemble their cells of origin well

High cytological atypia

High architectural disorganisation

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21
Q

What are some common sites of tumour metastasis?

A

Liver, Brain, Bone, Lung, LNs

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22
Q

Which are more aggressive malignancies, well or poorly differentiated cells?

A

Poorly are more aggressive

23
Q

What is targeted therapy?

A

A method of treating malignancies where specific cell factors such an ongene products are targeted to block their carcinogenic effect. This is less toxic to normal cells cf to tradition chemotherapy. It depends on the genotype/phenotype of the individual tumour. Small molecules or antibodies can be used.

24
Q

What are some investigations used to detect/diagnose cancer?

A

History and clinical examination

Blood - full blood, liver enzyme, Tumour markers (generally used for follow ups)

Radiology - xray, CT

Endoscopy

Tissue sampling

25
Q

How do tumour cells achieve replicative immortality?

A

Activated Telomerase to increase the length of chromosomal telomeres therefore allowing mitosis to continue.

27
Q

What are some examples of paraneoplastic effects?

A

Hypercalaemia in SCC lung cancers

Dermatologic in SCC

Clubbing in lung cancer

Cushing’s syndrome

28
Q

What is a polyp?

A

Glandular, dysplasic lesion often arising from epithelia

30
Q

What are the emerging hallmarks of cancer?

A

Immune evasion

Promote inflammation

Genome instability and mutation

Deregulating cellular energies

31
Q

What types of lung cancers are typically located centrally in the lung? What type are more peripheral?

A

SSC and small small cell carcinomas are central and adenocarcinomas peripheral

32
Q

How can a metastasis to the pertioneal cavity present?

A

Swelling of the abdomen due to overproduction of serous fluid

33
Q

What are some histological features of small cell carcinomas?

A

small cells , not particularly pleomorphic, fine chromatin, not necessarily nucleoli.

35
Q

Which cytokine is released to help a tumour to produce stroma?

A

TGF-beta

36
Q

What is the average tumour doubling time for clinically detectable lung and bowel cancer?

A

2 to 3 months

37
Q

What is the name given to tumour stroma?

A

Desmoplasic stroma

38
Q

What are the 4 mains types of lung carcinomas?

A

Adenocarcinoma

Small cell carcinoma

Large cell (undifferentiated) carcinoma

Squamous cell carcinoma

39
Q

What cell lineage does leiomyo refer to?

A

Smooth muscle

39
Q

What is the most common lung cancer in non-smokers?

A

Adenocarcinomas

41
Q

What are the top 5 most common cancers in Australian men?

A

Prostate

Bowel

Lung

Melanoma

Lymphoma

43
Q

What are some common paediatric cancers?

A

Certain leukaemias

Certain brain cancers

Neuroblastoma

Wilm’s tumor

Certain lymphomas

45
Q

Which type of neoplasia demonstrates a greater amount of cytological atypia?

A

Malignant

46
Q

What are some histological features of large cell carcinomas?

A

Large sheets of undifferentiated epithelial cells.

47
Q

What are some high growth factor tumours?

A

Lymphona, small cell carcinoma, leukaemias

48
Q

What are some source of genetic mutations that contribute to neoplasm?

A

Carcinogenic agents

  • microbes
  • radiation
  • chemical eg cigarette smoke

Inherited

  • abnoral tumour suppressor genes
  • Defective DNA repair
49
Q

Can surgery be used to treat small cell carcinomas?

A

No, they are very aggressive

50
Q

What is a neoplasia?

A

A new, uncontrolled growth. Includes benign growths.

50
Q

What are some histological features of squamous cell carcinomas?

A

They can have keratinization and a lot of eosinophilic cytoplasm

51
Q

What percentage of world wide cancer deaths are lung cancer?

A

18%

52
Q

What is the mechanism of metastasis?

A

Cellular adherins are disrupted allowing cells to escape their normal niche. Ie. Cadherins, beta-catenin and connexins

53
Q

What suffix is given to benign cells?

A

-oma

55
Q

What are the four classes of normal regulatory genes are that mutated in carcinogenesis?

A

Growth promoting proto-ongenes

Growth suppressing tumour suppressor genes

Genes that regulate apoptosis

Genes involved in DNA repair

56
Q

What can IHC do used for in neoplasm investigation?

A

Differentiating primary from metastatic tumours

Identifying certain proteins for specific treatments

57
Q

What is the clinical presentation of lung cancer?

A

Cough, dyspnoea, wheeze, haemoptysis, pneumonia, anorexia, fatigue

59
Q

Intraepithelial neoplasia is another term for what type of lesions?

A

Premalignant epithelial lesions

60
Q

What does tumour stroma typically contain?

A

Fibroblasts, immune cells, ECM, endothelial cells, soluble molecules

61
Q

How does mutant RAS act as a oncogene?

A

Mutant RAS is not normally inactivated after responding to a growth factor therefore there is sustained activation of transcription factors for cell cylce progression.

62
Q

What do you need to know once diagnosis of malignancy is made?

A

Cell linear

Grade

Stage

Presence of lymphovascular invasion

63
Q

What are the classic hallmarks of cancer?

A

Sustaining proliferative signals

Avoid apoptosis

Induce angiogenesis

Facilitation of invasion and metastasis

Replicative Immortality

Avoid growth suppressors

64
Q

How many copies of the an oncogene must be abnormal cf to TSGs?

A

1 allele compared to both alleles for TSGs

65
Q

What are some ways in which cancer causes death?

A

Cachexia

Secondary infection

Damage to a vital organ directly caused by the primary or secondary tumour

66
Q

What does sarcoma refer to?

A

Cancer of mesenchymal origin

68
Q

What are some common oncogene?

A

Ras, Myc and Her2-neu

69
Q

What are some clinical features indicative of metastasis?

A

Jaundice

Lymphadenopathy

Bone pain or features related to hypercalcaemia

Seizures

70
Q

What does the “stage” of a cancer refer to?

A

The progression of a maligancy in terms of local spread and metastasis

Hugh's MD1 Respiratory (15 decks)

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