Neoplasia and Tumor Immunity Flashcards
What does neoplasia mean?
new growth; abnormal mass of tissue, the growth which exceeds and isn’t coordinated with normal tissue
What is tumor?
swelling; often used interchangeable with neoplasia
What are the properties of a benign tumor?
-oma usually resemble normal tissue -slow growth rate -non-invasive, encapsulated -do not metastasize
What are the properties of a malignant (cancer)?
- carcinomas or sarcomas
- vary from resembling normal tissue to extremely different
- variable growth rate
- usually invasive
- capable of metastasizing
What are the properties of tumors arising from epithelial cells?
- 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)
What are the properties of mesenchymal cell of origin?
- arise from mesoderm
- fibroblasts, adipocytes, smooth/skeletal muscle, bone, cartilage, blood vessels
- may be benign or maliginant (sarcoma)
What are the properties of hematolymmpoid tumors?
always malignant; can be lymphomas, leukemias etc
Lipoma is an example of what?
benign mesenchymal tumor
A ovarian mucinous cystadenoma is an example of what?
an adenoma (glandular epithelium) benign epithelial tumor
What is the leiomyoma an example of?
benign mesenchymal tumor
What is a hemangioma an example of?
benign mesenchymal tumor
What is a pleomorphic adenoma an example of?
benign mixed tumor with both epithelial and mesenchymal components
What is a teratoma?
predominantly benign tumors
composed of tissue derived from multiple germ layers-totipotent cells
What is esophageal squamous cell carcinoma an example of?
malignant epithelial tumor
What is prostatic adenocarcinoma of?
malignant epithelial tumor
What is urethial carcinoma an example of?
malignant epithelial tumors
What is an osteosarcoma of?
malignant mesenchymal tumro
What is carinosarcoma of endometrium (MMMT) an example of?
mixed malignant tumor
What is a hamartoma?
Tumor like cndition; mass of disorganized, mature tissue which is specific to site of development. Represent anomalous development
What is a choriostoma?
tumor like condition; ectopic tissue ina foreign location
What is differentiation/grade?
extent to which tumor cells morphologically and functionally resemble the normal tissue counterpart
What is anaplastic mean?
complete lack of differentiation
What are some properties of a well differentiated tumor?
close resemblence to normal; evidence of maturation/fucntion for example squamous cell carcinoma
What are some properties of anaplasia?
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
What is carcinoma in situ (CIS)?
pre-invasive lesion
frequently seen in proximity to invasive tumor
malignant cells don’t penetrate beyond basement membrane
full thickness dyplasia
What is ysplasia?
disordered growth of epithelium
characterized by loss of polariy; loss of maturation; loss of architecture/organization, abnormal located mioses
Hematogenous metastisis is the most common way for what cancer to spread?
sarcomas, usually though veins instead of arteries
portal, venal caval,, and paravertebral plexus are most common
What are properties of metastatic spread by lymphatics?
most common pathway for carcinoma spread
rarer events with sarcomas
LN inolvment predictable based on drainage
What is the stage system?
TNM;
Tumor size
Nodal involvment
Metastasis
What is host reaction to cancer?
local effects hematologic abnoralities -anemia -hypercoagulability cachexia paraneoplastic syndromes
What is paraneoplastic syndrome?
10% of cancer patients’ non-horomonal or horomonal effects of a tumor
unrelated to local spread or metastasis
What is the exogenous pathway for tumor presentation to T cells?
class II; APC capture tumor proteins shed from dying cells; process and present the peptide
What is the endogenous pathway for presenting tumor proteins to T cells?
Tumor cells themselves can process cytoplasmic proteins into peptides taht get presentedg by MHC class I
What are the three appraoches to cancer immuntherapy??
monoclonal antibodies
adoptive cellular immunotherapy
vaccines
What are CTLA4 blocking antibodies used to treat?
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
What is PD1 blocking antibody used for?
in early phase clinical trial 20-30% of pts experience tumor regressions, fewer toxicities than CTLA4
What is a potential limitation of tumor antigen monoclonal antibodies?
mutation or down-modulation of tumor antigens
What are TILs?
tumo infiltrating lymphocytes that can be expanded in culture and given back in large numbers of highly activated T cells
