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Neoplasia Flashcards

1
Q

Characteristics of Benign vs Malignant Neoplasms

A
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2
Q

What is a leiomyoma?

A

Benign tumor of skeletal mm

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3
Q

What is a rhabdomyosarcoma?

A

Malignant tumor of skeletal mm

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4
Q

What is a hydatidiform mole?

A

benign placental neoplasm

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5
Q

What is choriocarcinoma?

A

Malignant placental neoplasm

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6
Q

What is an embryonal carcinoma?

A

Malignant testicular germ cell neoplasia

(also called seminoma)

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7
Q

What is a nevus?

A

Benign melanocyte neoplasia

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8
Q

Define:

  1. Polyp
  2. polypoid cancer
  3. papilloma
  4. cystadenoma
  5. Papillary cystadenoma
A
  1. Polyp: visible projection into a lumen, benign
  2. polypoid cancer: visible projection into lumen, malignant
  3. papilloma: epithelial neoplasm that forms finger/wart projections
  4. cystadenoma: epithelial neoplasm that forms large cystic mass
  5. Papillary cystadenoma: Form fingers into cystic spaces
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9
Q

Define:

  1. Sarcoma
  2. Carcinoma
  3. Adenocarcinoma
  4. Squamous cell carcinoma
A
  1. Sarcoma: malignant, mesenchymal (fleshy, little connective tissue)
  2. Carcinoma: malignant, epithelial
  3. Adenocarcinoma: malignant, glandular
  4. Squamous cell carcinoma: malignant, squamous cell
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10
Q

What are teratomas?

A

tumors composed of prenchymal cell types from more than one germ layer

(usually from totipotent cells in gonads)

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11
Q

Characteristics of Anaplasia

A
  • Cellular and nuclear pleomorphism
    • different sizes
    • hyperchromic, large nucleus
  • Unusual mitotic figures
  • Loss of polarity
    • disorganized growth
  • Giant cell formation
  • Areas of ischemic necrosis
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12
Q

Characteristics of benign vs malignant surface tumors

A
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13
Q

Characteristics of carcinoma in situ

  • Location
  • type of neoplasm
A
  • Dysplastic change in entire epithelium
    • Does not cross basement membrane
  • preinvasive
    • does not always progress to malignancy
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14
Q

What is the growth fraction in tumor growth?

A
  • Number of tumor cells that are actually dividing
  • Portion of cells affected by chemos
  • High with leukemia, lymphoma, lung cancer
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15
Q

What are the three routes of dissemination of tumors?

A
  1. Seeding body cavities
    • often peritoneal cavity
  2. Lymphatic spread
    • Most common for carcinomas
  3. Hematogenous spread
    • Most common for sarcomas
    • By veins
    • Travel to liver and lungs
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16
Q

Which nodes are the first to be biopsied?

A

Sentinel nodes

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17
Q

Types of cancer associated with Arsenic exposure

A

Lung

Skin

Hemangiosarcoma

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18
Q

Types of cancer associated with Abestos exposure

A

lungs

GI

mesothelioma (covers pleura/peritoneum)

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19
Q

Types of cancer associated with Benzene exposure

A

leukemia

Hodgkin lymphoma

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20
Q

Types of cancer associated with Beryllium exposure

A

Lung

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21
Q

Types of cancer associated with cadmium exposure

A

prostate cancer

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22
Q

Types of cancer associated with Chromium exposure

A

Lung

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23
Q

Types of cancer associated with Ethylene oxide exposure (ripening agent for fruit)

A

leukemia

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24
Q

Types of cancer associated with Nickel exposure

A

nose

lung

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25
Q

Types of cancer associated with Radon exposure

(decay of minerals containing uranium)

A

Lung

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26
Q

Types of cancer associated with Vinyl Chloride exposure

A

angiosarcoma

hepatocellular carcinoma

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27
Q

Characteristics of Retinoblastoma

  • type of cancer
  • defect
  • inheritance pattern
A
  • type of cancer
    • intraocular tumor
  • defect
    • inactivation of Rb tumor suppressor gene
  • inheritance pattern
    • Autosomal Dominant
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28
Q

Characteristics of Familial adenomatous polyposis

  • type of cancer
  • defect
  • inheritance pattern
A
  • type of cancer
    • ​Colon
  • defect
    • Inactivation of APC gene (tumor suppressor)
    • ß-catenin then induces cell proliferation (continuous)
      • reduced cell adhesion and cell polarity
  • inheritance pattern
    • autosomal dominant
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29
Q

Characteristics of BRCA gene mutation

  • type of cancer
  • function of genes
  • inheritance pattern
A
  • type of cancer
    • Breast cancer
    • Ovarian
  • function of genes
    • tumor suppressor
    • recombination repair associated with G1/S checkpoint
  • inheritance pattern
    • autosomal dominant
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30
Q

Characteristics of Hereditary nonpolyposis colon cancer

  • type of cancer
  • defect
  • inheritance pattern
A
  • type of cancer
    • Colon (presents initially as benign polyp)
  • defect
    • defective mismatch repair
  • inheritance pattern
    • autosomal dominant
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31
Q

Fanconi anemia

  • Symptoms
  • type of cancer
  • defect
  • inheritance pattern
A
  • Symptoms
    • pancytopenia and anemia
  • type of cancer
    • leukemia
  • defect
    • defective DNA repair
  • inheritance pattern
    • Autosomal recessive
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32
Q

Characteristics of Ataxia-telangiectasia

  • Symptoms
  • type of cancer
  • defect
  • inheritance pattern
A
  • Symptoms
    • cerebellar ataxia (loss of purkinje cells)
    • Immunodeficiency (defective lymphocyte maturation)
  • type of cancer
    • leukemia
    • lymphoma
  • defect
    • protein kinase that senses DNA double-stranded breaks and stimulates p53
  • inheritance pattern
    • Autosomal recessive
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33
Q

Characteristics of Xeroderma Pigmentosum

  • type of cancer
  • defect
  • inheritance pattern
A
  • type of cancer
    • basal and squamous cell carcinoma
    • malignant melanoma
  • defect
    • UV-induced pyrimidine cross-links
    • defective nucleotide excision repair
  • inheritance pattern
    • autosomal recessive
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34
Q

Which cyclins/cdks mediate progression thru G1/S checkpoint?

A
  • Cyclin D/cdk4&6
    • phosphorylates RB (released from E2F)
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35
Q

Which cyclins/cdks mediate DNA replication? What initiates synthesis of these molecules?

A
  • Cyclin E/cdk2
  • Stimulated by E2F
    • was released from RB by cyclin D
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36
Q

Which cyclins/cdks mediate progression thru G2/mitosis checkpoint? At what point does it stop regulating the cell cycle? What initiates synthesis of these molecules?

A
  • Cyclin A/cdk2
  • Regulates through prophase of mitosis
  • Stimulated by E2F
    • released from RB by cyclin D
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37
Q

Which cyclins/cdks initiates mitosis (progression beyond prophase)? What is another function of these molecules?

A
  • Cyclin B/cdk1
  • Another function is breakdown of the nuclear membrane
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38
Q

What is the function of the p21 gene? What molecule activates it?

A
  • Function:
    • competes with Cyclin D for binding to cdk 4,6
    • Inhibits RB phosphorylation
    • Arrest in G1
    • (No E2F for further cell cycle progression)
  • activated by p53 (detects DNA damage)
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39
Q

What is the function of p27? What activates it?

A
  • Function:
    • inhibit Cyclin E-stimulated G1 to S transition
  • Activated by TGF-ß (growth suppressor)
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40
Q

What is the function of p16INK4?

A
  • competes with Cyclin D for binding to cdk 4,6
  • Inhibits RB phosphorylation
  • Arrest in G1
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41
Q

What is the function of p14ARF?

A
  • Inhibits p53 degradation by MDM2
    • inhibits cell cycle
42
Q

Which phase is the “point of no return” in the cell cycle?

43
Q

What does the G2/M checkpoint check?

A

completion of DNA replication

Signals for mitosis

44
Q

Function of RB in cell cycle regulation

45
Q

Mutation in B cell follicular lymphoma

A

overexpression of Bcl-2 (translocated to heavy-chain Ig locus)

46
Q

Characteristics of Bloom Syndrome

  • Defect
  • Likely Cancer risk
A
  • Defect:
    • DNA ligase I
  • Leukemia
47
Q

What is the most frequent genetic cause of medullary carcinoma of the breast?

48
Q

How do tumor blood vessels differ from normal vessels?

A
  1. Leaky
    • overproduction of VEGF and FGF
  2. Not morphologically differentiated
    • Irregular shape
    • difficult to tell venules/capillaries/arterioles apart
49
Q

Steps of invasion and metastasis

50
Q

Steps in invasion by tumor cells

A
  1. Down-regulate E cadherin expression
    • loosens intercellular connections
  2. Forms new attachments to EC proteins
    • fibronectin
    • laminin
  3. Degrades basement membrane
    • secrete collagenases
51
Q

How are tumor emboli protected from the immune system?

A
  • form emboli (enhanced by platelets)
  • Reduce MHC I expression (decreased T cell interaction)
  • Shed ICAM-1 (decreased T cell interaction)
52
Q

Characteristics of Burkitt lymphoma

  • Genetic defect
  • Cell type affected
  • Cytology
  • Associated virus
A
  • c-myc proto-oncogene inserted near Ig heavy chain locus
    • Sustained stimulation and Proliferation
  • B-like cell proliferation
  • Cytology:
    • Round nuclei
    • Often multiple nuclei
  • Associated with EBV
53
Q

Characteristics of Ewing Sarcoma

  • Cancer type
  • mutation
  • Product
  • Cytology
A
  • Cancer type
    • Bone (children under 15)
  • mutation
    • translocation of transcription factor (FL1) to area near EWS gene
  • Product
    • FL-1-EWS
      • cell proliferation
  • Cytology
    • round oval nuclei
    • nucleoli absent
54
Q

What are direct-acting carcinogens?

What is an example?

What cancers are at an increased risk?

A
  • do not require metabolic processing
  • Alkylating agents
  • Leukemias and lymphomas
55
Q

What are indirect-acting carcinogens? What are examples?

A
  • Procarcinogens
    • metabolized by same pathway as detox
  • Aflatoxins
    • increased liver cancer
  • Aromatics
    • increased liver cancer
  • Naphthylamine
    • bladder cancer
56
Q

Which type of UV radiation is the main mutagen?

57
Q

What types of cancer result from UV radiation?

A
  1. Squamous cell carcinoma
  2. Basal cell carcinoma
  3. Malignant meloma
58
Q

What type of DNA damage is induced by ionizing radiation? What type of cancer is commonly caused?

A
  • Hydroxyl free radical injury
  • Acute leukemias
59
Q

Which forms of HPV cause cancer?

Which types of cancer?

What is the mechanism?

A
  • Cervical = HPV 16 and 18
  • Oropharyngeal carcinoma = HPV 16
  • Mechanism: genome integrated into host DNA, forms E6 and E7
60
Q

EBV

  • Cell types affected
  • Associated types of neoplasia
    • Pathology
A
  • Cell types affected:
    • epithelial
    • B cells
  • African Burkitt lymphoma
    • t(8;14) - activates C-myc (proto-oncogene)
  • Nasopharyngeal carcinoma
    • LMP-1 protein stimulates a response
      • functions like CD40L on T cells
    • EBNA-2 promotes entrance into cell cycle
      • G0 -> G1
61
Q

Kaposi’s sarcoma

  • Cell type
  • Associated with which disease
A
  • Cell type:
    • Spindle cell with endothelial and smooth m markers
  • Associated with AIDs
62
Q

Characteristics of Classic Kaposi’s Sarcoma

A
  • Found in Mediterraneans and Eastern Europeans
63
Q

Characteristics of Lymphoadenopathic Kaposi’s Sarcoma

A

The neoplastic cells are lymphoid cells

64
Q

Characteristics of AIDs-associated Kaposi’s Sarcoma

A

characteristic skin lesions

65
Q

HTLV-1 infection

  • associated neoplasia
  • Symptoms
A
  • Adult T-cell leukemia
    • targets CD4 and CD8 cells
  • Symptoms:
    • Lymphadenopathy
    • Hepatosplenomegaly
    • Skin nodules/papules
66
Q

Differences in the forms of Adult T-cell leukemia

  • Smoldering
  • Chronic
  • Acute
A
  • Smoldering
    • normal T cell count
  • Chronic
    • lymphocytosis (elevated lymphocyte count)
    • skin lesions
    • involvement of reticuloendothelial tissue
  • Acute
    • Lymphocytosis
    • Pleomorphic cells
    • Skin lesions
    • Systemic involvement
67
Q

Neoplasia associated with Helicobacter pylori

A

adenocarcinoma

(metaplasia from increased gastric acid)

68
Q

What are the indirect manifestations of neoplasia?

A
  1. Cachexia (loss of muscle and fat)
    • Due to inflammatory cytokines
  2. Fever
69
Q

With what types of neoplasia is Cushing’s Disease associated?

A
  • ACTH-secreting pituitary adenoma
  • Resulting increased cortisol secretion causes:
    • weight gain
    • “moon” facies
    • Mimics diabetes
70
Q

With what types of neoplasia is Inappropriate ADH secretion associated?

A
  • Small cell lung cancer
  • squamous cell carcinoma
  • Characteristics:
    • secretes vasopressin
    • result: hyponatremia
71
Q

With what types of neoplasia is Hypercalcemia associated?

A
  • Secretes PTH:
    • Breast
    • Ovarian
    • Lung
    • Kidney
  • Secretes calcitrol:
    • Lymphoma
  • Simulates hyperparathyroidism
72
Q

With what neoplasia is Hypoglycemia associated?

A
  • Pancreatic islet tumor
    • increased insulin secretion
  • Hepatocellular carcinoma
    • inhibits gluconeogenesis
73
Q

Carcinoid Syndrome

  • Neoplasm
  • Type of hormone secreted
A
  • Neoplasm of enterochromaffin cells
  • Increased serotonin
74
Q

Lambert-Eaton Syndrome

  • Associated neoplasias
  • Clinical presentation
  • Pathology
A
  • Neoplasias:
    • small-cell lung
  • Clinical presentation:
    • Similar to myasthenia gravis
  • Pathology:
    • Ab to P-type voltage-gated Ca++ channel
    • (-) ACh release
75
Q

Acanthosis Nigricans

  • Associated Neoplasias
  • Clinical presentation
A
  • Neoplasias:
    • Lung
    • Gastric
    • Uterine
  • Clinical Presentation:
    • gray-black hyperkeratosis
76
Q

With what types of neoplasia is Deep Vein Thrombosis associated?

A

Adenocarcinoma of:

Breast

Ovaries

Stomach

(often associated with increased estrogen levels?)

77
Q

With what types of neoplasia are hemorrhagic syndromes associated? What is the cause?

A
  • Neoplasia:
    • Acute leukemia
  • Cause:
    • DIC results in decreased clotting factors and increased bleeding
78
Q

Regulators of cyclins and G1 –> S checkpoint

79
Q

What is the function of RAS? What stimulates it? What pathway is involved?

A
  • Stimulated by growth factor
  • Pathway
    • exchanges GDP–>GTP
    • Stim. RAF
    • Mitogenesis
80
Q

What translocation is present in CML and ALL? What is the resulting gene? What is its function?

A
  • Translocation: t(9;22) (philidelphia chromosome)
  • Gene:
    • bcr-abl
  • Function:
    • Tyrosine kinase with unregulated activity
81
Q

What translocation is present in Burkitt’s lymphoma? What gene is moved? What is its function?

A
  • Translocation: t(8;14)
  • Gene: MYC moved near Ig gene
  • Function
    • transcription factor
82
Q

What protein is mutated in Neurofibromatosis I? What is its function?

A
  • Product: neurofibromin
  • Function: inhibits RAS by stimulating GTPase activity
    • no GTP, no RAS activation, no mitogenesis
83
Q

What protein is mutated in Neurofibromatosis II? What is its function? What malignancies result?

A
  • Protein: merlin
  • Function:
    • forms stable cell-cell junction
  • Malignancies
    • acoustic schwannoma
    • meningioma
84
Q

What is the function of p53? What inhibits it? What molecule does it stimulate?

A
  • Function: G1 arrest if DNA damage is present
  • Inhibited by MDM2
  • Stimulates:
    • BAX
    • p21 (inhibits CyclinD/CDK4,6)
85
Q

What translocation is present in Follicular lymphoma? What protein is affected? What is its function?

A
  • t(14;18) (gene moved to immunoglobulin heavy chain locus on chromosome 18)
  • Protein: Bcl-2
  • Function: prevent apoptosis
86
Q

What is the chromosomal change and the protein affected in the following:

  • Chronic myeloid leukemia
  • Follicular lymphoma
  • Burkitt lymphoma
  • Ewing sarcoma
A
  • Chronic myeloid leukemia (and ALL)
    • t(9;22) (philidelphia chromosome)
    • bcr-abl
    • Proliferation of immature granulocytes
  • Follicular lymphoma (B cell)
    • t(14;18)
    • Bcl-2 to Ig heavy chain Ig locus
  • Burkitt lymphoma (B cell)
    • **t(8;14) **(inserted next to Ig heavy chain locus)
    • c-myc proto-oncogene
    • Proliferation of B cells
  • Ewing sarcoma (bone cancer in children)
    • t(11;22)
    • FL-1-EWS
    • FL-1 = transcription factor
87
Q

What does the tumor marker Carcinoembryonic Ag signal?

A

colon carcinoma

88
Q

What does the tumor marker alpha-fetoprotein signal?

A

hepatocellular carcinoma

89
Q

Aflatoxins are procarcinogens (indirect-acting) that induce what type of neoplasia?

90
Q

Aromatic amines are procarcinogens (indirect-acting) that induce what type of neoplasia?

91
Q

Hydrocarbons are procarcinogens (indirect-acting) that induce what type of neoplasia?

92
Q

What does the tumor marker Bence Jones Protein signal?

A

Multiple Myeloma

(**mentioned a couple of times)

93
Q

What does the tumor marker Parathyroid hormome-related protein (PTHrP) signal?

A

Breast

Ovarian

Lung

Kidney

94
Q

What does the tumor marker CA-125 signal?

A

ovarian cancer

(adenocarcinoma)

95
Q

What does the tumor marker CA-19-9 signal?

A

GI

(adenocarcinoma)

96
Q

What does the tumor marker CA-15-3 signal?

A

Adenocarcinomas

ID recurrence of Breast cancer

97
Q

What type of disease does levels of increased hCG signal?

A
  • gestational trophoblast disease
    • potentially malignant
  • testicular cancer
98
Q

What does the tumor marker PAP or PSA signal?

A

Prostate Cancer

99
Q

What does the tumor marker hTG signal?

A

thyroid gland

(human thyroglobulin)

100
Q

What type of neoplasm does increased dopamine signal?

A

Neuroblastoma of adrenal medulla

Pathology (27 decks)

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