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Pathology > Neoplasia Part 1 > Flashcards

Neoplasia Part 1 Flashcards

1
Q

what is neoplasia

A
  • is the disordered and autonomous (uncontrolled) proliferation of NEW monoclonoal cells
  • unregulated cell proliferation
  • monoclonal, single genetically altered precursor cells
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2
Q

what does NEO mean

A

new

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3
Q

what does PLASIA mean

A

growth

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4
Q

what is benign neoplasms

A
  • LOCAL growth
  • inability to INVADE or METASTASIZE
  • amenable to surgical excisions (may recur)
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5
Q

are benign neoplasms life threatening

A

no (unless significant compression of adjacent structures)

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6
Q

benign neoplasm are designated by the suffix

A

-oma

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7
Q

what is lipoma

A

-benign neoplasm of adipose tissue, common in adults 40-60 yrs old

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8
Q

what are the characteristics of lipoma

A

-soft, movable, generally innocuous, can be aesthetically unpleasant

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9
Q

what is fibroadenoma

A

-neoplasm derived form glandular and mesenchymal breast tissue

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10
Q

what are the characteristics of fibroadenoma

A
  • movable, firm, painless

- “lump” often seen in women of reprodutive age

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11
Q

what is teratoma

A
  • tumor derived from totipotent cells composed of all 3 germ cell components
  • saccro-coccygeal or cervical in fetus/neonate
  • ovarian/testicular in children/adults
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12
Q

a vast majority of teratoma are what

A

-benign, some show histologic features of malignancy

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13
Q

are teratomas life threatening

A

despite benignancy, they can pose life-threatning complications

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14
Q

malignant neoplasma are referred to as what

A

CANCER

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15
Q

what are the characteristics of malignant neoplasms

A
  • able to INVADE AND DESTROY adjacent structures
  • able to METASTASIZE to distant structures
  • often LIFE-THREATENING
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16
Q

how do you treat malignant neoplasms

A
  • require a MULTI-THERAPETUTIC approach (surgery, radiation, chemotherapy)
  • key role of screening and early detection
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17
Q

name an example of malignant neoplasms

A

advanced breaks carcinoma with skin erosion and invasion into chest wall

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18
Q

what is the metastasic potential of malignant neoplasm

A
  • aggressive malignant neoplasms can reach and destroy distant structures
  • ex. patient with Burkitt’s lymphoma arising in the neck (cervial lymph nodes) with abdominal/:E metastases
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19
Q

where do benign tumor cells grow

A

only locally and cannot spread by invasion or metastasis

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20
Q

where do malignant (cancer) cells grow

A

-invade neighbouring tissues, enter blood vessels and metastasize to different sites

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21
Q

designation of neoplasms is based on what

A

their tissue of origin (lineage)

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22
Q

**neoplasms are usually composed of one cell-type of origin such as:

A

Epithelial (cells of skin or those lining glands/ducts of various organs)
Mesenchymal (cells in soft tissue, bone, cartilage)
Hematopoietic (cells in bone marrow and lymph nodes)
Melanocytic (melanin-producing cells of the skin)

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23
Q

what are exceptions to the nomenclature rule

A

mixed tumors

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24
Q

what are mixed tumors

A
  • neoplasms composed of different cell types
  • they are derived form a single cell type, but undergo divergent differentiation
    ex. pleomorphic adenoma of salivary glands, Fibroadema of the breast
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25
Q

what are the mixed tumors we should know

A
  1. Teratoma
  2. Hamartoma
  3. Choristoma
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26
Q

what are teratoma

A

-derived from totipotent germ cells, able to differentiate into multiple recognizable (mature) tissues or more than one germ cell layer

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27
Q

what are hamartoma

A
  • mass of disorganized cells native to tissue

- WRONG ARRANGEMENT

28
Q

what are Choristoma

A
  • mass of normal tissue in abnormal location

- WRONG PLACE (ectopic tissue)

29
Q

what are the fundamental differences btwn benign and malignant

A
  1. degree of differentiation and anaplasia
  2. rate of growth
  3. presence of local invasion
  4. presence of Metastasis
30
Q

what does differentiation designate

A

the degree to which tumors cells reflect the morphology and function of their normal counterparts

31
Q

what are the characteristics of benign neoplasms

A

-tend to be well-differentiated and resemble their cells of origin

32
Q

the degree of differentiation of malignant neoplams can range from

A

well to poorly differentiated or even undifferentiated

33
Q

what do well-differentiated adenocarcinoma of the lung look like

A

-bonchoioloalveolar pattern extending through the alveolar septa

34
Q

what do moderately-differentiated adenocarcinoma of the lung look like

A

-loss of normal architecture, retained glandular formation

35
Q

what does “reversion of differentiation” describe

A

malignant neoplasms that lack any differentiation

–> undifferentiated cells

36
Q

*what are the morphological features of malignancy

A

Increased N/C ratios: In normal cells (1:6), N/C of malignant cells can reach 1:1
Pleomorphism: Variation in size and shape of neoplastic cells and nuclei
Nuclear hyperchromasia: Dark nuclear staining (high color/stain)
Loss of Polarity: Loss of cellular orientation in relation to basement membrane or in relation to other cells (disordered growth)
Increased Mitotic Activity: Due to high, uncontrolled proliferation rate. Atypical mitotic forms are common

37
Q

what is the rate of growth for benign tumors

A

GENERALLY grow slowly over months/yrs

38
Q

malignant tumors have a more variable growth rate which inversely correlates with what

A

their level or differentiation (indolent vs. filminant course)

39
Q

high growth rates can cause malignancies to “outgrow” their blood supply and lead to what

A

hemorrhage and necrosis

40
Q

mitotic count and adjuvant studies show what

A
  • the proliferative index of tumors

- can provide information on prognosis and response to chemotherapy

41
Q

describe the local invasion of benign neoplasm

A

-have an expansile growth that maintains a well-demarcated boundary from the host tissue - they will not invade

42
Q

some benign tumors develop a surrounding fibrous capsule whcih demaractes what

A

the neoplastic boundary and facilitates enucleation

43
Q

malignant neoplasms have an invasive front that allow them to what

A

infiltrate and destroy adjacent tissues

44
Q

what is one of the most reliable features of malignancy

A

-local invasion

45
Q

what attribute defines malignancy

A

metastasis

46
Q

what is characteristic of metastasis

A

-presence of tumor deposits away from primary sites

47
Q

different malignancies have different

A

metastatic potential

48
Q

what are the 3 main paths malignancies metastasize

A
  1. seeding –> tumor implantation on surfaces of body cavities
  2. lymphatic –> tumor spread via lymphatic system
  3. hematogenous –> tumor spread via vascular system
49
Q

what is the most common pattern of spread in carcinomas

A

lymphatic spread

50
Q

what happens once metastasize to lymphatics

A

-cancer cells invade lymph nodes, usually sentinel lymph nodes first

51
Q

what pattern of spread is frequently seen in sarcomas and some carincomas (renal, hepatocellylar, thryoid and choriocarcinoma)

A

-hematogenous spread

52
Q

why are liver and lung more often affected by hematogenous spread

A

-they receive all portal and caval blood flow

53
Q

what is cancer epidemiology

A

Studies the distribution and patterns of cancer in populations, focusing on influencing factors and trends to better understand causes and prevention

54
Q

what is the 2nd leading cause of death in the US in both adults and children

A

cancer

55
Q

what are the most common cancer by incidence

A
  1. breast/prostate
  2. lung
  3. colorectal
56
Q

what are the most common causes of cancer death

A
  1. lung
  2. breast/prostate
  3. colorectal
57
Q

what factors affect cancer epidemiology

A

Geographic
Environmental –> Environmental carcinogens
Age
Heredity

58
Q

what are the important types of carcinogens

A

Chemical
Viral/Bacterial
Radiation

59
Q

see slide 49

A

see slide 49

60
Q

Epstein-Barr virus is a member of what family

A

Herpes

61
Q

what is EBV associated with

A

various B-cell neoplasms and nasopharyngela carcinoma (epithelial)

62
Q

what do EBV genes promote

A

proliferation and expansion of cells while decreasing their rate of apoptosis (death

63
Q

what are the main 2 types of radiation

A
  1. ionizing (nuclear receptor accidents and radiotherapy)

2. nonionizing (UVB rays)

64
Q

what are the 3 types of genetic predispostion in cancer

A
  1. autosomal dominant cancer cyndromes (Rb, BRCA1 and 2, APC)
  2. autosomal Recessive defects in DNA repair (Xeroderma Pigmentosa, Ataxia-telangentasia)
  3. Cancers of uncertain inheritance (not well understood, early onset of cancer clustered in families)
65
Q

cancer incidence and death rate increase with what

A

age

66
Q

what is associated with the increased incidence of cancer and age

A

-accumulation of somatic mutations and decreased immune competency contribute to this trend

Pathology (18 decks)

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