Neoplasia IV

Question 1

definition: dysplasia

Answer 1

disordered growth, pleomorphism, mitoses, loss of polarization

Question 2

leukoplakia can develop into what type of cancer?

Answer 2

squamous cell carcinoma (via dysplasia)

Question 3

Barrett esophagus can transform into what type of cancer?

Answer 3

adenocarcinoma (via dysplasia / metaplasia)

Question 4

chronic atrophic gastritis of pernicious anemia can transform into what type of cancer?

Answer 4

gastric adenocarcinoma (via dysplasia)

Question 5

chronic UC can transform into what type of cancer?

Answer 5

adenocarcinoma of colon (via dysplasia)

Question 6

hep B or C can transform into what type of cancer?

Answer 6

hepatocellular carcinoma (via macronodular cirrhosis)

Question 7

what are the roles of proto-oncogenes?

Answer 7

regulation of growth and differentiation

Question 8

what are the activation mechanisms for proto-oncogenes?

Answer 8

mutation, chromosomal translocation, amplification

Question 9

what are the two main categories of cellular / molecular change following activation of an oncogene?

Answer 9

1. normal protein is overproduced 2. mutant protein is produced and has an aberrant function

Question 10

ERBB2 / Her-2 / Neu is associated with what type of cancer? how?

Answer 10

breast / ovarian - amplification

Question 11

RET is associated with what type of cancer? how?

Answer 11

MEN 2a / 2b, familial medullary thyroid carcinomas - point mutation

Question 12

KRAS is associated with what type of cancer? how?

Answer 12

pancreas, colon, lung - point mutation

Question 13

ABL is associated with what type of cancer? how?

Answer 13

chronic myeloid leukemia, acute lymphoblastic leukemia - translocation

Question 14

B-catenin is associated with what type of cancer? how?

Answer 14

hepatoblastomas (point mutation), hepatocellular carcinoma (overexpression)

Question 15

C-myc is associated with what type of cancer? how?

Answer 15

Burkitt lymphoma - translocation

Question 16

N-myc is associated with what type of cancer? how?

Answer 16

neuroblastoma, small cell CA of lung - amplification

Question 17

cyclin D is associated with what type of cancer? how?

Answer 17

mantle cell lymphoma (translocation), breast and esophageal (amplification)

Question 18

what are the important clinical features of multiple endocrine neoplasia 2a / 2b?

Answer 18

1. mutation of RET 2. many endocrine organs can be involved 3. most are tumors, but can be hyperplasia

Question 19

what is the pathogenesis of chronic myelogenous leukemia (CML)?

Answer 19

1. c-abl oncogene on chromosome 9 translocated to bcr on chromosome 22 2. increase in tyrosine kinase activity 3. proliferation of granulocytic precursors

Question 20

what drug inhibits tyrosine kinase in CML?

Answer 20

Imatinib mesylate (Gleevec)

Question 21

what is the pathogenesis of burkitt lymphoma?

Answer 21

1. translocation of c-myc proto-oncogene from chromosome 8 to Ig heavy chain on chromosome 14 2. overexpression of c-myc leads to excess transcription signals

Question 22

what is the pathogenesis of B cell follicular lymphoma?

Answer 22

1. translocation 14-18 2. over expression of BCL-2 protein product 3. prevents apoptosis of B cells

Question 23

what is the most common lymphoma?

Answer 23

follicular lymphoma (evasion of apoptosis)

Question 24

what is the pathogenesis of neuroblastoma?

Answer 24

amplification of N-myc

Question 25

how is neuroblastoma diagnosed? how do they manifest?

Answer 25

1. homogenously stained regions (HSRs) or double minutes on a karyotype 2. arise in adrenal glands or kidney, present as abdominal masses