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Pathology > Neoplasia IV > Flashcards

Neoplasia IV Flashcards

1
Q

What is dysplasia?

A

Loss in uniformity of individual cells/ their architectural orientation

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2
Q

True or false: dysplasia always develops to CA?

A

False

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3
Q

How is the CIN grade determined?

A

By the proportion of epithelial occupied by immature cells

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4
Q

When is a dysplasia termed an invasive carcinoma?

A

When abnormal cells invade the BM

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5
Q

CIN 1 =?

A

between 0 and 1/3 =mild dysplasia

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6
Q

CIN 2 = ?

A

Between 1/3 to 2/3=moderate dysplasia

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7
Q

CIN 3 = ?

A

2/3 to almost full thickness = severe dysplasia

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8
Q

What is the difference between carcinoma in situ vs CIN 3?

A

CIN 3 is almost, but not full epithelial thickness.

Carcinoma in situ is full thickness, but not penetrate BM

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9
Q

Carcinoma in situ is only applicable to what type of tissue?

A

Epithelial

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10
Q

Oral leukoplakia can change into what?

A

Squamous cell carcinoma

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11
Q

What does Barrett’s esophagus progress to (what type of CA)?

A

Adenocarcinoma of the esophagus

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12
Q

Chronic atrophic gastritis of pernicious anemia can progress to what CA?

A

Gastric adenocarcinoma

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13
Q

Chronic ulcerative colitis can progress to what?

A

Adenocarcinoma of colon

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14
Q

Hepatitis infection can progress to what type of CA?

A

Macronodular cirrhosis to hepatocellular carcinoma

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15
Q

Simple/complex endometrial hyperplasia can progress to what?

A

Atypical hyperplasia to endometrial adenocarcinoma

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16
Q

Solar keratosis can progress to what?

A

Squamous cell carcinoma

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17
Q

Tumors are monoclonal or polyclonal?

A

Monoclonal

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18
Q

Carcinogenesis involves non-lethal genetic damage. What two places do these come from?

A

Inherited germline mutations

Acquired mutations

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19
Q

What does the Bax molecule do?

A

Signals apoptosis

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20
Q

What are the two causes of inherited mutations?

A

Failure of DNA repair

Mutations in the genome of somatic cells

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21
Q

What three genetic changes must occur for a tumor to develop?

A

Activation of growth promoting oncogenes

Inactivation of tumor suppressor genes

Alterations in genes that regulate apoptosis

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22
Q

How is generation of heterogeneity of tumors brought about?

A

Tumor cells mutate/progress to serve different purposes within the tumor (invasive, nonantigenic, GF producer etc)

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23
Q

What are the 7 essential alterations for malignant transformation?

A
  1. Self-sufficient growth signals
  2. Insensitive to growth inhibitory signals
  3. Evasion of apoptosis
  4. Limitless replicative potential
  5. Sustained angiogenesis
  6. Ability to invade and metastasize
  7. Defects in DNA repair
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24
Q

What are the four classes of normal regulatory genes?

A
  1. Growth promoting proto-oncogenes
  2. Growth inhibiting tumor suppressor genes
  3. Genes regulating apoptosis
  4. Genes regulating DNA repair
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25
Q

What are oncogenes?

A

Genes the promote autonomous cell growth

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26
Q

What is the two hit mechanism of CA development?

A

Need to have both alleles mutated to develop CA

27
Q

Oncogenes are proto oncogenes with what mutation?

A

Devoid of important regulatory elements

28
Q

True or false: oncogenes are CA causing genes

A

True

29
Q

How are proto oncogenes activated? (3)

A

Mutation
Chromosomal translocation
Amplification

30
Q

What are the five types of protooncogenes?

A
  1. Growth factors
  2. GF receptors
  3. Signal transduction
  4. Nuclear transcription
  5. Cell cycle regulators
31
Q

What is a translocation event? What can this lead to?

A

When chromosomes trade genetic elements–can lead to over or under expression of gene

32
Q

What are the two main categories of mutations?

A

Normal protein overproduced

Mutant protein has an aberrant function

33
Q

What is ERBB2 (HER-2/Neu) protein?

A

Amplification receptor for breast and ovarian CA

34
Q

What is the RET protein? What is it the result of?

A

GF Receptor for neurotrophic factors

Result of point muation

MEN2A ***

35
Q

What is CDK4? Mutation is the result of what? What CA is it associated with?

A

Amplification
Glioblastoma
Melanoma
Sarcoma

36
Q

What is PDGFRB? Mutation is the result of what? What CA is it associated with?

A

Receptor for neurotrophic factor
Point mutation
Gliomas, leukemias

37
Q

What is KIT? Mutation is the result of what? What CA is it associated with?

A

Receptor for stem cell factor
Point mutation
Gastrointestinal tumors

38
Q

What is KRAS? Mutation is the result of what? What CA is it associated with?

A

GTP binding protein
Point mutation
Pancreas, colon, lung CA

39
Q

What is ABL? Mutation is the result of what? What CA is it associated with?

A

Non-receptor tyrosine kinase
Translocation
Chronic myeloid leukemia

40
Q

What is Beta-catemin? Mutation is the result of what? What CA is it associated with?

A

WNT pathway
Point mutation
Hepatoblastomas, hepatocellular carcinoma

41
Q

What is BRAF? Mutation is the result of what? What CA is it associated with?

A

RAS signal transduction

Melanomas

42
Q

Multiple endocrine neoplasia (MEN-2a/2b) is the result of what? Is this always CA?

A

Mutation of the RET proto oncogene

can just be hyperplasia

43
Q

MEN 2a/2b has a familial occurance of what three things?

A
  1. Medullary thyroid carcinoma
  2. Bilateral pheochromocytoma
  3. Hyperparathyroidism d/t hyperplasia or tumor
44
Q

What is the chromosomal translocation that is involved in chronic myelogenous leukemia (CML)?

A

abl on Chromosome 9 translocated to chromosome 22 to produce the philadelphia chromosome (bcr-abl)

45
Q

The philadelphia chromosome produces what gene translocation? What does this lead to?

A

22 (Bcr) and 9 (abl) genes

Increases Y kinase activity

46
Q

What is the drug used to treat chronic myelogenous leukemia? MOA?

A

Gleevec (imatinib)

Inhibit Y-kinase activity

47
Q

Burkitt’s lymphoma is the result of what translocation? What does this produce?

A

Translocation of C-Myc from chromosome 8 to chromosome 14

Causes increased Myc protein production

48
Q

What are the three types of Burkitt’s lymphoma?

A
  1. Endemic
  2. Sporadic
  3. HIV associated
49
Q

What is the translocation of B cell follicular lymphoma? What does this result in

A

BCL-2 genes translocation (14:18), causing overexpression of BCL-2

50
Q

What is the function of BCL-2?

A

Prevents leakage of Cyt C from mitochondria

51
Q

What is the cause of neuroblastoma?

A

Amplification of N-Myc gene

52
Q

How do you identify neuroblastoma?

A

Homogenously staining regions (HSRs) seen on a karyotype

53
Q

Low grade squamous intraepithelial lesion = what CIN?

A

CIN1

54
Q

High grade squamous intraepithelial lesion = what CIN?

A

CIN 2-3

55
Q

There are two autoimmune inflammatory bowel diseases: crohn’s disease and ulcerative colitis? Which one is precancerous?

A

Ulcerative colitis

56
Q

What is c-Myc? Mutation is the result of what? What CA is it associated with?

A

Transcriptional activators
Translocation
Burkitt’s lymphoma

57
Q

What is n-Myc? Mutation is the result of what? What CA is it associated with?

A

Transcriptional activator
Amplification
Neuroblastoma, small cell CA of lung

58
Q

What is Cyclin D? Mutation is the result of what? What CA is it associated with?

A

Mantle cell lymphoma

Breast and esophageal CA

59
Q

IgH gene is on what chromosome?

A

14

60
Q

What is PDGF-beta chain? Mutation is the result of what? What CA is it associated with?

A

SIS growth factor

Over expression leads to astrocytoma/osteosarcoma

61
Q

What is HST? Mutation is the result of what? What CA is it associated with?

A

FBGF growth factor
Overexpression
Stomach CA

62
Q

What is TGF-alpha? Mutation is the result of what? What CA is it associated with?

A

Growth Factor
Over expression
Astrocytomas
Hepatocellular carcinoma

63
Q

What is HGF? Mutation is the result of what? What CA is it associated with?

A

GF
Over expression
Thyroid CA

Pathology (32 decks)

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