Neoplasia Flashcards
What are the two components of tumors?
Parenchyma - neoplastic cells
Stoma - non-neoplastic supportive stroma
What is a teratoma?
Tumor derived form >1 germ layer tha arises from totipotential germ cells in the ovaries and testes
Benign, malignant, or cystic
What is a hamartoma?
Mass of disorganized but mature specialized cells indigenous to the particular site
E.g. bronchial hamartoma
What is a choristoma?
Ectopic rest of normal tissue
I.e. normal pancreatic tissue found in the stomach
What are the four features that distinguish benign and malignant tumors?
Degree of differentiation
Growth rate
Local invasiveness
Metastasis
What is anaplasia?
Lack of differentiation
Hallmark of malignancy
What is the difference in differentiation between benign and malignant neoplasms?
Benign - well differentiated
Malignant - rang from well differentiated to anaplastic
What functional changes are associated with poor differentiation?
Well differentiated neoplasms retain functional capabilities
Poorly differentiated and anaplastic carcinomas are unable to perform their normal functions
Abnormal functions can emerge as well (e.g. production of proteins or hormones)
How do benign tumors grow?
Cohesive expansile masses that remain localized to their site of origin
Can develop a capsule
Cause problems via impingement on other structures
How do malignant tumors grow?
By infiltration, invasion and destruction of the surrounding tissue
Results in poor demarcation
How is metastasis defined?
Spread of tumor to sites that are physically discontinuous with the primary tumor
Unequivocally marks a tumor as malignant
What are the pathways of malignant spread?
Seeding of body cavities and surfaces
Lymphatic spread - most common
Hematogenous spread - typical of sarcomas
What are the two phases of metastatic cascade?
Invasion of ECM
Vascular dissemination, homing of tumor cells and colonization
How do malignant cancer cells dissociated from one another?
Down regulation of E-cadherin
This reduces the cells ability to adhere to each other
What are four components of cellular invasion of the ECM?
Dissociation of cancer cells from one another
Degradation of the basement membrane and interstitial connective tissue
Attachment of tumor cells to ECM componenets
Migration and invasion of tumor cells
What are three acquired predisposing conditions to cancer?
Chronic inflammation
Precursor lesions
Immunodeficiency states
What is metaplasia?
Replacement of one cell type with another
Associated with tissue damage, repair, and regeneration
What is cancer cachexia?
Progressive loss of body fat and lean body massa accompanied by profound weakness, anorexia and anemia
Equal loss of fat and muscle, BMR increased, systemic inflammation
What are paraneoplastic syndromes?
Symptom complexes in cancer patients that cannot be readily explained by either the local or distant spread of tumor or by elaboration of hormones indigenous to the tissue in which the tumor arose
What are common endocrinopathic paraneoplastic syndromes?
Cushing - small cell lung carcinoma
Hypercalcemia - breast, lung, kidney, ovary
What are common neuromyopathic paraneoplastic syndromes?
Peripheral neuropathies
Cortical cerebellar degeneration
Polymyopathy
Myasthenia gravis syndrome
What is hypertrophic osteoarthropathy?
Paraneoplastic syndrome associated with bronchogenic carcinoma
Periosteal new bone formation at end of long bones, metatarsals, metacarpals, proximal phalanges
Arthritis, clubbing
What are some vascular and hematologic PNS?
Migratory thrombophlebitis
DIC
Nonbacterial thrombotic endocarditis
Describe tumor grading?
Degree of differentiation, correlates with aggressiveness
Low grade/high grade (tiers)
Well, moderately, poorly, undifferentiated (I, II, III, IV)
How are tumors staged?
Tumor size, extent of invasion, metastasis
For treatment and prognosis
What is the TNM classification system?
T - primary tumor, size and local extent
N - regional lymph nodes, degree of involvement
M - metastasis, distant
What are three methods of sampling for histologic/cytologic examination?
Excision or biopsy
Needle aspiration
Cytologic smears
What are the uses for immunohistochemistry?
Categorization of undifferentiated or poorly differentiated tumors
Categorization of leukemias and lymphomas
Determiation of site of origin
Detection of prognosticc molecules
What are the uses for flow cytometry?
ID of cell-surface antigens widely used in the classification of leukemias and lymphomas
Routine for specific diagnosis of lymphoma subtypes
What are serum tumor markers?
Biochemical indicators of the presence of a tumor
Not primary modalities