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Pathology 1 Block 2 > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

1
Q

what is this?

A

small cell carcinoma

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2
Q

what is this?

A

small cell carcinoma

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3
Q

Carcinogenic agents and their cellular interactions

name 3 carcinogenic agents?

A
  1. Chemical carcinogenesis
  2. Radiant energy
  3. Oncogenic viruses and microbes
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4
Q

Chemical carcinogenesis: steps involved

what are the steps that chemical carcinogenesis follows? define them.

A

1) initiation: expose yourself to sufficient dose to damage DNA permanently
2) promoters: induce tumors in initiated cells (cause clonal expansion of initiated cells)

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5
Q

Chemical carcinogenesis: steps involved

can initiation cause tumors?

can promoters by themselves cause tumors?

A

no

no

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6
Q

Chemical carcinogenesis

what are the 2 categories of chemical carcinogenesis? Define each.

Give examples of each of these 2 categories.

A

1) direct acting compounds: dont require metabolic change to become carcinogenic
- Ex: cyclophosphamide, chlorambucil, busulfan, melphalan
2) indirect acting agents: require metabolic change
- Ex: polycyclic hydrocarbons (fossil fuels), Aromatic Amines (ß-naphthylamine)

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7
Q

Chemical carcinogenesis

are direct acting compounds strong carcinogens?

what is the 2nd most common cancer caused by direct acting compunds?

what enzyme is involved in the metabolism of indirect acting chemical compounds? this enzyme is considered polymorphic…what does this mean for indirect acting chemical compounds?

Give an example of a polymorphism that will activate fossil fuels into a carcinogen.

chemical initiating agents mostly target what structure in our bodies?

A

no, they are weak carcinogens

Acute Myeloid Leukemia (AML)

cytochrome P-450

it means that activation of carcinogen is variable

CYP1A1 changes fossil fuels to benzopyrene

DNA

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8
Q

Chemical Carcinogenesis

what is the most potent carcinogen coming from polycyclic aromatic hydrocarbons?

what is needed before it becomes a powerful carcinogen?

in what daily objects can we find the most poent carcinogen?

what cancer can it cause?

A

benzopyrene

metabolic activation

tobacco smoke, broiling of animal fat or fish

lung and bladder cancer, and AML

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9
Q

Lung cancer

small cell carcinoma is preceded by what first changes?

what common daily activity may lead to small cell carcinoma?

how aggresive is it?

What is the tumor that has glandular differentiation (mucin) that occurs in the lungs?

A

squamous metaplasia or dysplasia in bronchial epithelium and then carcinoma in situ

smoking cigarette

very aggresive

Adenocarcinoma

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10
Q

Chemical Carcinogenesis

Where can we find ß-napthylamine?

what cancer may this cause? how does it happen?

A

industrial rubber

Transitional cell carcinoma, occurs when the bladder secreted ß-glucouronidase has contact with ß-napthylamine

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11
Q

what is this?

A

transitional cell carcinoma

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12
Q

What is an example of a natural occuring carcinogen?

where do we find it?

what type of acting chemical agent is it?

what cancer does it lead to?

how do you know you have this cancer?

A

aflatoxin B1

strands of aspergillus flavus

indirect acting agent

hepatocellular carcinoma

because liver has pseudocapsule

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13
Q

what is this?

A

hepatocellular carcinoma

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14
Q

what cancer is this?

A

hepatocellular carcinoma

note: glandular structures being formed by tumor cells

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15
Q

what are all examples of indirect acting agents?

A

1) betel nuts
2) aflatoxin
3) aromatic amines (ß-napthylamine)
4) polycyclic aromatic hydrocarbons

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16
Q

why are bezel nuts a indirect chemical acting agent?

what cancer does asbestos give you?

what organ does it affect?

A

it has arecoline, a carcinogen

malignant mesothelioma

lungs

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17
Q

what is this?

how will macrophages look like in this malignancy?

will the risk of this malignancy increase with smoking?

with what symptoms will patients present for this?

where else can this malignancy occur? (what other body places?)

A

malignant mesothelioma

they will contain hemosiderin (blood)

no

symptoms: chest pain, dyspnea, recurrent pleural effusions

peritoneum, pericardium, tunica vaginalis, genital tract

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18
Q

what is this?

A

mesothelioma

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19
Q

vinyl chloride can cause what cancer?

where do we find vinyl chloride in daily life?

A

angiosarcoma of liver

PVC tubing

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20
Q

what tissues are targeted by angiosarcoma?

what is the relationship between angiosarcoma and lymphedema?

A

skin, breast, liver

if a patient receives a mastectomy for breast cancer involving the lymph nodes, the angiosarcoma will arise from the lymphatic vessels

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21
Q

where do we find nitrites in daily life?

how do nitrites give cancer?

what cancer will it lead to?

A

used as food preservative

nitrosamine is a carcinogen

stomach cancer (adenocarcinoma)

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22
Q

what is Diethylstilbestrol (DES) used for?

women who take this have increased risk of what cancer?

daughters of women who took DES are at greater risk of developing these cancers?

A

abortion

breast cancer

clear cell adenocarcinoma of vagina and cervix

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23
Q

Radiation carcinogenesis

1) ultraviolet rays
2) Ionizing rays

A
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24
Q

Radiation Carcinogenesis

ultraviolet rays will cause these cancers.

what ultraviolet ray light spectrum is the worst?

what changes will UV rays lead to in our bodies?

A

squamous cell carcinoma, basal cell carcinoma, and melanoma of the skin

280-320 nm = UVB

UV is absorbed by our DNA and causes covalent cross linking of pyrimidines bases, nucleotide excision repair takes place but is overwhelmed and errors in DNA become permanent

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25
Q

what is this?

A

basal cell carcinoma

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26
Q

what is this?

A

basal cell carcinoma

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27
Q

what are the 3 ways that therapeutic radiation is delivered?

A
  1. teletherapy: beams of radiation generated at a distance and aimed at the tumor within the patient
  2. brachytherapy: with encapsulated sources of radiation implanted directly into or adjacent to tumor tissues
  3. systemic therapy: radionuclides targeted in some fashion to a site of tumor
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28
Q

what is this?

A

basal cell carcioma

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29
Q

Microbial carcinogenesis

what are the ongogenic viruses?

A
  1. Human T-cell Leukemia virus type 1
  2. Papilloma virus (HPV)
  3. Epstein Barr virus (EBV)
  4. Hepatitis B virus (HBV)
  5. Kaposi sarcoma herpes virus (KSHV)
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30
Q

Human T-cell Leukemia virus type 1

what type of virus is it?

for what cancer does it increase the risk of?

this virus has tropism for what cell type?

what gene does it have?

what transcription genes does it activate?

A

retrovirus

T-cell leukemia/lymphoma

CD4+

‘tax’ gene, activates transcription of host genes

activates NF-κB, and IP3/akt

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31
Q

Human papilloma virus (HPV)

what cancers does it cause?

what does HPV serotype 1 cause?

what does HPV serotypes 6 & 11 cause?

what does HPV serotypes 16 & 18 cause?

what proteins does HPV use to interfere with tumor suppresor?

what cell does HPV use to replicate? how does the virus modify it?

A

squamous cell carcinoma of cervix and anogenital region

plantar wart

anogenital wart

cervical dysplasia

E6/E7

infects immature squamous cells but uses mature squamous cells to replicate by arresting its cell cycle are reactivating it when it needs to

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32
Q

Human Papilloma virus (HPV)

E7 protein will bind to what to cyclin dependent kinase inhibitors?

E7 will bind to what tumor suppresor gene in order to promote its degradation?

E6 will bind to what tumor suppresor gene to promote its degradation?

E6 has what relationship to telomerase?

A

p21 and p27

RB

p53

it increases cell proliferation of cells

33
Q

what is this?

A

HPV warts (papular lesion)

34
Q

what is this?

A

HPV warts (papular lesion)

35
Q

what is this?

A

ulcerative growth with HPV

36
Q

what is this?

A

PAP smear showing malignant HPV cells

37
Q

what is this?

A

pap smear showing koilocytosis

affirms HPV infection

38
Q

what is this?

A

squamous cell carcinoma

39
Q

what is this?

from what cell line does it come?

what other disease do these patients have?

A

Burkitts lymphoma

B cell cancer

HIV

40
Q

What virus can lead to Burkitt’s lymphoma?

how does the virus transmit?

what is the pathogenesis of the virus?

what can the virus do after it infects?

what do these viral proteins do? (EBNA1, LMP1, EBNA2)

how does the virus cause lymphoma?

A

Epstein Barr virus

through human contact (like saliva)

EBV infects B cells (binds to CD21) and spreads to lymphoid tissue (tonsils).

it may remain latent and hijack signaling system

EBNA1 = binds EBV genome to host cell chromosome during mitosis

LMP1 = activates NF-kB, JAK/STAT; causes B cell activation and proliferation

EBNA2 = B cell activation and proliferation

it causes lymphoma when it acquires mutation through translocation of C-MYC (8:14)

41
Q

70 - 85% of hepatocellular carcinomas are due to what?

where (country) is Hep. C mostly seen?

A

Hepatitis B or C

Far East and Africa

42
Q

how does Hep B cause hepatocellular carcinoma?

A
  • presence of growth factors, cytokines, chemokines, and oxygen free radicals hepatocytes become mutagenic
  • activate NF-kB to block apoptosis
  • accumulate mutations
43
Q

how does Hep C cause hepatocellular carcinoma?

A

by activating growth promoting signal transduction pathways

44
Q

Helicobacter pylori

can lead to what 2 cancers?

which is more common?

from where to gastric lymphomas arise from?

A

gastric carcinomas, gastric lymphomas

gastric lymphoma

from MALT

45
Q

what is this?

A

H. pylori infection

46
Q

what is this?

A

H. pylori infection

47
Q

Kaposi sarcoma (KS)

what virus causes this cancer?

this virus is associated with what other disease?

what is the most common mode of transmission?

what is classic Kaposi sarcoma?

on who does endemic african kaposi sarcoma occur?

what is transplant associated kaposi sarcoma?

what is AIDS-associated kaposi sarcoma?

A

HHV 8

HIV

sex

mostly caused by altered immunity and not HIV

in HIV negative ppl younger than 40

happens in solid organ transplant pt during T cell immunosuppresion

due to AIDS, involves lymph nodes, spreads to organs early

48
Q

kaposi sarcoma

classic kaposi sarcoma skin lesions will progress through what 3 stages?

A

1) Patches: red-purple macules in distal lower extremities
2) Raised plaques: dermal accumulation of dilated vascular channels surrounded by plump spindle cells
3) Nodular: distincly neoplastic, sheets of plump, proliferating spindle cells in dermis or subcutaneous tissues

49
Q

what are the clinical features of kaposi sarcoma?

A
  • anorexia and weight loss (lose fat and muscle, high BMR)
  • Paraneoplastic syndromes: symptoms that can not be identifies fast due to the anatomic region tumors are appearing in
50
Q

paraneoplastic syndromes

why are they important?

what are the 4 categories they are divided into?

A

they can be the earliest manifestation of a hidden neoplasm

  1. Endocrinopathies
  2. hypercalcemia
  3. dermatologic syndromes
51
Q

what is this?

A

small cell carcinoma

52
Q

what is this?

A

small cell carcinoma

note dark staining forming islands

53
Q

what is an example of a endocrinopathy? (paraneoplastic syndrome)

what is the most common endocrinopathy?

50% of this endocrinopathy (previosly mentioned) is related to what cancer?

tumors of the cancer previously mentioned will produce what hormone? what is the precursor of this hormone?

what hormones will appear elevated with the endocrinopathy mentioned first in this flashcard?

tumor cells form the disease first mentioned will be seen with this immunostain?

A

Cushing Syndrome

cushing syndrome

small cell carcinoma (lung)

corticotropin

pro-opiomelanocortin

coricotropin and pro-opomelanocortin

chromogranin

54
Q

small cell carcinoma is highly related to this daily activity?

what will microscopy reveal for small cell carcinoma?

from where does this type of tumor originate from?

A

smoking

dense neurosecretory granules

neuroendocrine cells

55
Q

hypercalcimea will cause this to happen due to cancer?

what type of primary bone cancer will cause the above mentioned to happen? what other type of cancer will cause it?

is the above considered paraneoplastic? why?

what is the most common lung cancer is associated with hypercalcemia of paraneoplastic syndrome?

what other cancer is associated with paraneoplastic syndrome?

A

osteolysis

multiple myeloma or metastatic to bone from any 1ry lesion

no, because only the production of calcemic humoral substances by extraosseous neoplasms is considered paraneoplastic

small cell carcinoma

breast cancer, kidney cancer and ovary cancer

56
Q

what is this?

with what cancers is it associated with?

A

osteolytic lesion

breast cancer and multiple myeloma

57
Q

what is SIDH?

what tumor or cancer causes this?

what are the clinical features of this?

A

ectopic ADH production by tumors

small cell carcinoma of lung

clinical features:

  • hyponatremia
  • weakness
  • confussion
  • depresion
58
Q

what is Eaton-Lambert syndrome?

what causes this?

what tumor is associated with this syndrome?

what are the clinical features?

how is it different from myasthenia gravis?

A

Type of Myasthenia

lack of ACh. release from the presynaptic terminal

small cell carcinoma

clinical features:

  • weakness of pelvis, trunk, lower extremities

because here muscle power increases with usage

59
Q

what is a cutaneous syndrome related to paraneoplastic syndrome?

how can you spot this?

what malignancy is associated with this?

A

acanthosis nigricans

hyperkeratosis and hyperpigmentation in axilla, neck, anogenital region

GI tumors (stomach carcioma)

60
Q

what is this?

A

acanthosis nigricans

61
Q

what does it mean when a tumor is graded?

UICC grading system is based on what classification? explain it.

A

its the determination of the degree of cellular differentiation

TNM classification: T (T1-T4) = 1ry tumor; checks for invasion and size of tumor. N (N0-N3) = regional lymph nodes, how much lymph node involvement is there. M (M0-M1) = distant metastatic disease, (has it metastasized)

62
Q

what is this?

how differentated is it?

A

squamous cell carcinoma

well differentated

63
Q

what is this?

how well differentiated is it?

A

squamous cell carcimoma

poorly

64
Q

what feature does this tumor show?

A

anaplastic feature

65
Q

what stain was used on this tumor?

what malignancy is it?

A

CD30

lymphoma

66
Q

what stain is used?

what cancer is it?

A

desmin

sarcoma

67
Q

what 2 stains are used for sarcomas?

A

desmin and vimentin

68
Q

what can we used to determine that a tumor metastasized from bone?

what can we used to determine that a tumor metastasized from thyroid?

what can we used to determine that a tumor metastasized from breast?

A

prostatic specific antigen (looks brown)

thyroglobulin

estrogen/progesteron for detecting HER2/Neu receptors (looks black)

69
Q

what is this positive for?

A

PSA (bone metastasis)

70
Q

what is this positive for?

A

breast cancer

71
Q

what marker can be used to determine a tumor is proliferating?

A

Ki-67

72
Q

What immunohistochemistry can be used for glial cells?

what is an example of glial tumor?

A

GFAP

astrocytoma

73
Q

what is this positive for?

what is this?

A

GFAP

astrocytoma

74
Q

what is S-100 used for?

A

marker of neural origin tumors and melanoma

75
Q

what marker is used here?

what malignancy is this?

A

S-100

melanoma

76
Q

what is a sister-mary joseph node?

A

is a periumbilical nodule that happens due to abdominal or pelvic cancers due by metastasis, appearing in umbilicus

77
Q

what is this?

A

sister-mary joseph nodule

78
Q

what is a pancoast syndrome?

what does it lead to? what is this? how does it present?

A

when you have a superior sulcus tumor arising in the apex of the lung

horner’s syndrome: lesion of central or peripheral sympathetic nervous system

presents: ptosis, dilated pupil, anhydrosis

Pathology 1 Block 2 (8 decks)

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