Neoplasia Flashcards
Non-Neoplastic Cell Growth
Hypertrophy, Hyperplasia, Metaplasia and Dysplasia
Malignant Cell Growth
Anaplasia
Hypertrophy examples
Phy: Uterine enlargement
Path: Cardiac enlargement with hypertension
Hyperplasia examples
Phy: Gland epithelial proliferation of breast at puberty
Path: Endometrial hyperplasia with menorrhagia
Metaplasia examples
Lung Cancer - Normal ciliated columnar replaced with squamos cells
Esophageal Adenocarcinoma - Normal stratified squamos of lower esophagus with columnar goblet cells
Tumor Components
Parenchyma - Biologic behavior, Stroma - Support (Non-neoplastic, CT, Blood vessels and inflammatory cells)
“-carcinoma”
Malignant, Older, Lymph
“-sarcoma”
Malignant, Younger, Hematogenous
Teratoma
Congenital, Multipotential cells, Hair, Teeth, Bone, Benign (more common) in women, Malignant in men
Hamartoma
Disorganized tissue indigenous to site
Choristoma
Congenital anomaly
Cancer New Cases
Prostate/Breast
Lung&Bronchus
Colon&Rectum
Cancer Deaths
Lung&Bronchus
Prostate/Breast
Colon&Rectum
Genetic Predispositon
5-10%, BRCA 1 & 2 gene mutation, MEN, Familial adenomatous polyposia, Li-Fraumeni, Xeroderma pigmentosum, Familial retinoblastoma, Neurofibromatosis
Environment/Lifestyle
75-80%,
Greatest modifiable risk factor for cancer
Cigarette smoking
Second most common cause of lung cancer
Radon - Decay of uranium, in quarries, mines, seeps into home basements
Diet Carcinogens
Red meats, Beta carotene, Drinking water with arsenic, Grains, nuts or pulses harboring aflatoxins
Oncogenic Viruses
RNA: HTLV -1
DNA: HPV, EBV, HEP B/C
Precancers
Leukoplakia - Squamos cell carcinoma
Chronic atrophic gastritis - Gastric carcinoma in pernicious anemia
Chronic ulcerative colitis - Colorectal carcionoma
Villous adenoma of colon - Colorectal carcinoma
Oral Precancer
Leukoplakia, Erythroplakia, Smokeless tobacco keratosis, Lichen planus, Reverse smokers palate, Oral submucous fibrosis, Actinic cheilosis
Plummer-Vinson Syndrome
Smooth, red tongue, Sideropenic dysphagia due to iron deficiency anemia, Esophageal webs, Squamos cell carcinoma of esophagus and pharynx
MYC
Proto-Oncogene
Nucleus of all cells
Over expressed - Increase CDK, Cycle to active phase (G1 to S)
RAS
Proto-Oncogene
Common mutation
Overactive sign to uncontrolled proliferation
TP53
p53 - Tumor Suppressor gene Anti-proliferative effects DNA Damage repair Apoptosis, Affect my stress MOST common mutation
Gene Change in Cancer
Balanced translocation, Deletion, Gene amplification
BCR-ABL
Chronic Myeloid Leukemia, Philadelphia Chromosome, Translocation 9 & 22
EGFR
Activation to Cyclin activator to proliferation in OSCC
HPV infection
Into host genome, Increase E6 and E7, E6 binds p53, E7 binds Rb
Hallmarks of Cancer
Growth signals Bodys signals to stop Evade apoptosis Limitless replication Improved blood supply Invade and Metastasize Deregulate cell energetics Avoid Immune destruction Genome instability Tumor promoting inflammation
Cancer elicit
CD8+ T cell response
Marker of Prostatic Carcinoma
Acid Phosphatase
PSA
Marker of Hepatocellular Carcinoma, Germ Cell tumors
Alpha Fetoprotein
Marker of GI Carcinoma
Carcinoembryonic Antigen
Paraneoplastic Pemphigus
Non-Hodgkin lymphoma, Chronic lymphocytic leukemia, Castlemann disease, Lung carcinoma, Malignant melanoma, Thymoma; Autoimmune disorder - Tumor antigens trigger immune response in skin blisters
VEGF
Vascular Endothelial Growth Factor - Increased angiogenesis, Embryonic circulatory system, Lung, Breast and Colon cancer
Common Sites of Metastasis
Bone, Liver, Lungs
Oral Cancer Metastasis
Cervical nodes inlarge, Firm, Painless, Fixed (matted), May move sideways, Distant = “Below clavicle”
Breast Cancer Metastasis
Axillary lymph nodes, Lymphedema
Lung Cancer Metastasis
Bronchial lymph node
Sarcoma Metastasis
Pulmonary metastases
Grading Differentiation
Grade I: Well differentiated
Grade II: Moderately differentiated
Grade III and IV: Poorly differentiated
Anaplasia
“Form backwards,” Undifferentiated, Primitive cells - High malignancy, Stem cells of some undergo divergent differentiation, Epithelial and mesenchymal, Certain tumors induce stromal change or fibrosis
TNM
Tumor size (0-3)
Presence of tumor in local/regional lymph nodes (0-2)
Presence of tumor at distant site (Beyond nodes; 0-X)
Therapy
Surgery, Radiation, Chemotherapy
Hormone Therapy, Immune Therapy and Targeted Therapy
Premalignant/Malignant Skin Lesion
Pre: Actinic Keratosis (Most common, Actinic cheillitis in lips)
Malignant: Basal cell carcinoma, Squamos cell carcinoma, Melanoma
Nevi VS Melanoma
Nevi = "Mole" Acquired, Benign neoplasm of melanocytic origin, Common, Intraoral - Palate, Muccobuccal fold and Gingiva; Junctional, Compound and Intradermal; Congenital; Melanoma = Malignant neoplasm of melanocytic origin, UV, Deaths
Types of Melanomas
Superficial Spreading Melanoma: Most common
Lentigo Maligna Melanoma: Elder, Sun exposed skin
Acral Lentiginous melanoma: Palmes and Soles of feet, sugungal areas, Common in backs, Mucous membranes
Nodular Melanoma: Amelanotic melanoma
ABCDE of Melanoma
Asymmetry Border Color Diameter Evolution
