Neoplasia Flashcards
neoplasm
clonal overgrowth of genetically abnormal cells with loss of normal growth control
benign neoplasm
has not invaded and cannot metastasize
malignant neoplasm
has invaded and has the capacity to metastasize
in-situ neoplasia
currently a benign neoplasm, but has the potential to invade but hasn’t yet
NOT CANCER - but have capacity to become cancer if not treated.
epithelial cancer term
types
carcinoma
gland-forming = adeno
squamous = squamous
Urothelium = transitional
Mesenchymal cancer term
sarcoma
add preface of type of cell (ex Lipo- Osteo-)
what has to happen before metastasis?
invasion
what is the usual killer in cancer
mets
endothelial cancer term
angiosarcoma
What does low-grade cancer look like?
cells look like normal tissue cells
What does high-grade cancer look like?
cells look nothing like normal tissue cells
criteria for grading of cancer
nuclear appearance - is it different from normal nuclei?
mitotic activity
structures + products - are they the same structures that the normal tissue makes or different?
tumor stage
size of primary tumor
lymph nodes involved
distant mets
stage 1:
stage 2:
stage 3:
stage 4:
1: confined to organ
2: locally invasive
3: spread to adjacent organs
4: diffuse mets throughout the body
is stage or grade more important in cancer prognosis?
stage
TNM nomenclature
Tis, T1-4: in-situ, T1-4 - increasing size of primary
N0-3: # of regional lymph nodes (none to lots)
M0-1: (distant mets, no distant mets)
What things does a neoplasm need to progress?
growth, angiogenesis, invasion and mets, evasion of immune system, evasion of senescence
how do tumor cells overgrow and take over normal tissue?
more tumor cells are dividing than normal cells
fewer amor cells are dying than normal cells.
oncogene
encodes protein that becomes constitutively active or over expressed that stimulates cell division or inhibits cell death
APC, Rb, p53, BRCA1/2 are…
tumor suppressor genes
erb-B2 (HER2), ras, myc, cyclin D are…
proto-oncogenes
14/18 translocation
Bcl2 (an anti-apoptotic oncogene) of chromosome 18 gets translocated to chromosome 14 next to a strong promoter (IgH) = constant expression of Bcl2 = no apoptosis = cancer
9/22 translocation
Philadelphia chromosome - Bcr and Abl next to each other creating a fusion oncogene = oncogenic tyrosine kinase -> CML
gene associated with male breast cancer
BRCA 2
BRCA1 associated with…
high grade breast cancer in young women, ovarian cancer
inactivation of APC leads to
familial adenomatous polyposis
via second hits in the colon
VEGF
stimulates production of/migration of/maturation of endothelial cells
tumor uses for angiogenesis via stimulating with hypoxia and growth factors
what does an in-situ neoplasm have to do in order to invade?
epithelial cells have to let go of each other, attach to basement membrane, degrade basement membrane, and migrate into storm below
metal-matrix proteases
degrade the basement membrane - critical for invasion
how do cancer cells evade immune system?
stop making tumor antigens
or mutate MHC genes that allow cells to wave around antigens
or make cytokines that repress immune system
how do cancer cells avoid senescence?
activate telomerase
if sentinel lymph nodes is positive what happens?
remove the rest of the axillary lymph nodes
If lumpectomy is chosen, what else needs to be done after surgery?
radiation
pt comes in with firm mass
mammogram, ultrasound, core biopsy
studies to order on core biopsy
ER/PR/HER2
when is neoadjuvant chemotherapy done? effect?
when cancer is very advanced - improves surgical outcome by shrinking tumor - also prevents progression of mets
