Neoplasia and Tumor Immunity

Question 1

What does neoplasia mean?

Answer 1

new growth; abnormal mass of tissue, the growth which exceeds and isn’t coordinated with normal tissue

Question 2

What is tumor?

Answer 2

swelling; often used interchangeable with neoplasia

Question 3

What are the properties of a benign tumor?

Answer 3

-oma
usually resemble normal tissue
-slow growth rate
-non-invasive, encapsulated
-do not metastasize

Question 4

What are the properties of a malignant (cancer)?

Answer 4

• carcinomas or sarcomas
• vary from resembling normal tissue to extremely different
• variable growth rate
• usually invasive
• capable of metastasizing

Question 5

What are the properties of tumors arising from epithelial cells?

Answer 5

• arise from ecto- or endoderm
• squamous. glandular/ductal, respiratory, and transitional epithelium, liver cells, and basal cells of skin
• may be benign or malignant(carcinoma)
• further classified based on architecture (papillary or villous)

Question 6

What are the properties of mesenchymal cell of origin?

Answer 6

• arise from mesoderm
• fibroblasts, adipocytes, smooth/skeletal muscle, bone, cartilage, blood vessels
• may be benign or maliginant (sarcoma)

Question 7

What are the properties of hematolymmpoid tumors?

Answer 7

always malignant; can be lymphomas, leukemias etc

Question 8

Lipoma is an example of what?

Answer 8

benign mesenchymal tumor

Question 9

A ovarian mucinous cystadenoma is an example of what?

Answer 9

an adenoma (glandular epithelium)
benign epithelial tumor

Question 10

What is the leiomyoma an example of?

Answer 10

benign mesenchymal tumor

Question 11

What is a hemangioma an example of?

Answer 11

benign mesenchymal tumor

Question 12

What is a pleomorphic adenoma an example of?

Answer 12

benign mixed tumor with both epithelial and mesenchymal components

Question 13

What is a teratoma?

Answer 13

predominantly benign tumors

composed of tissue derived from multiple germ layers-totipotent cells

Question 14

What is esophageal squamous cell carcinoma an example of?

Answer 14

malignant epithelial tumor

Question 15

What is prostatic adenocarcinoma of?

Answer 15

malignant epithelial tumor

Question 16

What is urethial carcinoma an example of?

Answer 16

malignant epithelial tumors

Question 17

What is an osteosarcoma of?

Answer 17

malignant mesenchymal tumro

Question 18

What is carinosarcoma of endometrium (MMMT) an example of?

Answer 18

mixed malignant tumor

Question 19

What is a hamartoma?

Answer 19

Tumor like cndition; mass of disorganized, mature tissue which is specific to site of development. Represent anomalous development

Question 20

What is a choriostoma?

Answer 20

tumor like condition; ectopic tissue ina foreign location

Question 21

What is differentiation/grade?

Answer 21

extent to which tumor cells morphologically and functionally resemble the normal tissue counterpart

Question 22

What is anaplastic mean?

Answer 22

complete lack of differentiation

Question 23

What are some properties of a well differentiated tumor?

Answer 23

close resemblence to normal; evidence of maturation/fucntion for example squamous cell carcinoma

Question 24

What are some properties of anaplasia?

Answer 24

Pleomorphism both cellular and nuclear
hyperchromatic nuclei
high N/C ratios
coarsely clumped chromatin
large nucleoli
atypicla bizzare mitoses
loss of polarity
tumor giant cell

Question 25

What is carcinoma in situ (CIS)?

Answer 25

pre-invasive lesion
frequently seen in proximity to invasive tumor
malignant cells don’t penetrate beyond basement membrane
full thickness dyplasia

Question 26

What is ysplasia?

Answer 26

disordered growth of epithelium

characterized by loss of polariy; loss of maturation; loss of architecture/organization, abnormal located mioses

Question 27

Hematogenous metastisis is the most common way for what cancer to spread?

Answer 27

sarcomas, usually though veins instead of arteries

portal, venal caval,, and paravertebral plexus are most common

Question 28

What are properties of metastatic spread by lymphatics?

Answer 28

most common pathway for carcinoma spread
rarer events with sarcomas
LN inolvment predictable based on drainage

Question 29

What is the stage system?

Answer 29

TNM;
Tumor size
Nodal involvment
Metastasis

Question 30

What is host reaction to cancer?

Answer 30

local effects
hematologic abnoralities
-anemia
-hypercoagulability
cachexia
paraneoplastic syndromes

Question 31

What is paraneoplastic syndrome?

Answer 31

10% of cancer patients’ non-horomonal or horomonal effects of a tumor
unrelated to local spread or metastasis

Question 32

What is the exogenous pathway for tumor presentation to T cells?

Answer 32

class II; APC capture tumor proteins shed from dying cells; process and present the peptide

Question 33

What is the endogenous pathway for presenting tumor proteins to T cells?

Answer 33

Tumor cells themselves can process cytoplasmic proteins into peptides taht get presentedg by MHC class I

Question 34

What are the three appraoches to cancer immuntherapy??

Answer 34

monoclonal antibodies
adoptive cellular immunotherapy
vaccines

Question 35

What are CTLA4 blocking antibodies used to treat?

Answer 35

first immune checkpoint target in an effort to treat cancer; neutralizing CTLA4 used to treat advanced melanoma
immune related adverse events in 60% of patients

Question 36

What is PD1 blocking antibody used for?

Answer 36

in early phase clinical trial 20-30% of pts experience tumor regressions, fewer toxicities than CTLA4

Question 37

What is a potential limitation of tumor antigen monoclonal antibodies?

Answer 37

mutation or down-modulation of tumor antigens

Question 38

What are TILs?

Answer 38

tumo infiltrating lymphocytes that can be expanded in culture and given back in large numbers of highly activated T cells