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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
Types of cancer associated with Radon exposure (decay of minerals containing uranium)
Lung
26
Types of cancer associated with Vinyl Chloride exposure
angiosarcoma hepatocellular carcinoma
27
Characteristics of Retinoblastoma * type of cancer * defect * inheritance pattern
* type of cancer * intraocular tumor * defect * inactivation of Rb tumor suppressor gene * inheritance pattern * Autosomal Dominant
28
Characteristics of Familial adenomatous polyposis * type of cancer * defect * inheritance pattern
* 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
29
Characteristics of BRCA gene mutation * type of cancer * function of genes * inheritance pattern
* type of cancer * Breast cancer * Ovarian * function of genes * tumor suppressor * recombination repair associated with G1/S checkpoint * inheritance pattern * autosomal dominant
30
Characteristics of Hereditary nonpolyposis colon cancer * type of cancer * defect * inheritance pattern
* type of cancer * Colon (presents initially as benign polyp) * defect * defective mismatch repair * inheritance pattern * autosomal dominant
31
Fanconi anemia * Symptoms * type of cancer * defect * inheritance pattern
* Symptoms * pancytopenia and anemia * type of cancer * leukemia * defect * defective DNA repair * inheritance pattern * Autosomal recessive
32
Characteristics of Ataxia-telangiectasia * Symptoms * type of cancer * defect * inheritance pattern
* 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
33
Characteristics of Xeroderma Pigmentosum * type of cancer * defect * inheritance pattern
* type of cancer * basal and squamous cell carcinoma * malignant melanoma * defect * UV-induced pyrimidine cross-links * defective nucleotide excision repair * inheritance pattern * autosomal recessive
34
Which cyclins/cdks mediate progression thru G1/S checkpoint?
* Cyclin D/cdk4&6 * phosphorylates RB (released from E2F)
35
Which cyclins/cdks mediate DNA replication? What initiates synthesis of these molecules?
* Cyclin E/cdk2 * Stimulated by E2F * was released from RB by cyclin D
36
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?
* Cyclin A/cdk2 * Regulates through prophase of mitosis * Stimulated by E2F * released from RB by cyclin D
37
Which cyclins/cdks initiates mitosis (progression beyond prophase)? What is another function of these molecules?
* Cyclin B/cdk1 * Another function is breakdown of the nuclear membrane
38
What is the function of the p21 gene? What molecule activates it?
* 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)
39
What is the function of p27? What activates it?
* Function: * inhibit Cyclin E-stimulated G1 to S transition * Activated by TGF-ß (growth suppressor)
40
What is the function of p16INK4?
* competes with Cyclin D for binding to cdk 4,6 * Inhibits RB phosphorylation * Arrest in G1
41
What is the function of p14ARF?
* Inhibits p53 degradation by MDM2 * inhibits cell cycle
42
Which phase is the "point of no return" in the cell cycle?
S phase
43
What does the G2/M checkpoint check?
completion of DNA replication Signals for mitosis
44
Function of RB in cell cycle regulation
45
Mutation in B cell follicular lymphoma
overexpression of Bcl-2 (translocated to heavy-chain Ig locus)
46
Characteristics of Bloom Syndrome * Defect * Likely Cancer risk
* Defect: * DNA ligase I * Leukemia
47
What is the most frequent genetic cause of medullary carcinoma of the breast?
BRCA-1
48
How do tumor blood vessels differ from normal vessels?
1. Leaky * overproduction of VEGF and FGF 2. Not morphologically differentiated * Irregular shape * difficult to tell venules/capillaries/arterioles apart
49
Steps of invasion and metastasis
50
Steps in invasion by tumor cells
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
How are tumor emboli protected from the immune system?
* form emboli (enhanced by platelets) * **Reduce MHC I** expression (decreased T cell interaction) * **Shed ICAM-1** (decreased T cell interaction)
52
Characteristics of Burkitt lymphoma * Genetic defect * Cell type affected * Cytology * Associated virus
* 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
Characteristics of Ewing Sarcoma * Cancer type * mutation * Product * Cytology
* 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
What are direct-acting carcinogens? What is an example? What cancers are at an increased risk?
* do not require metabolic processing * Alkylating agents * Leukemias and lymphomas
55
What are indirect-acting carcinogens? What are examples?
* Procarcinogens * metabolized by same pathway as detox * Aflatoxins * increased liver cancer * Aromatics * increased liver cancer * Naphthylamine * bladder cancer
56
Which type of UV radiation is the main mutagen?
UVB
57
What types of cancer result from UV radiation?
1. Squamous cell carcinoma 2. Basal cell carcinoma 3. Malignant meloma
58
What type of DNA damage is induced by ionizing radiation? What type of cancer is commonly caused?
* Hydroxyl free radical injury * Acute leukemias
59
Which forms of HPV cause cancer? Which types of cancer? What is the mechanism?
* Cervical = HPV 16 and 18 * Oropharyngeal carcinoma = HPV 16 * Mechanism: genome integrated into host DNA, forms E6 and E7
60
EBV * Cell types affected * Associated types of neoplasia * Pathology
* 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
Kaposi's sarcoma * Cell type * Associated with which disease
* Cell type: * Spindle cell with endothelial and smooth m markers * Associated with AIDs
62
Characteristics of Classic Kaposi's Sarcoma
* Found in Mediterraneans and Eastern Europeans
63
Characteristics of Lymphoadenopathic Kaposi's Sarcoma
The neoplastic cells are lymphoid cells
64
Characteristics of AIDs-associated Kaposi's Sarcoma
characteristic skin lesions
65
HTLV-1 infection * associated neoplasia * Symptoms
* Adult T-cell leukemia * targets CD4 and CD8 cells * Symptoms: * Lymphadenopathy * Hepatosplenomegaly * Skin nodules/papules
66
Differences in the forms of Adult T-cell leukemia * Smoldering * Chronic * Acute
* 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
Neoplasia associated with *Helicobacter pylori*
adenocarcinoma (metaplasia from increased gastric acid)
68
What are the indirect manifestations of neoplasia?
1. Cachexia (loss of muscle and fat) * Due to inflammatory cytokines 2. Fever
69
With what types of neoplasia is Cushing's Disease associated?
* ACTH-secreting pituitary adenoma * Resulting increased cortisol secretion causes: * weight gain * "moon" facies * Mimics diabetes
70
With what types of neoplasia is Inappropriate ADH secretion associated?
* Small cell lung cancer * squamous cell carcinoma * Characteristics: * secretes vasopressin * result: hyponatremia
71
With what types of neoplasia is Hypercalcemia associated?
* Secretes PTH: * Breast * Ovarian * Lung * Kidney * Secretes calcitrol: * Lymphoma * Simulates hyperparathyroidism
72
With what neoplasia is Hypoglycemia associated?
* Pancreatic islet tumor * increased insulin secretion * Hepatocellular carcinoma * inhibits gluconeogenesis
73
Carcinoid Syndrome * Neoplasm * Type of hormone secreted
* Neoplasm of enterochromaffin cells * Increased serotonin
74
Lambert-Eaton Syndrome * Associated neoplasias * Clinical presentation * Pathology
* Neoplasias: * small-cell lung * Clinical presentation: * Similar to myasthenia gravis * Pathology: * Ab to P-type voltage-gated Ca++ channel * (-) ACh release
75
Acanthosis Nigricans * Associated Neoplasias * Clinical presentation
* Neoplasias: * Lung * Gastric * Uterine * Clinical Presentation: * gray-black hyperkeratosis
76
With what types of neoplasia is Deep Vein Thrombosis associated?
Adenocarcinoma of: Breast Ovaries Stomach (often associated with increased estrogen levels?)
77
With what types of neoplasia are hemorrhagic syndromes associated? What is the cause?
* Neoplasia: * Acute leukemia * Cause: * DIC results in decreased clotting factors and increased bleeding
78
Regulators of cyclins and G1 --\> S checkpoint
79
What is the function of RAS? What stimulates it? What pathway is involved?
* Stimulated by growth factor * Pathway * exchanges GDP--\>GTP * Stim. RAF * Mitogenesis
80
What translocation is present in CML and ALL? What is the resulting gene? What is its function?
* Translocation: t(9;22) (philidelphia chromosome) * Gene: * **bcr-abl** * Function: * Tyrosine kinase with unregulated activity
81
What translocation is present in Burkitt's lymphoma? What gene is moved? What is its function?
* Translocation: t(8;14) * Gene: **MYC** moved near Ig gene * Function * transcription factor
82
What protein is mutated in Neurofibromatosis I? What is its function?
* Product: neurofibromin * Function: inhibits RAS by stimulating GTPase activity * no GTP, no RAS activation, no mitogenesis
83
What protein is mutated in Neurofibromatosis II? What is its function? What malignancies result?
* Protein: merlin * Function: * forms stable cell-cell junction * Malignancies * acoustic schwannoma * meningioma
84
What is the function of p53? What inhibits it? What molecule does it stimulate?
* Function: G1 arrest if DNA damage is present * Inhibited by MDM2 * Stimulates: * BAX * p21 (inhibits CyclinD/CDK4,6)
85
What translocation is present in Follicular lymphoma? What protein is affected? What is its function?
* t(14;18) (gene moved to immunoglobulin heavy chain locus on chromosome 18) * Protein: Bcl-2 * Function: prevent apoptosis
86
What is the chromosomal change and the protein affected in the following: * Chronic myeloid leukemia * Follicular lymphoma * Burkitt lymphoma * Ewing sarcoma
* 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
What does the tumor marker Carcinoembryonic Ag signal?
colon carcinoma
88
What does the tumor marker alpha-fetoprotein signal?
hepatocellular carcinoma
89
Aflatoxins are procarcinogens (indirect-acting) that induce what type of neoplasia?
liver
90
Aromatic amines are procarcinogens (indirect-acting) that induce what type of neoplasia?
Liver
91
Hydrocarbons are procarcinogens (indirect-acting) that induce what type of neoplasia?
Bladder
92
What does the tumor marker Bence Jones Protein signal?
Multiple Myeloma | (\*\*mentioned a couple of times)
93
What does the tumor marker Parathyroid hormome-related protein (PTHrP) signal?
Breast Ovarian Lung Kidney
94
What does the tumor marker CA-125 signal?
ovarian cancer | (adenocarcinoma)
95
What does the tumor marker CA-19-9 signal?
GI | (adenocarcinoma)
96
What does the tumor marker CA-15-3 signal?
Adenocarcinomas ID recurrence of Breast cancer
97
What type of disease does levels of increased hCG signal?
* gestational trophoblast disease * potentially malignant * testicular cancer
98
What does the tumor marker PAP or PSA signal?
Prostate Cancer
99
What does the tumor marker hTG signal?
thyroid gland | (human thyroglobulin)
100
What type of neoplasm does increased dopamine signal?
Neuroblastoma of adrenal medulla

Pathology (27 decks)

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