Neoplasia III Flashcards
What are the four places that tumor cells can invade?
- Adjacent tissue
- Penetrate body cavity
- Lymph nodes
- Small venules/capillaries
What is the protein that attaches cells to each other?
Cadherins
What type of collagen forms BM?
4
What are laminins?
A cell surface molecule that attaches to the ECM to degrade it
What happens to E-cadherin in tumor cells? What is the consequence of this
Downregulated or not expressed–leads to ability of tumor cell to metastasize
How do tumor cells get through a BM?
induce inflammatory cells to release collagenases (MMPs) to degrade collagen IV
What allows tumor cells to migrate through the BM?
Binding of fibronectin to its receptor
Other motility factors secreted
What is a metastasis?
Tumor implantation that is discontinuous with primary tumor
What are the four steps of tumor metastatic cascade?
- Invasion of BM
- Movement through ECM
- Vascular dissemination
- Homing
What do NK cells do in vascular dissemination?
Kills tumors
What is CD44?
Expression of CD44 on tumor cells seems to favor metastasis
What protects tumor cells in the circulation?
Clumped up or covered by platelets
How do tumor cells migrate to the blood via lymphatic ducts?
Through the thoracic duct
What are the three routes of metastases?
- Seeding of body cavities
- Lymph spread
- Hematogenous
What is the most common type of spread for tumors?
Lymphatic spread
Which type of tumor uses lymphatic spread: carcinomas or sarcomas?
Carcinomas
What is the pattern of lymphatic spread of tumors?
Up the lymphatic chain (e.g. breast CA migrates to axillary node)
Hard or soft for tumors?
Usually hard
TTP or not for tumors?
Usually no TTP
How does metastatic adenocarcinoma appear in lymph nodes microscopically?
Looks like glands, as opposed to normal lymph nodes
What are the three carcinomas that do not spread via the lymph nodes?
- Follicular carcinoma
- Renal cell carcinoma
- Hepatocellular carcinoma
Hematogenous spread is characteristic of what type of tumors?
Sarcomas
What is the one sarcoma that does not spread via the hematogenous route? How does it spread?
Rhabdomyosarcoma–spread via local invasion of the submucosal layer
What are the four sites that are frequently involved in hematogenous spread?
Liver
Lungs
Brain
Bone
Multiple tumors are characteristic of local tumor or metastatic tumors?
Metastatic
What is umbilication?
Term to characterize the central area of necrosis in tumors
What are sentinal lymph nodes?
1st node in a regional lymphatic system that receives lymph flow from primary tumor
How are sentinel lymph node tumor detected?
Radio labels tracers
What is the most common site for bony metastases? Why?
Vertebral column, d/t direct connection with the vena cava
What is the primary symptom with bone metastases?
Pain
What are the two types of bone metastases?
Osteoblastic
Osteolytic
How do osteoblastic metastases appear on x-ray?
Radio-dense loci
What is the elevated lab seen in osteoblastic metastases?
Increased Serum alk phos
How do osteolytic metastases appear on x-ray?
Pathological fractures
Lucency of bones
What are the factors that are produced in osteolytic tumors?
PGE2
IL-1
What is the complication with osteolytic metastases?
Hypercalcemia
What is the common site of metastases for: stomach adenocarcinoma
Left Supraclavicular node
What is the common site of metastases for: breast CA
Bone
lung
What is the common site of metastases for: colorectal CA
Liver
What is the common site of metastases for: renal adenocarcinoma
Lung
What is the common site of metastases for: lung
Adrenal/liver
What is the common site of metastases for: melanoma
liver
Lung
What is the common site of metastases for: the prostate
Bone
What is the common site of metastases for: testicular tumors
Para-aortic nodes
Which is more important, the grade or stage of a tumor?
Stage
What is grading of a tumor?
Looking histologically at a tumor by a pathologist
Higher grade tumor = ? prognosis
Worse
How many grades are there for a tumor
I-IV
Well differentiated tumors with a loss of polarity = what grade?
I
Moderately differentiated tumor = what polarity?
II
Poorly differentiated tumor = what grade?
III
Nearly anaplastic tumor = what grade?
IV
What are the three most common CA causes of death?
Lung CA
Prostate/breast
Colorectal
What are the three highest incidence causes of CA?
Breast/Prostate
Lung
Colorectal
Where, geographically, is gastric CA high?
Japan
What are the three CAs associated with arsenic?
Lung
Skin
Hemangiosarcoma
What are the three CAs associated with asbestos?
Lung
Mesothelioma
GIT
What are the two CAs associated with Nickel?
Nose
Lung
What is the CA associated with Radon?
Lung CA
What is the CA associated with vinyl chloride?
Angiosarcoma of liver
Aniline dyes are associated with what CA?
Bladder CA
Asbestos is associated with what CA?
Mesothelioma
Cigarette smoking is associated with what CA?
Oropharynx and lung
What type of CAs particularly increase with age?
Carcinomas
What are the four types of CA found in young adults?
- Leukemia
- Lymphoma
- CNS/soft tissue CA
What are the three CAs found commonly in infancy?
Blastomas
Leukemia
Rhabdomyosarcoma
What are the four steps of tumor metastases?
- Detachment of tumor cells from each other
- Attachment to matrix component
- Degrade ECM
- Migration of tumor cell
What is the receptor that tumor cells use to attach to the BM?
Laminin receptor
Where do the enzymes that tumor utilize to pierce the ECM come from?
Fibroblasts and inflammatory cells induced by the tumor cell
What is the primary collagenase that tumor cells cause to release?
Type IV collagenase
What is the function of fibronectin in tumor cells?
Prevent the ECM from coming back
Where do the motility factors that tumor cells needs to migrate through a tissue come from?
The tumor
Intravasation = enter blood or leave blood? Extravasation?
Enter blood
Extravasation is leave blood
What are the two features of the conventional grading method performed by pathologists?
Degree of differentiation
Mitotic index
What molecule is used to grade tumors, and is uptaken by tumor cells?
BrdU (Bromodexy-uridine)
In what part of the cell cycle does BrudU uptake occur by tumor cells? Why?
S phase–is a Thymidine analogue
What is the TNM system of staging?
T = size of primary tumor N = nodal involvement M = distant metastases
What is the staging system used for colorectal CA?
Duke system
What is the staging system used for Hodgkin’s and Non-hodgkin’s lymphoma?
Ann Arbor
Where is skin CA found geographically?
New Zealand
What is the CA associated with beryllium?
lung CA
What is the CA associated with benezes?
Leukemia and Hodgkin’s lymphoma
What is the CA associated with chromium?
Lung CA