Neoplasia I

Question 1

What are the seven hallmarks of cancer?

Answer 1

1.) evasion of apoptosis; 2.) self-sufficiency in growth signals; 3.) insensitivity to anti-growth signals; 4.) sustained angiogenesis; 5.) limitless replicative potential; 6.) tissue invasion; 7.) metastasis (p.218)

Question 2

What are the five steps of cancer progression?

Answer 2

Normal tissue –> hyperplasia –> carcinoma in situ (preinvasive) –> invasive carcinoma –> metastaic focus (p.218)

Question 3

Describe normal differentiation of cells.

Answer 3

Contain an epithelial cell layer and a basement membrane. Normal cells have basal –> apical differentiation (p.218)

Question 4

What is hyperplasia?

Answer 4

Cells have increased number (p.218, 219)

Question 5

What is dysplasia?

Answer 5

An abnormal proliferation of cells with loss of cellular orientation, shape, and size in comparison to normal tissue maturation; Commonly preneoplastic (p.218, 219)

Question 6

What are the features of a carcinoma in situ?

Answer 6

Neoplastic cells have not invaded the basement membrane; there is a high nuclear/cytoplasmic ratio and clumped chromatin; neoplastic cells encompass entire thickness (p.218)

Question 7

What are the features of an invasive carcinoma?

Answer 7

Cells have invaded the basement membrane and there is potential to metastasize if they reach a blood or lymphatic vessel (p.218)

Question 8

How do cancer cells invade the basement membrane in an invasive carcinoma?

Answer 8

Using collagenases and hydrolases (metalloproteinases) (p.218)

Question 9

What distinguishes metastatic cancer from non-metastatic cancer?

Answer 9

Spread to distant organs with cells that have survived an immune attack (p.218)

Question 10

What is the ‘seed and soil’ theory of metastasis?

Answer 10

Seed- tumor embolus; soil- target organ (liver, lungs, brain, bone, etc.) (p.218)

Question 11

How do cancer cells spread during metastasis?

Answer 11

Though the blood or lymphatic vessels (p.218)

Question 12

What is metaplasia?

Answer 12

One adult cell type is replaced by another. This is often secondary to irritation and/or environmental exposure (p.219)

Question 13

Give an example of metaplasia.

Answer 13

Squamous metaplasia in trachea and bronchi of smokers (p.219)

Question 14

Which ‘plasias’ are reversible?

Answer 14

Hyperplasia, metaplasia, dysplasia (p.219)

Question 15

Which ‘plasias’ are irreversible?

Answer 15

Anaplasia, neoplasia, desmoplasia (p.219)

Question 16

What is anaplasia?

Answer 16

Abnormal cells lacking differentiation. Cells resemble primitive cells of the same tissue, often equated with undifferentiated malignant neoplasms. Cells have little to know resemblance to the tissue of origin (p.219)

Question 17

What is neoplasia?

Answer 17

A clonal proliferation of cells that is uncontrolled and excessive. Neoplasia may be benign or malignant (p.219)

Question 18

Is neoplasia benign or malignant?

Answer 18

It can be either benign or malignant (p.219)

Question 19

What is desmoplasia?

Answer 19

Fibrous tissue formation in response to neoplasm (p.219)

Question 20

What is tumor grade?

Answer 20

The degree of cellular differentiation based on histological appearance of an individual tumor (p.219)

Question 21

How is tumor grade ‘graded’?

Answer 21

Graded 1-4; 1= low grade, well differentiated to 4= high grade, poorly differentiated, anaplastic (p.219)

Question 22

How does the prognostic value of tumor grade compare to that of tumor stage?

Answer 22

Stage usually has more prognostic value than grade (p.219)

Question 23

What is tumor stage?

Answer 23

Describes the spread of tumor in a particular patient. It is determined by the degree of localization/ spread, size of primary lesion, spread to regional lymph nodes, presence of metastases (stage = spread) (p.219)

Question 24

What findings is tumor stage based upon?

Answer 24

Clinical (c) and pathologic (p) findings (ex. cT3N1M0) (p.219)

Question 25

What is the TNM staging system for tumors?

Answer 25

T= tumor size; N= node involvement; M= metastases (p.219)