Neoplasia

Question 1

Reactive cellular changes (4)

Answer 1

1. Atrophy
2. Hypertrophy
3. Hyperplasia
4. Metaplasia

Question 2

Atrophy

Answer 2

Dec in tissue mass 2/2 dec size and/or number of cells

Caused by: disuse, denervation, loss of blood supply, loss of hormonal stimulation, poor nutrition

Question 3

Hypertrophy

Answer 3

Increase in cell size

Question 4

Hyperplasia

Answer 4

Increase in number of cells. May be a RF for malignancy

Question 5

Metaplasia

Answer 5

Replacement of one cell type by another.
Usually due to exposure to irritant. May be reversible if irritant is removed. BUT may also undergo malignant transformation if stimulus continues.
Ex: Barrett esophagus

Question 6

Paraneoplastic and neoplastic cellular changes (4)

Answer 6

1. Neoplasia
2. Dysplasia
3. Differentiation
4. Anaplasia

Question 7

Neoplasia

Answer 7

Uncontrolled, clonal proliferation of cells, can be benign or malignant

Question 8

Dysplasia

Answer 8

Disordered, non-neoplastic cell growth.
(only epithelial)
Mild usually reversible
Severe usually progresses to carcinoma in situ

Question 9

Differentiation

Answer 9

Degree to which a malignant tumor resembles its tissue of origin.
Well-dif resemble tissue of origin
Poorly-dif do not

Question 10

Anaplasia

Answer 10

Complete lack of differentiation of cells in malignant neoplasm

Question 11

Tumor grade

Answer 11

• Degree of cellular differentiation and mitotic activity on histology
• Range from low grade (well differentiated) to high grade (poorly differentiated, undifferentiated, anaplastic)

Question 12

Tumor stage

Answer 12

• Degree of localization/spread based on site and size of 1o lesion, spread to regional LN, presence of metastases (TNM)a
• Stage is almost always more prognostic than grade

Question 13

Carcinoma

Answer 13

implies epithelial origin

Question 14

Sarcoma

Answer 14

denotes mesenchymal origin

Question 15

Hamartoma

Answer 15

non-neoplastic disorganized overgrowth of tissues in their native locations (Peutz-Jeghers polyps)

Question 16

Choristoma

Answer 16

Normal tissue in a foreign location (gastric tissue in distal ileum such as in a Meckel diverticulum)

Question 17

Characteristics of a benign tumor

Answer 17

Well dif, well demarcated, low mitotic activity, no metastasis, no necrosis

Question 18

Characteristics of a malignant tumor

Answer 18

Poor dif, erratic growth, local invasion, metastasis, decrease in apoptosis

Upregulation of telomeres prevents chromosomal shortening and cell death

Question 19

Epidemiology of skin cancer

Answer 19

basal > squamous&raquo_space;> melanoma

Question 20

Incidence of cancers in males

Answer 20

1. prostate
2. lung (dropped in men but not in women)
3. colon/rectum

Question 21

Incidence of cancers in women

Answer 21

1. Breast
2. Lung
3. colon/rectum

Question 22

Mortality of cancer in men

Answer 22

1. Lung
2. Prostate
3. colon/rectum

Question 23

Mortality of cancer in women

Answer 23

1. Lung
2. Breast
3. colon/rectum

Question 24

Mediators of cachexia

Answer 24

TNF
INF-g
IL1
IL6

Question 25

P-glycoprotein

Answer 25

aka multidrug resistance protein 1 (MDR1)

Pumps out toxins including chemotherapy drugs

Question 26

Psammoma bodies

Answer 26

1. Papillary carcinoma of the thyroid
2. Serous papillary cystadenocarcinoma of the overy
3. Meningioma
4. Malignant mesothelioma

Question 27

Sarcoma spread …

Answer 27

Hematogenously (most)

Question 28

Carcinomas spread …

Answer 28

via lymphatics

EXCEPT: hepatocellular carcinoma, renal cell carcinoma, follicular thyroid carcinoma and choriocarcinoma

Question 29

Brain site of metastasis

Answer 29

Lung > breast > prostate > melanoma > GI

50% of brain tumors are due to metastased
Commonly seen as multiple lesion in the gray-white matter division

Question 30

Liver site of metastasis

Answer 30

Colon&raquo_space;> stomach > pacreas

Liver and lung mets MC sites of metastasis after regional lymph node invasion

Question 31

Bone site of metastasis

Answer 31

Prostate (blastic), breast (mixed) > lung (mixed), thyroid (lytic), kidney (lytic)