Neoplasia

Question 1

what is neoplasia?

Answer 1

Neoplasia means “new growth”, used to describe abnormal tissue with excessive, uncoordinated, autonomous growth

Question 2

2 types of neoplasia

Answer 2

Benign neoplasia

Malignant neoplasia

Question 3

____ is the study of neoplasms

Answer 3

Oncology

Question 4

Cancer describes ____tumors

Answer 4

malignant

Question 5

Steps in Neoplasia

Answer 5

Transformation and progression
Clonal expansion and tumor growth
Invasion
Metastasis

Question 6

___________ refer to changes in regulation of cell differentiation and growth, usually related to more than one critical mutation

Answer 6

Transformation and progression

Question 7

Transformation refers to the mutation of certain genes which provide_____________.

Answer 7

early growth and proliferation advantages,

Question 8

two types of transformations that result in mutations

Answer 8

tumor supressor genes and proto-oncogenes

Question 9

tumor suppressor genes ____ a function,

Answer 9

lose

Question 10

proto-oncogenes ___ a function

Answer 10

gain

Question 11

_____ refers to sequential mutations of other genes that confer various additional traits such as immortality, unchecked proliferation, response or lack of response to hormones / growth factors / suppressive factors, tissue invasion, eluding immune system detection, stimulating angiogenesis, and metastasis

Answer 11

Progression

Question 12

_______ transfer their own viral oncogenes into human cells, causing uncontrolled proliferation (e.g., HPV, HTLV, HBV, HCV, others)

Answer 12

Oncogenic viruses

Question 13

Throughout the changes of transformation and progression there may be changes that occur as a result of the genetic mutations which may be used as ________ of cancer or guide treatment in later stages

Answer 13

predictive markers

Question 14

Distinctive physical presentations

that can be markers in cancers

Answer 14

Polyps (e.g., mucosal neoplasms such as colon tumors)
Dysplastic nevi (e.g., melanoma)
Actinic keratosis (e.g., squamous cell carcinomas)
Barret’s esophagus (e.g., esophageal cancer)
Other lesions associated with neoplasia, e.g., leukoplakia, erythroplakia

Question 15

______ implies that the individual neoplastic cells in which beneficial mutations occur will outcompete other surrounding neoplastic cells, changing the characteristics of the tumor

Answer 15

Clonal expansion

Question 16

_______is the overall result of clonal expansion of neoplastic cell clones with multiple growth and survival advantages

Answer 16

Tumor growth

Question 17

The rate of growth of a neoplasm is determined by three main factors:
what are they?

Answer 17

1. Doubling time of the neoplastic cells
2. Fraction of neoplastic cells that are in the replicative pool (e.g., mitotic figures)
3. Rate at which cells die or are lost from the growing neoplasm

Question 18

Normal tissues segregate by ____

Answer 18

cell type

Question 19

Malignant neoplasia is able to invade into nonsimilar tissues by degrading ________and other separations between tissues

Answer 19

basement membranes

Question 20

_______requires the ability to invade and re-establish growth in a distant tissue

Answer 20

Metastasis

Question 21

– most common metastasis pathway

Answer 21

lymphatics

Question 22

lymphatics metastasis pathway

Answer 22

Into lymphatics,into lymph nodes and then into blood (follows natural lymphatic drainage)

Question 23

metastasis into blood vessels pathway

Answer 23

Into blood vessels (hematogenous) – follows invasion into veins and arteries, most common with liver, lung, kidney tumors (follows natural venous drainage)

Question 24

example of metastasis that Directly spread into cavities / tissues

Answer 24

colon carcinoma

Question 25

_____neoplasms are well-demarcated from surrounding tissues and do not invade or metastasize

Answer 25

Benign

Question 26

characteristics of benign neoplasms

Answer 26

Easily moveable, not attached to deeper tissues, discreet, often encapsulated Well differentiated

Question 27

can benign neoplasms have mass effect?

Answer 27

yes

Question 28

____ neoplasms invade into surrounding tissues and can metastasize

Answer 28

Malignant

Question 29

how are malignant neoplasms differentiated?

Answer 29

Poorly differentiated (including dysplastic or anaplastic)

Question 30

can malignant neoplasms have mass effect?

Answer 30

yes

Question 31

_____ neoplasms display the cytologic features of malignancy without invasion through the basement membrane

Answer 31

“In situ”

Question 32

what Refers to the extent to which neoplastic cells resemble normal cells of the same type, both morphologically and functionally

Answer 32

Cellular Differentiation

Question 33

______ tumor cells look and function like normal tissue cells from the tissue of origin

Answer 33

Well differentiated

Question 34

______ Tend to grow and spread more slowly, have a better prognosis

Answer 34

Well differentiated

Question 35

_____ Tend to grow and spread more quickly, poorer prognosis

Answer 35

Poorly differentiated

Question 36

_____ tumor cells have a primitive, unspecialized appearance and function differently, barely resembling their tissue of origin

Answer 36

Poorly differentiated

Question 37

_______neoplasms look and function like normal cells Same cell shape, size, polarity May function like normal Rarely if ever invasive

Answer 37

Well differentiated

Question 38

_____ refers to loss of uniformity of cells and architectural orientation

Answer 38

Dysplasia

Question 39

Dysplasia is characterized by

Answer 39

Anisocytosis – cells of unequal size Poikilocytosis – abnormally shaped cells Hyperchromatism – excessive pigmentation Presence of mitotic figures – an unusual number of cells which are currently dividing

Question 40

_____ cells lose the morphological characteristics of mature cells, including their orientation

Answer 40

“Anaplastic”

Question 41

Pleomorphism

Answer 41

– variation in size and shape of cells and nuclei

Question 42

Abnormal nuclear morphology

Answer 42

dark staining (hyperchromic), large for cell size, variable shape

Question 43

Mitoses

Answer 43

large numbers of mitotic figures indicating active proliferation

Question 44

Loss of polarity

Answer 44

cells lose normal directional characteristics

Question 45

Benign, non-germ cell tumors generally indicated by adding the suffix____to the cell of origin

Answer 45

–oma | ., lipoma, adenoma, fibroma

Question 46

exceptions to the Oma naming rule

Answer 46

., lipoma, adenoma, fibroma

Question 47

___are smooth benign mucosal projections, on a stalk (pedunculated) or not (sessile)

Answer 47

Polyps

Question 48

____are rough benign epithelial projections

Answer 48

Papillomas

Question 49

Malignant epithelial tumors are called _____, named after the tissue and growth pattern (e.g., ductal adenocarcinoma, squamous cell carcinoma)

Answer 49

carcinomas

Question 50

Malignant non-epithelial tumors are called _____, named after the tissue of origin (e.g., osteosarcoma, rhabdomyosarcoma)

Answer 50

sarcomas

Question 51

____are tumors (frequently malignant) formed from germ cells and therefore differentiate into multiple tissue types

Answer 51

Teratomas

Question 52

tumor Cells that would generate from ova and sperm are ___

Answer 52

Teratomas

Question 53

___ is a system to describe the extent of cancer development

Answer 53

Staging

Question 54

Different staging schemes depending on the ____________

Answer 54

type of cancer, rate of growth, invasion and metastasis

Question 55

“Carcinoma in situ” is stage __

Answer 55

0

Question 56

Stage is important because it affects the selected______

Answer 56

therapy and prognosis

Question 57

TNM Classification of malignant neoplasms (TNM)

Answer 57

“T” describes the Tumor: its size and whether it has invaded nearby tissue “N” describes Lymph Node involvement: do regional lymph nodes contain tumor cells, and how distant involved lymph nodes are from the primary tumor “M” describes the presence of Metastases

Question 58

Chemotherapy and radiation therapy are most effective with ________

Answer 58

rapidly growing tumor cells

Question 59

Increasing the growth fraction of proliferating cells by_______ can force remaining neoplastic cells into proliferative phase, increasing their susceptibility to chemotherapy and radiation therapy

Answer 59

surgical or radiation debulking

Question 60

Cancer Risk

Answer 60

``` Age, gender Geography (Diet? Exposures? Sunlight?) Environmental exposures Genetic predisposition Chronic inflammation, precancerous conditions, microbe infection ```

Question 61

Autosomal dominant cancer syndromes (many related to ______)

Answer 61

mutated tumor suppressor genes

Question 62

Autosomal recessive cancer syndromes (many related to defective______)

Answer 62

DNA repair mechanisms