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Histopathology and Cytologic Techniques (Laboratory) > Neoplasia (M) > Flashcards

Neoplasia (M) Flashcards

1
Q

What is neoplasia?

A

It is the abnormal mass of tissue

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2
Q

What is the characteristic of neoplasia?

A

The growth of w/c is virtually autonomous and exceeds that of normal tissues

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3
Q

True or False

Growth of tumors persists after cessation of the stimulus that initiated the change

A

True

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4
Q

What is the meaning of term neoplasia?

A

It means new growth and does not imply benign / malignant

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5
Q

True or False

There are benign neoplasms, and there are malignant neoplasms

A

True

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6
Q

What are the 2 broad categories of neoplasms?

A

1) Benign

2) Malignant

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7
Q

What are the characteristics of benign neoplasm?

A

1) It is common in younger age grp
2) It grows slowly, usually by expansion
3) It is not fixed to the tissues, movable, easily removed at operations w/ less chances of recurrence
4) It is usually encapsulated
5) Metastasis is rarely observed, w/ no blood or lymphatic invasion
* 6) Pt’s w/ this has no cachexia
7) The cells w/c look more like normal cells differentiated, less mitotic figures (<1/1,000 cells), not hyperchromatic, less tendency to hemorrhage and necrosis

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8
Q

What is cachexia?

A

It is a condition that causes the body muscles to waste away is observed

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9
Q

What are the characteristics of malignant neoplasia?

A

1) It is common in the older age grp
2) It grows rapidly either by infiltration / by expansion
* 3) The metastasis is produced thru lymphatic and blood invasion
4) It produces ultimate death either by cachexia, mechanical pressure, hemorrhage, and infection
5) It is undifferentiated, more mitotic figures (20/1,000 cells), and hyperchromatic
6) It has more tendency to hemorrhage and necrosis

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10
Q

What are the 2 components of neoplastic tissues?

A

1) Parenchyma

2) Stroma

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11
Q

What is parenchyma?

A

It is the transformed neoplastic cells

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12
Q

What is the characteristic of parenchyma?

A

It is the active element of neoplastic tissues

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13
Q

What is stroma?

A

It is the connective tissue framework w/ lymphatic and vascular channels

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14
Q

What are the nomenclature for general categories of neoplasms (for malignant tumors)?

A

1) Carcinoma

2) Sarcoma

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15
Q

What is carcinoma?

A

These are malignant tumors of the epithelial tissue organ

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16
Q

What is the characteristic of carcinoma?

A

It has the less tendency to produce supporting tissue / stroma

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17
Q

What is sarcoma?

A

These are malignant tumors of connective tissue origin

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18
Q

What is the characteristic of sarcoma?

A

These are characterized by abundant intercellular tissue framework (fat muscle)

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19
Q

*What are the nomenclature for general categories of neoplasms (for malignant neoplasms)?

A

1) Lymphoma

2) Melanoma

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20
Q

What is lymphoma?

A

These are malignant neoplasms derived from lymphocytes

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21
Q

What is melanoma?

A

These are malignant neoplasms w/c are derived from melanocytes

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22
Q

What are the exs of nomenclature for benign neoplasms?

A

1) Adenoma
2) Fibroadenoma
3) Leiomyoma

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23
Q

What is adenoma?

A

It is the benign neoplasm of glandular epithelium

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24
Q

What is fibroadenoma?

A

It is the benign neoplasm of the breast

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25
Q

What is leiomyoma?

A

It is the benign neoplasm of smooth muscle

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26
Q

What are some exceptions w/ regards to the nomenclature for benign neoplasms?

A

1) Hepatoma
2) Melanoma
3) Mesothelioma
4) Seminoma

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27
Q

What is hepatoma?

A

It is the malignant neoplasm of liver

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28
Q

What is melanoma?

A

It is the malignant neoplasm of melanocytes

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29
Q

What is mesothelioma?

A

It is the malignant neoplasm of mesothelial cells

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30
Q

What is seminoma?

A

It is the malignant germ cell neoplasm of testis

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31
Q

What are the exs of nomenclature for malignant neoplasms?

A

1) Adenocarcinoma
2) Rhabdomyosarcoma
3) Leiomyosarcoma

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32
Q

What is adenocarcinoma?

A

It is the malignant neoplasm of glandular tissue

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33
Q

What is rhabdomyosarcoma?

A

It is the malignant neoplasm of skeletal muscle

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34
Q

What is leiomyosarcoma?

A

It is the malignant neoplasm of smooth muscle

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35
Q

*What is the principle of differentiation of terminologies related to the microscopic appearance of neoplasms?

A

How histologically similar to the normal tissue the neoplasm (i.e., how analogous the neoplastic cells look to the tissue type from w/c they arose)- terms used are well differentiated, or poorly differentiated

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36
Q

True or False

Differentiation is not a subjective determination made by the patho

A

False, because differentiation is a subjective determination made by the patho

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37
Q

What is the characteristic of anaplasia?

A

It lacks differentiation

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38
Q

What is dysplasia?

A

It is the disordered growth of epithelium

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39
Q

What are the characteristics of dysplasia?

A

1) There is a loss of cellular uniformity and architectural orientation
2) The cells may have an increased # of mitotic figures
3) It does not necessarily form a mass or tumor
4) In many cases, it is a precursor of malignancy, but it does not always progress to malignancy
5) It can be reversible, if the inciting agent is removed

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40
Q

What is the characteristic of carcinoma present in situ?

A

Presence of full-thickness dysplasia of the epithelium

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41
Q

*In terms of terminology, is the term carcinoma in situ related to neoplasms?

A

Yes, it is a miscellaneous terminology related to neoplasms

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42
Q

What is hamartoma?

A

It is a disorganized collection of tissue, w/ the tissue composing the mass being tissue that is normally found in the organ in w/c the mass occurred

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43
Q

What is the characteristic of hamartoma?

A

It is not a neoplasm

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44
Q

What is choristoma?

A

It is a mass composed of ectopic tissue

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45
Q

What are the characteristics of choristoma?

A

1) It is otherwise a fairly normal tissue
2) It is located at a site where it normally is not found
3) It is not a neoplasm

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46
Q

What is polyp?

A

It is a mass projecting from a mucosal surface

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47
Q

In terms of terminology, what is the characteristic of the term polyp?

A

It is not a descriptive term

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48
Q

True or False

The mass causing polyp is a neoplasm

A

False, because the mass causing polyp may or may not be a neoplasm

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49
Q

*What are the terminologies related to the microscopic appearance of (neoplasms?)?

A

1) Anaplasia
2) Dysplasia
3) Carcinoma in situ
4) Hamartoma
5) Choristoma
6) Polyp

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50
Q

What are the features used to distinguish benign neoplasms from malignant neoplasms?

A

1) Histologic features of malignancy
2) Rate of growth
3) Invasion and metastases

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51
Q

What is the principle of histologic features of malignancy (as a feature used to distinguish benign neoplasms from malignant neoplasms)?

A

Histologic features are reliable indicators of malignancy in many organs, although in some sites

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52
Q

What are the histologic features of malignancy that can be observed (as a way to distinguish benign neoplasms from malignant neoplasms)?

A

1) Pleomorphism
2) Abnormal mitotic figures
3) Hyperchromasia
4) Hypercellularity

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53
Q

What is pleomorphism?

A

It is the variation in nuclear and cytoplasmic shape bet cells

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54
Q

What is associated along abnormal mitotic figures (that can be used to distinguish benign neoplasms from malignant neoplasms)?

A

Increased #s of mitotic figures

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55
Q

What is hyperchromasia?

A

It is the condition where there is an increased basophilia (/ basophils) of the nucleus

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56
Q

What is associated along hypercellularity (that can be used to distinguish benign neoplasms from malignant neoplasms)?

A

It is associated w/ a loss of normal polarity

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57
Q

What is the principle of rate of growth (as a feature used to distinguish benign neoplasms from malignant neoplasms)?

A

Benign neoplasms tend to grow slower whereas malignant neoplasms tend to grow more quickly often at a rate corresponding to their degree of anaplasia

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58
Q

*What is under rate of growth?

A

Growth fraction

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59
Q

What is growth fraction?

A

It is the proportion of neoplastic cells in the proliferative phase

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60
Q

What is the percentage of growth fraction at the point when most malignant tumors are clinically detected?

A

It is usually < 20%

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61
Q

What is the characteristic of most neoplasms (in connection to rate of growth)?

A

Most neoplasms have their most rapid rate of growth prior to detection

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62
Q

What is the principle of invasion and metastases (as a feature used to distinguish benign neoplasms from malignant neoplasms)?

A

Histologic features and rate of growth alone cannot always distinguish bet benign and malignant neoplasms

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63
Q

What are the 2 features that reliably distinguish benign from malignant neoplasms (in connection to invasion and metastases)?

A

1) Invasion

2) Metastasis

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64
Q

What is invasion?

A

It is the infiltration of tumor cells into surrounding organs

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65
Q

What is metastasis?

A

It is the spread of tumor cells to distant organs through the blood

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66
Q

What is the characteristic of sarcomas (in relation to metastasis)?

A

The spread of tumor cells to distant organs through the blood

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67
Q

What is the characteristic of carcinomas (in relation to metastasis)?

A

The spread of tumor cells to distant organs through the lymphatics

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68
Q

What are the viruses associated w/ neoplasms?

A

1) Human T-cell leukemia virus type 1 (HTLV-1)
2) Human papillomavirus (HPV)
3) Epstein-Barr virus (EBV)
4) Hepatitis B virus (HBV)
5) Helicobacter pylori
6) Human herpesvirus 8 (HHV-8)

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69
Q

What is the neoplasm associated w/ HTLV-1?

A

Adult T-cell leukemia / lymphoma

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70
Q

What is the mechanism of HTLV-1?

A

TAX gene of HTLV-1 can activate transcription of host cell genes, including c-fos and IL-2, w/c are both impt in the proliferation and differentiation of T cells

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71
Q

What is the neoplasm associated w/ HPV?

A

Squamous cell carcinoma of the cervix

72
Q

What is the mechanism of HPV?

A

Production of viral E6 and E7 proteins, w/c interfere w/ the fxn of p53 and RB, respectively

73
Q

What are the neoplasms associated w/ EBV?

A

1) Burkitt lymphoma
2) Post-transplantation lymphoproliferative disorder
3) B-cell lymphomas in AIDS pts
4) Nasopharyngeal carcinoma
5) Some cases of Hodgkin lymphoma

74
Q

What is the mechanism of EBV?

A

EBV enters B cells through binding w/ CD21. EBV viral genes activate the transcription of latent membrane protein-1 (LMP-1), w/c activates nuclear factor-κβ (NF-κβ and JAK / STAT) (Janus kinase / signal transducers and activation of transcription) signaling pathway. Activation of the JAK / STAT pathway promotes B cell survival

75
Q

What is the associated neoplasm w/ HBV?

A

Hepatocellular carcinoma

76
Q

What is the mechanism of HBV?

A

Through chronic inflammation; also because HBV protein binds p53, interfering w/ its fxn

77
Q

*What are associated w/ helicobacter pylori?

A

MALTomas of the stomach (neoplasm of mucosa-associated lymphoid tissue [MALT])

78
Q

*What are associated w/ HHV-8?

A

1) Primary effusion lymphoma

2) Kaposi sarcoma

79
Q

*What are the diff types of effects of tumors?

A

1) Effects of tumors based upon location
2) Types of paraneoplastic syndromes
a. Hormone production

80
Q

*What is the principle of effects of tumors based upon location (as part of effects of tumors)?

A

Consider the location of the tumor to determine the effects

81
Q

*Provide an ex of the principle of effects of tumors based upon location (as a part of effects of tumors)?

A

A 2.0 cm tumor in the brainstem may kill a pt; a 2.0 cm tumor in the leg may not even be noticed

82
Q

What are the various effects of neoplasms that are extensive and not exhaustive (w/c may have based upon there location)?

A

1) A space-occupying lesion can obliterate bone marrow causing pancytopenia, impinge upon the brain leading to herniations, or it can block a cardiac valve orifice
2) Growth of a mass can impinge upon vasculature and can cause ischemia and infarction of tissue (w/ arterial compression) or congestion and infarction of tissue (w/ venous compression)
3) Invasion of a nerve can lead to neurologic deficits or pain
4) A mass can cause ulceration of overlying mucosa
5) A mass in the brain can serve as a focus for seizures or other neurologic deficits
6) A mass can obstruct the colon causing constipation; obstruct the bile duct causing jaundice; or obstruct the bronchus causing pneumonia or bronchiectasis
7) Bone destruction can lead to fracture (i.e., pathologic fracture)

83
Q

What is cachexia?

A

It is the loss of body fat and muscle; weakness and anorexia associated w/ a neoplasm

84
Q

*What is the mechanism of cachexia?

A

It is caused by cytokines produced by the tumor (possibly TNF) and by host response to the tumor

85
Q

What are paraneoplastic syndromes?

A

These are side effects of a neoplasm not attributable to fxns normally associated w/ the cell type of origin or by the location of the tumor

86
Q

In connection to hormone production, what is the mechanism of the production of parathyroid hormone (PTH)-like protein?

A

PTH like protein is produced by squamous cell carcinoma of the lung, breast carcinoma, and renal cell carcinomas; results to hypercalcemia

87
Q

In connection to hormone production, what is the mechanism of the production of adrenocorticotropic hormone (ACTH)-like protein?

A

ACTH-like protein is produced by small cell lung carcinoma and pancreatic carcinoma; results in Cushing syndrome

88
Q

*In connection to hormone production, what is the mechanism of the production of syndrome of inappropriate antidiuretic hormone (SIADH)?

A

SIADH is produced by the small cell carcinoma of the lung and cerebral neoplasms; results in retention of H2O

89
Q

In connection to hormone production, what is the mechanism of the production of erythropoietin (EPO)?

A

EPO is produced by renal cell carcinoma, hepatocellular carcinoma, and cerebellar hemangioblastoma; results in polycythemia

90
Q

*What are the characteristics of carcinogenesis?

A

1) Acquire self-sufficiency in growth signals and ignore growth inhibitory signals
2) Evade apoptosis, since apoptosis is the body’s mechanism to rid itself of cells w/ genetic damage so they cannot propagate that damage
3) Acquire defects in DNA repair
4) Acquire the ability to divide an unlimited # of times
5) Promote angiogenesis
6) Invade surrounding tissue, passing through the basement membrane and spreading to distant organs (i.e., metastasize)

91
Q

*What is the process (or steps) of carcinogenesis?

A

1) The cell acquires mutations, which are nonlethal, so the cell can survive to divide and thus propagate the mutations. Mutations are acquired through damage caused by initiators. Promoters cause cell growth through promotion of the cell cycle and thus cause the propagation of mutations induced by initiators. Neither an initiator nor a promoter acting on its own can cause neoplasia; both must act on the cells. Genes most commonly affected during carcinogenesis
2) Proto-oncogenes: Proto-oncogenes are genes commonly used during normal growth and development; without control, they have the potential to produce neoplasms through their uncontrolled expression. Oncogenes are genes that have made the transition and are now capable of producing neoplasms. Most commonly, oncogenes cause unregulated cell growth through promotion of cellular division, which results in further mutations
3) Tumor suppressor genes: Genes that function to help control cell growth; their loss thus results in uncontrolled cell growth through loss of regulation of division.
4) Apoptosis genes
5) DNA repair genes

92
Q

What are the impt points regarding genes involved w/ carcinogenesis?

A

1) No one mutation will result in a malignant neoplasm; malignant neoplasms result from the survival of cells that have accumulated multiple mutations.
2) Conversion of one of the two allelic genes from a protooncogene to an oncogene is sufficient to promote neoplasia. However, it requires loss of both tumor suppressor genes to promote neoplasia, as one of the two genes is sufficient to produce enough product to inhibit neoplasia.

93
Q

What are the roles of oncogenes?

A

1) Synthesize growth factors
2) Synthesize growth factor receptors
3) Synthesize signal-transducing proteins
4) Synthesize nuclear transcription factors
5) Loss of regulation of cyclins and cyclin- dependent kinases

94
Q

*What is the principle of synthesizing growth factors (as a role of oncogenes)?

A

Synthesize growth factors to w/c the neoplastic cell is also responsive

95
Q

Provide an ex of synthesizing growth factors (as a role of oncogenes)?

A

Glioblastomas produce PLT derived growth factor (PDGF)

96
Q

Provide exs of the role of oncogenes w/c is to synthesize growth factor receptors

A

1) RET receptor for glial cell line-derived neurotrophic factor- in medullary and papillary thyroid carcinoma (MEN syndrome)
2) ERB B1, an epidermal growth factor (EGF) receptor, is overexpressed in squamous cell carcinoma of the lung
3) ERB B2, an EGF receptor, is overexpressed in 25% of breast carcinomas

97
Q

*Provide an ex of a sp gene that is associated w/ the role of oncogenes w/c is to synthesize signal-transducing proteins

A

RAS gene

98
Q

What is the principle of incidence of mutations in RAS gene?

A

Mutations of the RAS gene are in 30% of all malignant neoplasms and in 90% of pancreatic adenocarcinomas

99
Q

What is the principle of the role of normal RAS gene?

A

The RAS gene codes for protein that is associated w/ a growth factor receptor. When stimulated by a growth factor, RAS binds guanosine triphosphate (GTP) and activates the mitogen-activated protein (MAP) kinase pathway, which results in activation of transcription. The RAS protein is controlled by its GTPase activity; it cleaves the GTP bound to it to guanosine diphosphate (GDP), which inactivates the RAS protein

100
Q

What is the principle of effects of mutations in the RAS gene?

A

The RAS protein loses its GTPase activity, so it remains activated, resulting in continual promotion of transcription

101
Q

*Provide an ex of a sp gene that is associated w/ the role of oncogenes w/c is to synthesize nuclear transcription factors

A

MYC gene

102
Q

What are the neoplasms that are associated w/ mutations of the MYC gene?

A 
1) Burkitt lymphoma
Also amplified in:
2) Breast
3) Lung
4) Colon cancers
103
Q

What is the principle of the role of normal MYC gene?

A

MYC protein binds to DNA and activates transcription of several genes, including cyclindependent kinases (CDK). CDK proteins help drive the cell through the cell cycle

104
Q

What is the principle of the effect of activation to oncogene?

A

Overexpression of MYC results in overpromotion of the cell cycle

105
Q

What is implied by two-hit hypothesis?

A

It implies that w/ many hereditary neoplasms, a tumor suppressor gene is involved

106
Q

Is the protein product from 1 gene is enough to prevent neoplasms from developing?

A

Yes

107
Q

True or False

The protein product from 1 gene is enough to prevent neoplasms from developing, however, individuals born w/ a mutation of 1 gene are 1 step closer to the development of a neoplasm than those born w/ 2 normal genes

A

True

108
Q

*In relation to mutations in tumor suppressor genes, what should be done?

A

Select tumor suppressor genes

109
Q

*In connection to selecting tumor suppressor genes w/c should be done in relation to mutations in tumor suppressor genes, what are the most common tumor suppressor genes w/ mutations within neoplasms?

A

1) Retinoblastoma

2) p53

110
Q

*What are the tumor suppressor genes that mutate?

A

1) Retinoblastoma (RB) gene
2) p53 gene
3) Other tumor suppressor genes
a. APC / β-catenin
b. INK4a / ARF
c. TGF-β (transforming growth factor beta)
d. NF-1
e. VHL
f. PTEN (phosphatase and tensin homologue)
4) Apoptosis genes
a. Bel-2
b. p53

111
Q

What are the associated neoplasms in RB gene mutation?

A

1) Familial retinoblastoma
2) Osteosarcoma
3) Breast cancer
4) Small cell lung carcinoma

112
Q

What is the role of normal RB gene?

A

Retinoblastoma binds E2F transcription factor, w/c is needed for the cell to move from the G1 phase of the cell cycle to the S phase. When retinoblastoma is phosphorylated, the E2F is released and the cell moves through the cell cycle

113
Q

What are the effects of mutations of RB gene?

A

It can affect retinoblastoma / the proteins that phosphorylate retinoblastoma, resulting in hyperphosphorylation of RB

114
Q

*What is the incidence of p53 gene?

A

Mutations of the p53 gene are found in more than 70% of tumors

115
Q

What are the roles of p53 gene?

A
  • 1) It is activated by DNA damage
    2) It arrests the cell cycle by transcription of CDK21 (p21)
    3) It promotes production of GADD45
    4) If cellular damage is not repaired, it promotes the induction of the Bax gene
116
Q

What are the fxns of CDK1 (p21)?

A

1) It inhibits cyclin / CDK complexes

2) It prevents phosphorylation of RB

117
Q

What is the fxn of GADD45?

A

It helps repair the cell

118
Q

What is the fxn of p53?

A

If cellular damage is not repaired, its production is induced w/c in turn promotes apoptosis

119
Q

What are the other tumor suppressor genes?

A

1) APC / β-catenin
2) INK4a / ARF
3) TGF-β
4) NF-1
5) VHL
6) PTEN

120
Q

What is the normal fxn of the protein product APC / β-catenin?

A

APC protein down-regulates β-catenin

121
Q

What is the result of mutation of APC / β-catenin?

A

Elevated lvls of β-catenin result in interaction w/ TCF

122
Q

The elevated lvls of β-catenin w/c result in interaction w/ TCF results in what?

A

It results in increased lvls of c-MYC and cyclin D1

123
Q

What are the percentages of incidence of APC / β-catenin?

A

1) It is found in 70 - 80% of nonfamilial colon carcinomas
2) It is also found in 50% of hepatoblastomas
3) It is also found in 20% of hepatocellular carcinomas

124
Q

What is the normal fxn of the protein product INK4a / IRF?

A

It blocks cyclin D-CDK4 activity in the cell cycle

125
Q

What are the percentages of incidence and of INK4a / IRF and in what cases are this incidentally present?

A

1) 20% of familial melanomas
2) 50% of pancreatic adenocarcinomas
3) Present in squamous cell carcinomas of the esophagus

126
Q

What are the percentages of incidence and of TGF-β and in what cases are this incidentally present?

A

1) It is inactivated in 70% > of colon cancers in pts w/ hereditary nonpolyposis colon cancer (HNPCC)
2) It is incidentally present in pts w/ sporadic colon cancer w/ microsatellite instability

127
Q

What are the associated mutations of TGF-β?

A

SMAD4 w/c is originally termed as DPC4 (deleted in pancreatic cancer)

128
Q

What is the fxn of SMAD4?

A

It encodes part of the TGF-β growth inhibitory pathway

129
Q

Mutations of SMAD4 are seen in what percentage of cases?

A

It is seen in 50% of cases of pancreatic adenocarcinomas

130
Q

What is the normal fxn of the protein product NF-1?

A

Neurofibromin is a GTPase-activating enzyme

131
Q

What is the effect of mutation of NF-1?

A

RAS is trapped in an active form

132
Q

What are the associated neoplasms of NF-1?

A

1) Neurofibromas

2) Malignant peripheral nerve sheath tumors

133
Q

What is the normal fxn of the protein product VHL?

A

VHL protein is a ubiquitin ligase whose substrate includes HIF-1

134
Q

What is the fxn of HIF-1?

A

It regulates vascular endothelial growth factor (VEGF)

135
Q

What is the associated neoplasms of VHF?

A

Nonfamilial renal cell carcinomas

136
Q

What is the normal fxn of the protein product PTEN?

A

It blocks the cell cycle

137
Q

How does PTEN block the cell cycle?

A

It blocks the cell cycle by increased transcription of p27

138
Q

What is the effect of mutation of PTEN?

A

Cells are allowed to easily progress into the cell cycle

139
Q

In what conditions is PTEN incidentally present?

A

It is frequently found in:
1) Endometrial carcinomas
2) Glioblastomas
It is associated w/ Cowden syndrome

140
Q

What is the normal fxn of Bel-2?

A

It is an inhibitor of apoptosis

141
Q

What is the method of activation of Bel-2?

A

Often a translocation of bcl-2 gene adjacent to a more heavily used gene, such as the Ig heavy chain gene

142
Q

What is the consequence of activation of Bel-2?

A

Increased production of bcl-2

143
Q

Increased production of bcl-2 results to what?

A

It results in inhibition of apoptosis

144
Q

What is the associated neoplasm w/ Bel-2?

A

Follicular lymphoma

145
Q

What is the normal fxn of p53?

A

It promotes production of Bax

146
Q

What is Bax?

A

It is a proapoptotic gene

147
Q

What is the consequence of mutation of p53?

A

Less p53 results in less Bax

148
Q

Less p53 w/c results in less Bax results to what?

A

It results to an indirect cause of inhibition of apoptosis

149
Q

What is the process / general morphology of cancer development in epithelial cells?

A

Normal cells -> hyperplasia -> dysplasia -> in situ carcinoma -> invasive carcinoma -> metastatic carcinoma

150
Q

What is hyperplasia?

A

It is the increase in the # of normal cells

151
Q

What is dysplasia?

A

It is the disorganized cell growth

152
Q

What are the characteristics of dysplasia?

A

1) There are cells having hyperchromasia
2) There are mitotic figures present
3) There is an increased nuclear to cytoplasmic ratio

153
Q

What is the characteristic of in situ carcinoma?

A

Dysplastic changes throughout the full thickness of the epithelium w/ no evidence of invasion

154
Q

What is the event present in invasive carcinoma?

A

Tumor cells invading through the basement membrane

155
Q

What is the event present in metastatic carcinoma?

A

Tumor cells spreading to distant organs

156
Q

What are tumor Ags?

A

These are Ags that are sp for the tumor

157
Q

What is the action of tumor Ags?

A

These can provoke an inflammatory response

158
Q

*What are the mechanisms of production?

A

1) Product of mutated oncogene or tumor suppressor gene
2) Protein produced by oncogenic virus
3) Altered cell surface glycoprotein / glycolipid
4) Overexpressed protein
5) Oncofetal Ags
6) Cell-type-specific differentiated Ag (such as expression of CD10)

159
Q

What are the methods of evading detection by immune system?

A

1) Growth of Ag-negative variant
2) Apoptosis of cytotoxic T cells through production of FAS ligand
3) Immunosuppression
4) Loss of MHC molecule

160
Q

What are the type of methods utilized for the dx of neoplasms?

A

Noninvasive methods

161
Q

What is the fxn of noninvasive methods in terms of dx of neoplasms?

A

To detect neoplasms at an early point in their development

162
Q

What is the importance of utilizing noninvasive methods to detect neoplasms at an early point in their development?

A

These are crucial to improve the prognosis

163
Q

What is the action of neoplasms?

A

These secretes tumor markers into the blood

164
Q

True or False

Tumor markers are not proteins

A

False, because tumor markers are proteins

165
Q

Since the action of neoplasms is to secrete tumor markers, what are the results / uses of this action?

A

1) It allows for the dx of the tumor or

2) For monitoring of the tumor following treatment

166
Q

True or False

Metastatic nodules, poorly differentiated neoplasms, and as well as those sharing histologic features may be difficult to be diagnosed microscopically

A

True

167
Q

What is crucial for pt care in cases of metastatic nodules?

A

Determining the site of origin

168
Q

What is immunohistochemistry?

A

It is a specialized form of histology employing Abs to identify sp proteins within the tumor to allow for better differentiation of tumor type

169
Q

*What are the results of dx of neoplasms depending on the differentiation of the tumor?

A

1) Well differentiated
2) Moderately differentiated
3) Poorly differentiated

170
Q

What is grade?

A

It is the differentiation of a tumor as determined by the patho (i.e., subjective evaluation)

171
Q

What is differentiation?

A

It is how similar the tumor cells look when compared w/ the cell type of origin

172
Q

Provide an ex of differentiation

A

Well-differentiated squamous cell carcinoma looks very similar to stratum corneum, and poorly differentiated squamous cell carcinoma may be difficult to determine w/out immunohistochemical stains directed against squamous cell-specific proteins

173
Q

What is stage?

A

It is the extent of the tumor based upon both objective pathologic and objective clinical criteria

174
Q

What is the most common system used in terms of the principle of grade and stage?

A

TNM

175
Q

What does TNM stands for?

A

T - tumor characteristics
N - lymph node status
M - metastases

176
Q

What is the characteristic of stage of the tumor?

A

It has good prognostic value

Histopathology and Cytologic Techniques (Laboratory) (20 decks)

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