Neoplasia characterization

Question 1

Localized neoplasm

Answer 1

-Frequently benign
-Minimal effects
-examples: lipoma, histocytoma, sebaceous adenoma
-Cant cause invasion
-Clone and subclones proliferate at a greater rate
-angiogenesis minimal

Question 2

Angiogenesis

Answer 2

Growth of new blood vessels in response to VEGF and b-FGF

Question 3

Localized neoplasm interaction with ECM

Answer 3

Minimal, stick to eachother tightly, cadherins and adhesins often normal

Question 4

Effects of localized neoplasm

Answer 4

-Largely locally
-Can compress adjacent tissues an organs
-Small ones normally non critical
-Minimal systemic effects

Question 5

Outcome of localized neoplasms

Answer 5

-Remain static for a long time
-Can get spontaneous regression
-Usually remove surgically

Question 6

Locally invasive neoplasm

Answer 6

-Can be malignant or benign
-Affect variable depending on cell type
-Ex: Hemngiopercytoma, fibrosarcoma, mast cell tumor
-Capable of local invasion
-Subclones have additional mutations
-Adequate angiogenesis, can get growth that exceeds this and leads to necrosis

Question 7

Locally invasive neoplasms and ECM

Answer 7

Interactions extensive, less adhesion cel-to-cell
-Decreased cadherins
-Increased expression of receptors for laminin, fibronectin, and collagen

Question 8

Locally invasive Epithelial neoplasms

Answer 8

Seperated by basement membrane to ECM. Have to penetrate this making it malignant

Question 9

Locally invasive mesenchymal neoplasms

Answer 9

Already in ECM harder to determine if it is malignant

Question 10

Effects of locally invasive neoplasm

Answer 10

-Largely local
-Can infiltrate normal tissues and organs
-Can get loss of function of tissue
-Systemic effects may occur because of damaged tissue

Question 11

Outcome of locally invasive neoplasms

Answer 11

-Some grow to a certain size then remain static
-May continue to grow until damaged
-Surgical removal often followed by local reoccurence
-Malignancy and can metastasize

Question 12

Metastatic neoplasm

Answer 12

-ALways malignant
-Always significant and ultimately fatal
-Ex: hemangiosarcoma, osteosarcoma, mammary adenocarcinoma
-Local and systemic invasion
-greater number of subclones with additional mutations

Question 13

Pathogenesis of metastatic neoplasm

Answer 13

-Angiogenesis at the site of primary neoplasm, can serve as route of entry into circulation
-Angiogenesis is very important at site of secondary ones so they can survive

Question 14

Metastatic interaction with ECM

Answer 14

Extensive. Similar to locally extensive neoplasms

Question 15

What is required for metastasis

Answer 15

Intravasuclar invasion and has to penetrate the vascular basement membrane. Usually use collagenase

Question 16

Carcinomas spread through

Answer 16

Lymphatic vessels

Question 17

Sarcomas spread through

Answer 17

Blood vessels

Question 18

Outcome of intravascular neoplastic emboli

Answer 18

Usually die or are killed by host defenses

Question 19

Criteria for successful metastasis

Answer 19

-Adhere to endothelium
-Migrate out of vessel
-Local extravascular environment where they can grow

Question 20

How do they adhere to endothelium

Answer 20

Receptor mediated binding (CD44). More prominent in arease with slow moving blood

Question 21

Migrating out of vessel

Answer 21

Have to break through basement membrane

Question 22

Local extravascular environment for neoplastic growth

Answer 22

-Need adequate vascularity
-Appropriate nutrients and microenvironment

Question 23

Significance of metastatic neoplasms

Answer 23

-Local and systemic
-Primary and secondary ones infiltrate and destroy tissues and organs
-Cytokines and products of neoplastic cells disrupt homeostasis

Question 24

Outcomes of metastatic neoplasm

Answer 24

-Invariably fatal
-Time course and progression variable depending on tumor

Question 25

Local effects of neoplasia

Answer 25

-Destroy and replace normal tissue
-Compression
-Interfere with normal function
-metatstatic sites cause localized damage
-Vascular erosion and hemorrhage

Question 26

Systemic effects of neoplasia

Answer 26

-Dyshomeostasis brom products of normal and neoplastic cells such as TNF, IL 1, IL6, prostaglandins
-Cachexia and fever

Question 27

Paraneoplastic disorders

Answer 27

Systemic effects induced by tumor cell products

Question 28

Paraneoplastic syndromes

Answer 28

Hypercalcemia
-Hypo or hyperglycemia
-Leukocytosis/leukopenia
-Neuropathy
-Myelofibrosis
-Thrombocytosis/penia

Question 29

Recognition of neoplastic cells

Answer 29

-Tumor specific antigens (class I MHC molecules)
-Tumor-associated antigens
-Humoral and cell-mediated responses

Question 30

Responses to neoplastic cells

Answer 30

-T cell mediated cytotoxicity
-Type II hypersensitivity reaction
-Innate responses by NK cells and activated macrophages

Question 31

Tumor-specific antigens

Answer 31

May be products of normal genes that aren’t normally expressed or from mutated genes that are now present

Question 32

Tumor associated antigens

Answer 32

Always present at low levels, but get up regulated when undergoes transformation