Neoplasia

Question 1

neoplasm

Answer 1

clonal overgrowth of genetically abnormal cells with loss of normal growth control

Question 2

benign neoplasm

Answer 2

has not invaded and cannot metastasize

Question 3

malignant neoplasm

Answer 3

has invaded and has the capacity to metastasize

Question 4

in-situ neoplasia

Answer 4

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.

Question 5

epithelial cancer term

types

Answer 5

carcinoma

gland-forming = adeno

squamous = squamous

Urothelium = transitional

Question 6

Mesenchymal cancer term

Answer 6

sarcoma

add preface of type of cell (ex Lipo- Osteo-)

Question 7

what has to happen before metastasis?

Answer 7

invasion

Question 8

what is the usual killer in cancer

Answer 8

mets

Question 9

endothelial cancer term

Answer 9

angiosarcoma

Question 10

What does low-grade cancer look like?

Answer 10

cells look like normal tissue cells

Question 11

What does high-grade cancer look like?

Answer 11

cells look nothing like normal tissue cells

Question 12

criteria for grading of cancer

Answer 12

nuclear appearance - is it different from normal nuclei?

mitotic activity

structures + products - are they the same structures that the normal tissue makes or different?

Question 13

tumor stage

Answer 13

size of primary tumor

lymph nodes involved

distant mets

Question 14

stage 1:
stage 2:
stage 3:
stage 4:

Answer 14

1: confined to organ
2: locally invasive
3: spread to adjacent organs
4: diffuse mets throughout the body

Question 15

is stage or grade more important in cancer prognosis?

Answer 15

stage

Question 16

TNM nomenclature

Answer 16

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)

Question 17

What things does a neoplasm need to progress?

Answer 17

growth, angiogenesis, invasion and mets, evasion of immune system, evasion of senescence

Question 18

how do tumor cells overgrow and take over normal tissue?

Answer 18

more tumor cells are dividing than normal cells

fewer amor cells are dying than normal cells.

Question 19

oncogene

Answer 19

encodes protein that becomes constitutively active or over expressed that stimulates cell division or inhibits cell death

Question 20

APC, Rb, p53, BRCA1/2 are…

Answer 20

tumor suppressor genes

Question 21

erb-B2 (HER2), ras, myc, cyclin D are…

Answer 21

proto-oncogenes

Question 22

14/18 translocation

Answer 22

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

Question 23

9/22 translocation

Answer 23

Philadelphia chromosome - Bcr and Abl next to each other creating a fusion oncogene = oncogenic tyrosine kinase -> CML

Question 24

gene associated with male breast cancer

Answer 24

BRCA 2

Question 25

BRCA1 associated with…

Answer 25

high grade breast cancer in young women, ovarian cancer

Question 26

inactivation of APC leads to

Answer 26

familial adenomatous polyposis

via second hits in the colon

Question 27

VEGF

Answer 27

stimulates production of/migration of/maturation of endothelial cells

tumor uses for angiogenesis via stimulating with hypoxia and growth factors

Question 28

what does an in-situ neoplasm have to do in order to invade?

Answer 28

epithelial cells have to let go of each other, attach to basement membrane, degrade basement membrane, and migrate into storm below

Question 29

metal-matrix proteases

Answer 29

degrade the basement membrane - critical for invasion

Question 30

how do cancer cells evade immune system?

Answer 30

stop making tumor antigens

or mutate MHC genes that allow cells to wave around antigens

or make cytokines that repress immune system

Question 31

how do cancer cells avoid senescence?

Answer 31

activate telomerase

Question 32

if sentinel lymph nodes is positive what happens?

Answer 32

remove the rest of the axillary lymph nodes

Question 33

If lumpectomy is chosen, what else needs to be done after surgery?

Answer 33

radiation

Question 34

pt comes in with firm mass

Answer 34

mammogram, ultrasound, core biopsy

Question 35

studies to order on core biopsy

Answer 35

ER/PR/HER2

Question 36

when is neoadjuvant chemotherapy done? effect?

Answer 36

when cancer is very advanced - improves surgical outcome by shrinking tumor - also prevents progression of mets