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Pathology > Neoplasia complete > Flashcards

Neoplasia complete Flashcards

1
Q

Benign tumor origin

A

Epithelial or Connective tissue origin

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2
Q

Benign tumors of epithelial origin

A

Ectoderm, endoderm

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3
Q

Benign tumors of connective origin

A

mesoderm

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4
Q

Teratomas origin

A

Derives from ectoderm, endoderm, mesoderm

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5
Q

Origin of Carcinomas

A

Derive from squamous, glandular (adenocarcinoma), transitional epithelium

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6
Q

Origin of Sarcomas

A

Derive from connective tissue

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7
Q

Hamartoma

A

non-neoplastic overgrowth of tissue

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8
Q

Choristoma

A

normal tissue where it should NOT be

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9
Q

Neoplastic component of that determines the tumors biologic behavior

A

parenchyma (tissue that does the work)

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10
Q

Grade of cancer asks…

A

does the cancer resemble its parent tissue or not?

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11
Q

Features of Malignant tumors

A

↑ nuclear/cytoplasmic ratio; abnormal mitotic spindles

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12
Q

How many doubling times (cell cycles) are required b4 a tumor can be clinically evident

A

30

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13
Q

Benign and malignant tumors derive from a…

A

single precursor cell (monoclonality)

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14
Q

Why dont malignant tumors lose genetic material after multiple cell divisions?

A

d/t upregulation of telomerase activity

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15
Q

Feature of Basal cell carcinoma

A

invade tissue but do NOT metastasize

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16
Q

2nd most important criterion for malignancy

A

Invasion

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17
Q

Tissue resistant to invasion

A

Cartilage, elastic tissue

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18
Q

Loss of intercellular adherence (E-cadherin)

A

→ cell invasion

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19
Q

Extranodal metastasis (eg liver) has greater prognostic significance than…

A

nodal metastasis (TNM )

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20
Q

Routes of metastasis

A

lymphatic (carcinomas), hematogenous (sarcomas), seeding body cavities

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21
Q

Type of metastasis common w/ surface-derived ovarian cancers

A

Seeding

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22
Q

Bone metastasis

A

Vertebra MC site; paravertebral venous plexus

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23
Q

Feature of Osteoblastic metastasis

A

↑ serum alkaline phosphatase (dephosphorylates pyrophosphate which inhibits bone formation); seen in prostate cancer

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24
Q

Consequences of Osteolytic metastasis

A

hypercalcemia, pathologic fxs

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25
Q

Bone metastasis on X-ray

A

Osteoblastic-radiodense; Osteolytic-radiolucent

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26
Q

MC tissue metastasize to

A

Lymph node

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27
Q

2nd MCC death in US

A

Cancer

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28
Q

Lifetime risk for cancer

A

Men 〉 Women

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29
Q

Population w/ greatest overall risk for cancer

A

Blacks

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30
Q

MC cancer in children

A

Acute lymphoblastic leukemia (ALL)

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31
Q

Cancer incidence in men

A

Prostate 〉 Lung 〉 Colorectal

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32
Q

Cancer incidence in women

A

Breast 〉 Lung 〉 Colorectal

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33
Q

Incidence of gynecologic cancer

A

Endometrial 〉 Ovarian 〉 Cervical (lowest d/t pap smears)

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34
Q

MCC of cancer death in adults

A

Lung cancer

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35
Q

Cancer-related deaths in men

A

Lung 〉 Prostate 〉 colorectal

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36
Q

Cancer-related deaths in women

A

Lung 〉 Breast 〉 Colorectal

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37
Q

Most rapidly ↑ing cancer worldwide

A

Malignant melanoma

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38
Q

Cancer in china

A

Nasopharyngeal carcinoma 2ndary to EBV

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39
Q

Cancer in Japan

A

Stomach adenocarcinoma d/t smoked foods

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40
Q

Cancer of SE Asia

A

Hepatocellular carcinoma d/t Hep B and aflotoxins (produced by Aspergillus) in food

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41
Q

Cancer of Africa

A

Burkitts lymphoma d/t EBV and Kaposis sarcoma d/t HHV 8

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42
Q

AD cancer syndromes

A

Retinoblastoma, Familial Adenomatous Polyposis, Li-Fraumeni syndrome, Hereditary nonpolyposis colon cancer (Lynch syndrome), BRCA1 and BRCA2 genes

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43
Q

Retinoblastoma

A

point mutation inactivates RB suppressor gene; predisposition for osteogenic sarcoma in adolescence

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44
Q

Familial Adenomatous Polyposis (FAP)

A

inactivation of APC suppressor gene → malignant transformation of of polyps by age 50

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45
Q

Li-Fraumeni syndrome

A

inactivation of TP53 suppressor gene → ↑ risk for sarcomas, leukemia, carcinomas

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46
Q

Hereditary nonpolyposis colon cancer (HNPCC) aka Lynch syndrome

A

inactivation of DNA mismatch repair genes → cannot correct errors in nucleotide pairing; ↑ risk colorectal cancer w/o previous polyps

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47
Q

BRCA1 and BRCA2 genes

A

inactivation of genes ↑ risk for breast and ovarian cancer; can also be involved in Familial cancer syndromes

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48
Q

Autodomal recessive syndromes w/ defects in DNA repair

A

Xeroderma pigmentosum, Chromosome instability syndromes

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49
Q

Xeroderma pigmentosum

A

UV light → cross links adjacent pyrimidines (C&T) producing pyrimidine dimers; ↑ risk of skin cancer like basal cell carcinoma, squamous cell carcinoma

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50
Q

Chromosome instability syndromes

A

Chromosomes susceptible to damage by ionizing radiation and drugs→to cancer

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51
Q

Examples of Chromosome instability syndromes

A

Fanconi anemia, ataxia telangiectasia, bloom syndrome

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52
Q

Precursor of squamous cell carcinoma

A

Actinic (solar) keratosis

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53
Q

Most important factor in ↓ risk for cancer

A

Cessation of smoking

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54
Q

Name something that ↓ risk for hepatocellular carcinoma

A

HBV immunization

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55
Q

Name something that ↓ risk for cervical cancer

A

Human papillomavirus immunization

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56
Q

Least common gynecologic cancer in US

A

Cervical cancer

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57
Q

Test most responsible for ↓ incidence/mortality rate for cervical cancer

A

Cervical pap smear

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58
Q

Prostate-specific antigen (PSA)

A

more sensitive (yes,yes) than specific (no,no)

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59
Q

Rx H. pylori infection

A

↓ risk for developing gastric lymphoma/adenocarcinoma

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60
Q

Rx GERD

A

↓ risk for distal adenocarcinoma of esophagus

61
Q

MC type of mutation in cancer

A

Point mutations

62
Q

Genes involved in normal growth and repair

A

Proto-oncogenes

63
Q

Genes that protect against unregulated cell growth

A

Suppressor genes

64
Q

Antiapoptosis genes (prolife)

A

BCL2 gene family

65
Q

apoptosis gene

A

BAX gene; activated by TP53 if DNA damage is excessive; BAX gene inactivates BCL2 antiapoptosis gene

66
Q

Proto-oncogenes

A

ABL, HER (ERBB₂), MYC, N-MYC, RAS, RET, SIS

67
Q

ABL

A

Nonrecptor tyrosine kinase; t(9;22); CML, chr. 22 Philadelphia chr

68
Q

HER (ERBB₂)

A

Receptor synthesis; amplification mutation; Breast carcinoma (marker of aggression)

69
Q

MYC

A

Nuclear transcription; t(8;14); Burkitts lymphoma

70
Q

N-MYC

A

Nuclear transcription; amplification mutation; Neuroblastoma

71
Q

RAS

A

GTP signal transduction; Point mutation; leukemia; lung, colon, pancreatic cancer

72
Q

RET

A

Receptor synthesis; Point mutation; Multiple Endocrine Neoplasia IIa/IIb (MEN) syndromes

73
Q

SIS

A

Growth factor synthesis; Overexpression; Osteogenic sarcoma, astrocytoma

74
Q

Tumor suppressor genes

A

APC, BRCA1/BRCA2, RB, TGF-β, TP53, VHL, WT₁

75
Q

Mutation common to tumor suppressor genes

A

Point mutation

76
Q

APC

A

prevents nuclear transcription; Famililal adenomatous polyposis

77
Q

BRCA1/BRCA2

A

Regulated DNA repair; Breast ovary, prostate cancers

78
Q

RB

A

Inhibits G₁ to S phase; Retinoblastoma, osteogenic sarcoma, breast carcinoma

79
Q

TGF-β

A

Inhibits G₁ to S phase; pancreatic and colorectal carcinomas

80
Q

TP53

A

Inhibits G₁ to S phase, Repairs DNA, activates BAX; Lung, colon, breast carcinomas; Li-Fraumeni syndrome: breast carcinoma, brain tumors, leukemia, sarcomas

81
Q

VHL

A

Regulates nuclear transcription; Von Hippel-Lindau syndrome; cerebellar hemanioblastoma, retinal angioma, renal cell carcinoma (bilateral), pheochromocytoma (bilateral)

82
Q

Pheochromocytoma

A

Neuroendocrine tumor of medulla of adrenal glands; secretes excessive catacholamines

83
Q

WT₁

A

Regulates nuclear transcription; Wilms tumor

84
Q

Fxn of DNA repair genes

A

correct errors in nucleotide pairing; excise pyrimidine dimers

85
Q

Enzymes involved in dimer excision

A

endonuclease, exonuclease, polymerase, ligase

86
Q

Agent most responsible for cancer and cancer deaths in the US

A

Tobacco

87
Q

Sequence of chemical carcinogenesis

A

Initiaion → promotion→ progression

88
Q

Aflatoxin (from aspergillus)

A

HCC in assoc. w/ Hep B

89
Q

Alcohol

A

Squamous cell carcinoma or oropharynx and upper/middle esophagus; pancreatic and Hepatocellular carcinomas

90
Q

Alkylating agents

A

Malignant lymphoma

91
Q

Arsenic

A

Squamous cell carcinoma of skin, lung cancer, liver angiosarcoma

92
Q

Asbestos

A

Bronchogenic carcinoma, pleural mesothelioma

93
Q

Benzene

A

Acute Leukemia

94
Q

Beryllium

A

Bronchogenic carcinoma

95
Q

Chromium

A

Bronchogenic carcinoma

96
Q

Cyclophosphamide

A

Transitional cell carcinoma of urinary bladder

97
Q

Diethylstilbestrol (DES)

A

Clear cell carcinoma of vagina/cervix

98
Q

β-Naphthylamine (aniline dyes)

A

Transitional cell carcinoma of urinary bladder

99
Q

Nickel

A

Bronchogenic carcinoma

100
Q

Oral Contraceptives

A

Breast, cervical carcinomas

101
Q

Polycyclic hydrocarbons

A

Squamous cell carcinoma: oral cavity, midesophagus, larynx, lung; Adenocarcinoma: pancreas, kidney; Transitional cell carcinoma: urinary bladder, renal pelvis

102
Q

Silica

A

Bronchogenic carcinoma

103
Q

Oncogenic RNA viruses

A

HCV , HTLV-1 (human T-cell lymphotropic virus)

104
Q

HCV

A

produces postnecrotic cirrhosis; HCC

105
Q

HTVL-1 (Human T-cell lymphotropic Virus)

A

Activates TAX gene, stimulates polyclonal T-cell proliferation, inhibits P53; T-cell leukemia and lymphoma

106
Q

Oncogenic DNA viruses

A

EBV, HBV, HHV-8, HPV 16 and 18

107
Q

EBV

A

Promotes polyclonal B cell proliferation, which ↑ risk for t(8;14); Burkitts lymphoma, CNS lymphoma in AIDS, mixed cellularity Hodgkins lymphoma, nasopharyngeal carcinoma

108
Q

HBV

A

activates proto-oncogenes, inactivates p53; HCC

109
Q

HHV-8

A

acts via cytokine released from HIV and HSV; Kaposis sarcoma in AIDS

110
Q

HPV 16 and 18

A

Type 16: E6 gene product inhibits P53, Type 18: E7 inhibits RB; squamous cell carcinoma of vulva, vagina, cervix, anus, larynx, oropharynx

111
Q

Pathogens and cancer

A

Viruses 〉 bacteria 〉 parasites

112
Q

MC cancer d/t ionizing radiation

A

AML (acute myeloblastic leukemia) or CML (chronic myeloblastic leukemia)

113
Q

MC cancer d/t excessive UV light exposure

A

Basal cell carcinoma

114
Q

Squamous cell carcinoma in physical injury

A

3rd degree burns; chronically draining sinuses (chronic osteomyelitis)

115
Q

Most effective host defense against cancer

A

Cytotoxic CD8 T cells

116
Q

Most important prognostic factor

A

Staging criteria; TNM system

117
Q

Least to most important prognostic factor

A

T 〈 N 〈 M (most important)

118
Q

Molecule involved in Cachexia

A

TNF-α secreted by macrophages and tumor cells→suppresses appetite in hypothalamus and stimulates apoptosis

119
Q

MC anemia in cancer

A

Anemia of chronic dz; normocytic anemic w/ corrected reticulocyte count 〈 3 %

120
Q

Hemostasis abnormality in malignancy

A

Thrombogenic

121
Q

MCC of death in cancer

A

Gram - sepsis

122
Q

Skin abnormality that may be assoc. w/ stomach cancer

A

Acanthosis nigricans; black, verrucoid-appearing lesion

123
Q

Signs of ectopic hormone production

A

hypercalcemia, hyponatremia, hypoglycemia, hypercortisolism, polycythemia

124
Q

Eaton-Lambert syndrome

A

Small cell carcinoma of lung; Myasthenia gravis-like Sxs (muscle weakness); Ab against Ca channel

125
Q

Hypertrophic osteoarthropathy

A

Bronchogenic carcinoma; Periosteal rxn of distal phalanx (often assoc. w/ clubbing of nail)

126
Q

Nonbacterial thrombotic endocarditis

A

Mucus-secreting pancreatic and colorectal carcinomas; sterile vegetations on mitral valve

127
Q

Seborrheic keratosis

A

Stomach carcinoma; Sudden appearance of numerous pigmented seborrheic keratoses (leser-Trélat sign)

128
Q

Superficial migratory thrombophlebitis

A

Pancreatic carcinoma; Release of procoagulants (Trousseaus sign: hypercoagulability)

129
Q

Nephrotic syndrome

A

Lung, breast, stomach carcinomas; Diffuse membranous glomerulopathy

130
Q

Cushing syndrome

A

ACTH; small cell carcinoma of lung, medullary carcinoma of thyroid

131
Q

Gynecomastia

A

hCG; Choriocarcinoma (testis)

132
Q

Hypercalcemia

A

PTH-related protein: Renal cell carcinoma, 1° squamous cell carcinoma of lung, breast carcinoma; Calcitriol (VitD): malignant lymphoma (contain α1-hydroxylase)

133
Q

Hypocalcemia

A

Calcitonin; Medullary carcinoma of thyroid

134
Q

Hypoglycemia

A

Insulin-like facter; HCC

135
Q

Hyponatremia

A

ADH; small cell carcinoma of lung

136
Q

2° Polycythemia

A

EPO; Renal cell and Hepatocellular carcinoma

137
Q

α-fetoprotein (AFP)

A

HCC, yolk sac tumor of ovary or testis

138
Q

Bence Jones Protein

A

Multiple myeloma, Waldenströms macroglobulinemia

139
Q

CA 15-3

A

Breast cancer

140
Q

CA 19-9

A

Pancreatic, colorectal carcinomas

141
Q

CA 125

A

Surface-derived ovarian cancer (eg serous cystadenocarcinoma; helpful in distinguishing malignant from b9

142
Q

Carcinoembryonic antigen (CEA)

A

Colorectal and pancreatic carcinomas

143
Q

Lactate dehydrogenase

A

Malignant lymphoma

144
Q

Cytokeratin

A

epithelial origin

145
Q

Vimentin

A

Connective tissue origin

146
Q

Desmin

A

Muscle

147
Q

GFAP

A

Neuroglia

148
Q

Neurofilaments

A

Neurons

149
Q

CD45+

A

Malignant lymphoma

Pathology (10 decks)

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