Neoplasia Part 1 Flashcards
1
Q
cancer = ______ tumors
A
malignant
2
Q
what is the 2nd leading cause of death in the US?
A
cancer
3
Q
cancer is a ____ disorder
A
genetic
4
Q
with cancer being a genetic disorder, what are the 2 ways are the mutations that cause it mostly acquired?
A
-arise spontaneously
-environmental exposure
5
Q
T/F genetic changes are heritable with the accumulation of mutations leading to characteristic features of cancer; however, actual inherited cancers are infrequent
A
true
6
Q
the loss of normal growth control where cells become transformed and start doing their own thing
A
neoplasia
7
Q
what is another name for a neoplasm?
A
tumor
8
Q
what are the 2 major qualities of neoplasia?
A
parasitic and autonomous
9
Q
what do the root words of neoplasia mean?
A
“new growth”
10
Q
study of neoplasms/tumors
A
oncology
(“oncos” = tumor)
11
Q
neoplasia is a spectrum of diseases, what are the ranges of neoplasms? (4)
A
-benign
-locally aggressive
-intermediate malignant
-malignant
12
Q
what are the 2 anatomic components of tumors?
A
-parenchyma
-stroma
13
Q
the tumor component that consists of neoplastic cells
A
parenchyma
14
Q
the tumor component that consists of the supporting connective tissue and vasculature
A
stroma
15
Q
which tumor component determines how a tumor is named?
A
parenchyma
16
Q
the degree of resemblance of tumor cells to parent cells
A
Differentiation
17
Q
what does “well-differentiated”, in regards to tumor cells, mean?
A
more resemblance to parent cells
18
Q
what does “poorly differentiated”, in regards to tumor cells, mean?
A
little resemblance to parent cells
19
Q
what does “anaplasia”, in regards to tumor cells, mean?
A
no resemblance to parent cells
20
Q
what are other names for “anaplasia”?
A
dedifferentiated and undifferentiated
21
Q
in a “poorly differentiated” tumor cell, increased/abnormal DNA replication lead to what? (6)
A
-pleomorphism
-nuclear hyperchromatism
-increased nuclear/cytoplasmic ratio
-atypical nuclei
-numerous and atypical mitoses
-prominent nucleoli
22
Q
what is pleomorphism?
A
when all the cell shapes and sizes are different
23
Q
a microscopic, potentially reversible, altered growth or maturation pattern
A
dysplasia
(“altered growth”)
24
Q
what does dysplasia refer to when seen in epithelial tissues?
A
-precancerous (premalignant) state –> may progress to malignancy
-you will see disorderly maturation, pleomorphism, and mitotic activity
25
what does dysplasia refer to when seen in bone lesions?
does NOT imply pre-cancerous state, just means altered growth
26
what is carcinoma in-situ?
dysplastic changes involving the full thickness of the epithelium, but lesion remains confined to the normal tissue and does not pass beyond the basement membrane = "pre-invasive/precancerous"
(NOT cancer but one step away; final step of dysplasia)
27
in general, how are benign epithelial tumors named?
-root word = clinical appearance, anatomic site, or cell type form
- suffix = "-oma"
28
what is a papilloma?
finger-like epithelial projections overlying cores of vascular fibrous connective tissue that arises from surface epithelium --> benign epithelial tumor
29
what is an adenoma?
benign tumor of glandular epithelium - benign epithelial tumor
30
what is a papillary cystadenoma?
adenoma characterized by adenomatous papillary processes that extend into cystic spaces (i.e. cystadenoma of ovary) - benign epithelial tumor
31
how are benign mesenchymal tumors named?
most often named by tissue of origin + "oma"
32
benign mesenchymal tumor of fibrous tissue
fibroma
33
benign mesenchymal tumor of cartilaginous tissue
chondroma
34
benign mesenchymal tumor of smooth muscle
leiomyoma
35
benign mesenchymal tumor of skeletal muscle
rhabdomyoma
36
benign mesenchymal tumor of fat
lipoma
37
benign mesenchymal tumor of bone
osteoma
38
benign mesenchymal tumor of blood vessels
angioma
39
what are two examples of benign mixed tumors we learned about?
-pleomorphic adenoma (salivary glands)
-fibroadenoma (breast; only the fibrous part is neoplastic)
40
a benign tumor that involved both the epithelium and connective tissue
benign mixed tumors
41
what is a teratoma?
a neoplasm (tumor) with cells derived from more than 1 germ layer (totipotent --> can form many different types of tissue)
42
what is a hamartoma?
disorganized overgrowth of tissue that is native to the site that is generally non-neoplastic (not a tumor bc it does not grow autonomously)
43
what is a choristoma?
disorganized overgrowth of tissue at unexpected site that is non-neoplastic (not a tumor bc it does not grow autonomously)
44
what is a polyp?
a mass that projects above a mucosal surface
45
what are notable "-oma" exceptions that are actually malignant, rather than benign? (6)
-lymphoma
-melanoma
-mesothelioma (lungs)
-seminoma (gonad germ cells)
-glioblastoma (brain)
-hepitoma (hapatocellular-carcinoma; liver)
(Lady Made Miso Soup Gladly Here)
46
what are notable "-oma" exceptions that are non-neoplastic (i.e. not tumors)? (2)
-granuloma (multi-nucleated giant cells, epithelioid histiocytes, lymphocytes)
-hematoma (bruse)
47
in general, how are malignant epithelial tumors named?
-root word: anatomically or cellularly
-suffix: + "-carcinoma"
48
what is a squamous cell carcinoma?
- malignant epithelial tumor from squamous epithelium (skin, mouth, esophagus, vagina) or areas of squamous metaplasia (bronchi or cervix)
49
production of squamous cell carcinomas are marked by what?
keratin
50
what is a transition cell carcinoma?
malignant epithelial tumor from urinary tract epithelium
51
what is adenocarcinoma?
malignant epithelial tumor from glandular origin (including GI mucosa, endometrium, and pancreas)
52
adenocarcinomas usually show desmoplasia. what is that?
CT growth in reaction to the tumor
(reason why tumors feel firm)
53
in general, how are malignant mesenchynal tumors named?
-root word = anatomically or cellularly
-suffix: + "sarcoma"
54
malignant mesenchymal tumor of fibrous tissue
fibrosarcoma
55
malignant mesenchymal tumor of cartiaginous tissue
chondrosarcoma
56
malignant mesenchymal tumor of bone
Osteosarcoma
57
malignant mesenchymal tumor of skeletal muscle
rhabdomyosarcoma
58
malignant mesenchymal tumor of smooth muscle
leiomyosarcoma
59
malignant mesenchymal tumor of fat
lipsarcoma
60
malignant mesenchymal tumor of vessels
angiosarcoma
61
what are some eponyms/malignant tumors that have their own special name since they were named after the person that discovered them? (3)
-Burkitt Lymphoma
-Hodgkin disease/lymphoma
-Wilm's tumor
62
what are 3 ways to name tumors based on their resemblance to tissue of origin and/or degree or differentiation?
-well-differentiated ("low grade")
-moderately differentiated
-poorly differentiated ("high grade")
63
what are ways to name tumors based on their appearance under the microscope? (4)
cystic, papillary, tubular, solid, etc
(often added to describe variants of a tumor)
64
Is the following clinical description for benign or malignant tumors:
non-cancerous?
benign
65
is the following clinical description for benign or malignant tumors:
slow growing?
benign
66
is the following clinical description for benign or malignant tumors:
remains localized and does not spread but may cause local damage?
benign
67
is the following clinical description for benign or malignant tumors:
surgically removable?
benign
68
is the following for clinical description benign or malignant tumors:
survivable with good prognosis?
benign
69
is the following clinical description for benign or malignant tumors:
cancer?
malignant
70
what is latin for cancer?
crab
71
is the following clinical description for benign or malignant tumors:
rapid growth?
malignant
72
is the following clinical description for benign or malignant tumors:
leaves the anatomic compartment to invade and destroy adjacent tissues?
malignant
73
is the following clinical description for benign or malignant tumors:
metastasis is a defining feature?
malignant
74
what is metastasis?
spread of a tumor to a distant site
75
is the following clinical description for benign or malignant tumors:
can cause death due to poor prognosis?
malignant
76
is the following gross/microscopic description for benign or malignant tumors:
well-differentiated?
benign
77
is the following gross/microscopic description for benign or malignant tumors:
normal mitosis?
benign
78
is the following gross/microscopic description for benign or malignant tumors:
encapsulated?
benign
79
is the following gross/microscopic description for benign or malignant tumors:
well to poorly differentiated (or anaplastic)?
malignant
80
is the following gross/microscopic description for benign or malignant tumors:
atypical mitoses?
malignant
81
is the following gross/microscopic description for benign or malignant tumors:
non-encapsulated?
malignant
82
the typically growth rate of benign tumors is affected by what factors? (3)
-hormones
-blood supply
-pressure constrains
83
how fast do benign tumors grow?
very slowly -- months to years
84
how fast do malignant tumors grow?
fast -- variable but can be rapid enough to outgrow blood supply and make its own or cause tissue death (necrosis)
85
describe the local invasion of benign tumors
are encapsulated at the periphery so can't invade much
86
describe the local invasion of malignant tumors
they infiltrate and invade --> destructive and have no capsule = can infilatrate
87
what is the hallmark of malignancy?
metastasis
88
T/F metastatic capacity depends on tumor type
true
89
what factors mean a tumor is more likely to metastasize? (2)
more anaplastic and larger tumor = more likely to metastasize
90
____% of newly diagnosed malignant tumors have clinically evident metastases
30% (early detection is soo important!!!)
91
what are ways that malignancy is spread? (5)
-seeding in body cavities
-lymphatic spread
-hematogenous (blood) spread
-neural spread (path of least resistance)
-Batson's venous plexus, along vertebral column (path of least resistance)
92
how is malignancy of carcinoma typically spread? what are the 2 exceptions to this rule?
-lymphatic spread
-exceptions: renal cell carcinoma, hepatocellular carcinoma
93
how is malignancy of sarcoma typically spread?
hematogenous (blood) spread
(lungs and liver = secondary sites)
94
What are examples of paths of least resistance
- Neural spread
- Batson's venous plexus: along vertebral column = potential spread to the jaw
95
tissue stem cells live within ____ within a tumor
niches
96
what controls stem cell division into additional stem cells or differentiated cancer cells?
signals from surrounding niche cells
97
what is the theory surrounding cancer stem cells?
if they exist, then they must be eliminated to cure the disease but they may be resistant to therapy or harbor resistance
98
T/F multiple subtypes of oral cancer stem cells have been identified, all with different markers
true
99
neoplasia epidemiology gives insights into causes. what are examples of possible epidemiological causes? (5)
-incidence
-geographic and environmental factors
-age
-heredity
-acquired predisposing conditions
100
T/F for all cancers combined, the incidence (new cases/100,000) and death rate have decreased with some modest individual exceptions
true
101
what is the life time risk for cancer?
1 in 2-3 chance of getting cancer with 1 in 5 chance of dying from cancer in US
102
T/F there is remarkable variation around the world in cancer incidence and death rates
true
103
T/F the study of populations, habits, dietary features and environmental exposures can identify risk factors for cancer
true
104
what are some examples of environmental exposures that are associated with an increased cancer risk? (6)
-occupation exposure to carcinogens
-chronic sun exposure
-cigarette smoking
-chronic alcohol consumption
-obesity
-oncogenic HPV
105
T/F Young individuals (5-15 years) are most likely to get cancer
False
old individuals (55-75 years) are most likely to get cancer
106
in children (0-15 years), cancer accounts for ____% of deaths (leukemia, lymphoma, CNS tumors, bone/ST sarcomas)
10
107
there are hereditary predispositions for cancer but only ____% of cancers are related to inherited mutations
5-10%
108
what are two inheritance patterns that have been noted in cancer? give examples of each
-autosomal dominant: retinoblastoma, familial adenomatous polyposis
-autosomal recessive: (typically DNA repair genes) xeroderma pigmentosum
109
describe what is meant by "familial cancers of uncertain inheritance"
clustering of cancer in families without specific marker genes or predicatale inheritance patterns
110
what are the features of "familial cancers of uncertain inheritance"?
-early age at onset
-2+ close relatives with tumors
-multiple/bilateral tumors
111
about ___% of cancers are caused by random mutations during regular cell division
65
112
are most cancers developed from environment and hereditary factors or just random bad luck?
random, bad luck
113
what is meant by "acquired preneoplastic disorder"
an acquired disorder that is pre-cancerous / premalignant --> a precursor lesion
(need to closely follow these for early cancer detection)
114
what does the abbreviation "CA" mean?
carcinoma
115
what is the following "acquired preneoplastic disorder" a precursor for?
-smoking induced squamous metaplasia
-dysplasia of bronchial mucosa
bronchogenic CA
116
what is the following "acquired preneoplastic disorder" a precursor for?
-endometrial hyperplasia
-endometrial dysplasia
endometrial CA
117
what is the following "acquired preneoplastic disorder" a precursor for?
-oral, vulvar and penile leukoplakia
squamous cell CA
118
what is the following "acquired preneoplastic disorder" a precursor for?
-villous adenoma of colon
colorectal carcinoma
119
what is a. villous adenoma of colon?
preneoplastic glandular growth that grows like a polyp
120
are benign tumors premalignant? explain
generally no but a few exceptions:
-adenomas of the colon can undergo malignant transformation
121
what defines the molecular basis of cancer
carcinogenesis
122
what are the 2 main principles of carcinogenesis?
-non-lethal genetic damage
-there are 4 classes of cancer genes that are recurrently affected in cancers
123
what are the 4 classes of cancer genes that are recurrently affected in cancers?
-proto-oncogenes
-tumor suppressor genes
-apoptosis regulation genes
-tumor cell/host cell interaction genes
124
What are proto-oncogenes?
genes that encode for proteins that stimulate normal cell growth & division (normal versions of oncogenes)
125
what is an oncogene?
a mutated proto-oncogene that will stimulate innappropriate growth (tumor)
126
what are the 2 types of tumor suppressor genes and what do they do?
-governors/promoters: stop cell proliferation (directly)
-guardians/caretakers: help in DNA repair
127
what are the 2 types of classes of mutations that cause cancer?
-driver (pathogenic) mutations
-passenger (neutral) mutations
128
what are driver (pathogenic) mutations?
mutations that alter function of cancer-promoting genes to directly influence development or progression of cancer
129
where are driver (pathogenic) mutations found?
tightly clustered within cancer genes
130
what are passenger (neutral) mutations?
an acquired mutation that does not directly affect formation of cancer
131
where are passenger (neutral) mutations found?
widely scattered throughout the genome?
132
since passenger (neutral) mutations do not directly cause cancer, how can they lead to it?
they create genetic variants that can provide a selective advantage for tumor cells (i.e. drug resistance)
133
what are some patterns of genetic damage?
-point mutations
-balanced translocations
-deletions
-gene amplification
-aneuploidy
134
what type of genetic damage pattern is the RAS oncogene usually affected by in cancer?
point mutation
135
what type of cancers are balanced translocations common in? (2)
hematopoietic neoplasms and sarcomas
136
what are 3 classic cancers that are caused by balanced translocations?
-Chronic myeloid leukemia (CML)
-Burkitt's lymphoma
-Follicular B-cell lymphoma
(CML is the "Philadelphia chromosome")
137
what chromosome and gene undergo a balanced translocation in Chronic myeloid leukemia (CML)?
Philadelphia Chromosome - BCR-ABL fusion gene
138
what gene undergoes a balanced translocation in Burkitt's lymphoma?
t(8:14)
139
what genes are deletions normally found in? give an example that would lead to a cancer
-tumor suppressor genes
-ex: Rb in retinoblastoma
140
T/F the genetics damage pattern of 'gene amplification' can increase to hundreds of copies
true
141
gene amplifications are seen _____ and _____
-homogeneously staining regions
-double minutes
142
what are double minutes in gene amplification?
extrachromosomal circular DNA fragments
143
what are 2 examples of normal genes that can be altered via gene amplification and the cancers they cause?
-MYC --> Neuroblastomas
-HER-2/neu --> breast cancer
(possibly also EGFR --> lung cancer)
144
what is aneuploidy?
when there is a number of chromosomes that is not a multiple of the haploid state (i.e. 23)
(he said it technically could be considered gene amplification but with an entire chromosome)
145
aneuploidy is very common in cancers, especially ____
carcinomas
146
aneuploidy occurs due to errors of the _____
mitotic checkpoint
147
in cancer cells, aneuploidy tends to increase _____ and decrease _____
-increase oncogene copies
-decrease tumor suppressor gene copies
148
non-coding single stranded RNAS that are ~22 bases long
microRNA (miRNAs)
149
what are some functions of microRNA (miRNAs)? (3)
-inhibit gene expression by repressing translation or by mRNA cleavage
-help control cell growth, differentiation, and cell survival
-may promote increased oncogene or decreased tumor suppressor gene expression
150
T/F clinical trials are evaluating the use of microRNA (miRNAs) as therapeutic targets to treat some cancers
true
151
T/F miRNA-based drugs in combination with first-line agents may be adopted as a new therapeutic modality to treat oral cancer
true
152
T/F There are thousands of Long non-coding RNAs (lncRNAs) in the cancer genome with specific expression patterns.
true
153
T/F Long non-coding RNAs (lncRNAs) help regulate cancer development and may be crucial for future studies for targeted therapy
true
154
what are epigenetic changes?
reversible, heritable changes in gene expression without mutation (no DNA mutation involved)
155
what are 3 things that can lead to epigenetic changes?
-post-translational modification of histones
-changes in methylation
-mutations in genes that regulate the epigenome (thus, how much methylation occurs)
156
what are 2 forms of changes in methylation that cause epigenetic changes that lead to cancer?
-genome-wide hypomethylation in cancer cells --> instability --> induces tumors
-selective promoter hypermethylation --> silences tumor suppressor genes = no expression
(remember, CpG islands)
157
what is an example of selective promoter hypermethylation that silences tumor suppressor genes = no expression
CDKI (p16INK4a) altered in many cancers
158
are most neoplasms (tumors) monoclonal or polyclonal?
monoclonal
159
(monoclonal/polyclonal) proliferations are almost always non-neoplastic (no tumors)
polyclonal
160
T/F Carcinogenesis is a multi-step process leading to tumor progression (increased malignant potential)
true
161
Clinically evident tumors are most likely (homogeneous/heterogeneous)
heterogeneous
162
_____ and _____ lead to more aggressive tumors and less response to therapy over time
Evolution and selection
163
explain how to write out genes vs the gene's protein product
-genes: italicized
-proteins: no italicized
(i.e. RB gene vs RB protein or Tp53 gene vs p53 protein)
164
