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mechanism of disease > Neoplasm > Flashcards

Neoplasm Flashcards

1
Q

Hypoplasia

A

Incomplete or underdevelopment of an organ with decreased number of cells

Organ fail to reach normal size

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2
Q

Di george syndrome

A

Thymic hypoplasia causing T cell deficiency

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3
Q

Aplasia

A

Absence of an organ due to primordium failure , organ could just be a fibrous cord

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4
Q

Agenesis

A

Complete absence of an organ and it’s primordium

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5
Q

Is Corpus callosum agenesis compatible with life ?

A

Yes , but chil may be mentally retarded with normal mental function

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6
Q

Is Kidney agenesis compatible with life ?

A

Not when bilateral. Compatible when unilateral

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7
Q

What happens to normal kidney when there unilateral kidney agenesis

A

The normal kidney hypertrophies and chronically fails (CRF)

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8
Q

Harmatoma

A

Excessive and focal growth of cell forming mass of mature and specialized cells indigenous to site of mass

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9
Q

Is harmatoma benign or malignant

A

Benign

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10
Q

Ectopia

A

Congenital displacement of any organs or tissues

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11
Q

Ectopia Cordis

A

Absence of sternum and pericardium causing heart to be exposed

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12
Q

Ectopia lentis

A

Lens up outward displacement in Marfans syndrome

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13
Q

Choristoma/ heterotopia

A

Ectopic collection of normal tissue

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14
Q

Dysplasia

A

Disordered cells with reversible proliferation , loss of uniformity in respect to size, shape and orientation

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15
Q

Neoplasia

A

Persistent abnormal growth of tissue forming neoplasm

Purposeless and autonomic mass

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16
Q

Classification of tumors

A

Histogenetic (epithelial or connective tissue origin)

Behavioural (benign and malignant)

Histological (anaplastic, follicular, papillary)

Naked eye appearance - ( annular, fungating, schirrous, medullary)

Functional- insulinoma, glucagonoma

Aetiological- radiation, chemical, carcinogen, microbial

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17
Q

Main classification of neoplasm

A

Histogenesis

Behavior

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18
Q

Benign neoplasm

A

Neoplasm with good prognosis

do not spread , do not invade , and generally do not kill

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19
Q

Malignant neoplasm

A

Neoplasm with bad prognosis

Can spread and kill

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20
Q

Secondary malignant tumor

A

Metastatic tumor from another site

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21
Q

Primary malignant tumor

A

Tumor from original site

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22
Q

Basic component of tumor cells

A

Parenchyma - can proliferate

Supporting connective tissue - helps in tumor growth and contain blood vessels

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23
Q

Messenchymal benign tumor

A 
Lipoma 
Fibrous 
Chondrome 
Osteoma
Leiomyoma
Rhabdomyoma
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24
Q

Epithelial benign tumor types

A

Adenomas- glandular cells origin

Papillomas- surface epithelium origin with fingerlike or warty projections

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25
Q

Cystadenomas

A

Large cysts benign tumors

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26
Q

Follicular adenomas

A

Form follicles benign tumors

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27
Q

Papillary cystadenoma

A

Fingerlike projection in epithelium of cyst - benign tumor

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28
Q

Suffix for malignant tumor of mesenchyme

A

Sarcoma

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29
Q

Suffix for malignant cancer of the epithelium

A

Carcinoma

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30
Q

Mixed tumors

A

Tumors arising from multiple cells types

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31
Q

Example of mixed tumors

A

Salivary glands tumors

Fibroadenoma of breast

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32
Q

Teratomas

A

Cancer cells that arise from totipotent cells

Can be malignant or benign

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33
Q

Eponymous cancers example

A

Burkitt lymphoma
Wills tumors
Hodgkin’s disease
Krukenberg tumor

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34
Q

Cancer

A

Any malignant neoplasm

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35
Q

Benign tumor of adipose tissue

A

Lipoma

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36
Q

Benign tumor of fibrous tissue

A

Fibroma

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37
Q

Benign tumor of bone

A

Ostéoma

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38
Q

Benign tumor of cartilage

A

Chondroma

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39
Q

Benign tumor of smooth muscle

A

Leiomyoma

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40
Q

Benign tumor of skeletal muscle

A

Rhabdomyoma

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41
Q

Benign tumor of blood vessel

A

Hemangioma

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42
Q

Malignant tumor of adipose cells

A

Liposarcoma

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43
Q

Malignant tumor of fibrous tissue

A

Fibrosarcoma

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44
Q

Malignant tumor of bone

A

Osteosarcoma

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45
Q

Malignant tumor of cartilage

A

Chondrosarcoma

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46
Q

Malignant tumor of smooth muscle

A

Leiomyosarcoma

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47
Q

Malignant tumor of skeletal muscle

A

Rhabdomyosarcoma

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48
Q

Malignant tumor of blood vessel

A

Angiosarcoma

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49
Q

Malignant tumor of nerve

A

Malignant schwanomma

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50
Q

Malignant tumor of squamous cellsl

A

Squamous cell carcinoma

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51
Q

Malignant tumor of transitional cell

A

Transitional cell carcinoma

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52
Q

Malignant tumor of placenta

A

Choriocarcinoma

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53
Q

Benign tumor of nerve cell

A

Neurofibromas

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54
Q

Benign tumor of squamous cells

A

Squamous cell papilloma

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55
Q

Benign tumor of transitional cell

A

Transitional cell papilloma

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56
Q

Benign tumor of placenta

A

Hydatidiform mole

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57
Q

Benign tumor of breast nodule

A

Fibroadenoma

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58
Q

Benign tumor of salivary glands

A

Pleiomorphic adenoma

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59
Q

Benign tumor of melanocytes

A

Melanocytic nevus

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60
Q

Malignant tumor of breast lobule

A

Ductal or lobular carcinoma

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61
Q

Malignant tumor salivary glands

A

Malignant mixed tumors

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62
Q

Malignant tumor of melanocytes

A

Melanoma

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63
Q

Malignant tumor of hematopoietic cells ( always malignant)

A

Leukaemia

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64
Q

Malignant tumor of lymphoid tissue ( always malignant)

A

Lymphoma

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65
Q

Benign tumor growth rate

A

Slow

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66
Q

Malignant tumor growth rate

A

relatively rapid

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67
Q

Benign tumor mototic activity

A

Low

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68
Q

Malignant tumor mitotic activity

A

High

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69
Q

Benign tumor histological resemblance to normal tissue

A

Good

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70
Q

Malignant tumor histological resemblance to normal tissue

A

Variable often poor

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71
Q

Benign tumor nuclear morphology

A

Often normal

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72
Q

Malignant tumor nuclear morphology

A

Usually hyper chromatic, irregular outline , multiple nucleoli and pleomorphic

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73
Q

Benign tumor invasion?

A

Non

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74
Q

Malignant tumor invasion ?

A

Yes

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75
Q

Necrosis in benign tumor

76
Q

Necrosis in malignant tumor

77
Q

Differentiation definition

A

Extent to which parenchymal cell ressemble normal cells morphologically and functionally

78
Q

Well differentiated tumors

A

Ressemble normal tissue of origin

79
Q

Undifferentiated

A

Primitive appearance, resemble in specialized cells

80
Q

Generally , are benign tumor well differentiated of undifferentiated

A

Well differentiated

81
Q

How do characterize a malignant tumor with undifferentiated cells

A

Anaplastic

82
Q

Features of anaplasia

A

Pleomorphism (Variation in size and shape of the cells)

Hyperchromasia

High nuclear cytoplasmic ratio

Enlarged and multiple nucleoli

Angulated nuclear shapes

Possible mitotic figures

Tumor giant sells

Loss of polarity

Dysplasia

83
Q

Carcinoma in situ

A

Dysplasia involves the entire thickness

84
Q

Type of tumor that can produce hormones of the cell of origin

A

Benign tumor and well differentiated malignant tumor of endocrine glands

85
Q

Why is there necrosis in some tumors

A

Rapid growth which outstrip blood supply

86
Q

Why is there hemorrhage in some tumors

A

Necrosis or disruption of a blood vessel

87
Q

Why do you Leiomyomas increase rapidly during pregnancy

A

Estrogen and progesterone Production increase rate of growth

88
Q

Mode of growth of benign tumors

A

Cohesive expensile masses
Fibrous capsule presents
Benign tumors are discretes well circumscribed ,readily palpable ,movable masses

89
Q

Malignant tumors mode of growth

A

Progressive infiltration with invasion and destruction

90
Q

Epithelial malignant tumor normally starts as in situ carcinoma right or wrong ?

91
Q

Metastasis

A

Tomorrow implants in a zone discontinuous s from the primary tumor

92
Q

Three pathways for distance metastasis

A

Heamatogenous

Lymphatic

Through Body cavities

93
Q

Type of cell that do not metastasize widely

A

Glial tumor of the central nervous system

Basal cell carcinoma of the skin

94
Q

Sarcoma main type of metastasis pathway

A

Haematogenous spread throtgh mainly veins

95
Q

Main metastasis pathway for carcinoma’s

A

Lymphatic spread

96
Q

Macro features to note of cancers

A 
Size 
Color
Shape 
Necrosis 
Haemorrhage 
Capsule 
Ulceration of surface 
Edges of ulcer
97
Q

Polyp

A

Benign tumor projecting above mucosal surface

98
Q

Sessile papilloma

A

Broad based stalk

99
Q

Pedunculated papilloma

A

Narrow base

Elongated stalk and

100
Q

Billows papilloma

A

Thin fronds

101
Q

Grade of tumors

A

Level of differentiation of the tumor

102
Q

Stage of tumor

A

Extent of spread of tumor

103
Q

Basis of different tumors grades

A

Nuclear size
Pleomorphism
Mitosis

104
Q

The different grades of tumors

A

I , II , III

Done from least differentiated area

105
Q

Limits of grade system of tumors

A

Heterogeneity of tumors
Change of tumor over time
Poor correlation with histological appearance and biological behavior

106
Q

Basis of stage of tumors

A

Size of primary tumor
Extent of spread
Presence and extent of metastasis

107
Q

TNM classification

A

T - size of primary tumor
N - number of regional lymph node involved
M- metastasis

108
Q

T criteria of TNM

A

Tis- in situ lesion
T0- no primary tumor detected
T1-T4- increasing size of tumor
Tx- size of primary tumor not known

109
Q

N stage of TNM

A

N0- no regional node involved
N1-n3- increasing group of node present
Nx - cannot be assessed

110
Q

M criteria of TNM

A

M0- no metastasis blood
M1- present metastasis in blood
Mx- cannot be assessed

111
Q

AJCC classification of cancers

A 
Stage 0 
Stage I
Stage II
Stage III
Stage IV
Incorporate TNM at each stage
112
Q

4 phases of malignant tumor

A

Transformation
Clonal expansion
Local invasion
Distant metastasis

113
Q

Doubling time of cancer

A

Detectable tumor at 1gm - takes 30 population doubling

114
Q

Maximum size of cancer compatible with life

A

1kg tumor (40 population doublings)

115
Q

Growth fraction

A

Proliférating cells ratios

116
Q

Type of cancer with high growth fraction

A

Leukemia
Lymphomas
Small cell carcinoma
Nasopharyngeal carcinoma

117
Q

Low growth carcinoma fraction

A

Carcinoma colon
Carcinoma breast
Salivary glands carcinoma

118
Q

Is chemotherapy more effective in high of low growth fraction cancers ?

119
Q

2 ways to acquire neovascularization

A

Tumor associated angiogenesis factors

Inflammatory cell derived angiogenic factors

120
Q

Hallmarks of malignancy

A

Invasion

Metastasis

121
Q

Step from single epithelial cell to metastatic growth

A

Transformed cell

Clonal expansion with growth and angiogenesis and heterogeneity

Development of invasive subclone

Adhésion and degradation of basal membrane

Invasion of extra cellular matrix

Intravasation

Interaction with host lymphocytes

Tumor cells embolises

Adhere to another basal membrane and extravasation

Metastatic deposit

Angiogenesis

Growth of metastasis

122
Q

Metastatic subclone down regulate …

A

E cadherin

123
Q

Incidence of cancer around the world

A

Higher in advanced countries

124
Q

Most common cancer in male

A

Prostate
Lymphomas
Stomach

125
Q

Most common cancer in Female

A

Breast cancer

Cervix cancer

Lymphomas

126
Q

Commonest cause of cancer death in male

A

Hepatoma

Lymphoma

Prostate

127
Q

Commonest cause of cancer death in female

A

Breast

Lymphoma

Heaptoma

Brain tumors

128
Q

Most common cancer in Japan

A

Stomach cancers

129
Q

Most common cancer in China and sub saharan Africa

A

Nasopharyngeal cancer

130
Q

Environmental factors of cancer

A 
UV rays 
Chemicals 
Asbestos (lung ca)
Vinyl chloride (liver angiosarcoma)
Benzene (leukemia, hodgkins)
Alcohol ( ca mouth, larynx, pharynx, esophagus) 
Smoking ( ca mouth, pharynx, larynx, esophagus, pancreas , bladder, lung )
Viruses ( ca cervix , B cell lymphomas)
131
Q

Most common age range of cancer

A

More than 55years

132
Q

Most common cancer 0-15years

A 
Congenital and embryonic tumors 
Retinoblastoma 
Neuroblastoma
Nephroblastoma
Leukemia 
Lymphomas 
Brain tumors
133
Q

Main tumor 16-34yo

A 
Breast 
Leukemia
Lymphoma 
HCC
Cervix 
Brain tumors
134
Q

Type of tumors 35-54years old

A 
Breast 
Lymphomas 
Ovary 
Cervix 
Lungs 
Stomach 
HCC 
Prostate
135
Q

Common cancer +55years old

A 
Prostate 
Breast 
Lymphomas 
Female 
Genital cancers
136
Q

Cancer associated with defective DNA repair

A

Xeroderma pigmentosum

Ataxia telangiectasia

Bloom’s syndrome

Fanconis anemia

137
Q

Carcinogenic agents types

A

Chemical
Radiation
Oncogenic microbes

138
Q

Initiation of chemical carcinogenicity

A

DNA damage by chemical

Proliferation to fix dna change as inherited change

139
Q

Promotion of chemical carcinogenicity

A

Promoters render cell susceptible to DNA damage by increasing proliferation

140
Q

Direct acting initiator chemicals

A 
Alkylating agents 
Acylations agents 
B propiolactone
Dimethylsulfate 
Diepoxybutane
141
Q

Indirect acting pro carcinogens

A 
Aromatic hydrocarbons 
Aromatic amines amides azodyes 
Plant extract 
Nitrosamines 
Insecticides
142
Q

Molecular targets of carcinogens

A

Tumor suppressor genes
Proto oncogenes
Genes for apoptosis

143
Q

Natural carcinogens

A

Aflatoxins B1 seen in peanuts and dried grain. Causes hepatoma in africa

144
Q

Radiation carcinogens

A 
Uv light 
Alpha beta particles 
Protons 
Neutrons 
X ray 
Y ray
145
Q

UV light damage causes …

A

Squamous cell carcinoma
Basal cell carcinoma
Melanocarcinoma

146
Q

What type of uv light is most associated with cutaneous carcinoma

147
Q

Tumors produced by radiation …

A 
Leukemia’s 
Thyroid 
Breast 
Lungs 
Salivary glands
148
Q

Human papilloma virus causes

A

Warts ( 1,2,4,7)

Warts with low malignant potential ( 6,11)

Squamous cell carcinoma (16,18,33,35,39,45,51,59,52)

149
Q

Virus that causes burkitt lymphoma

150
Q

Virus associated with hepatocellular carcinoma

A

Hepatitis B and C virus

151
Q

Helicobacter jejuni causes

A

Gastric lymphoma and carcinoma

152
Q

Oncogenes

A

Cancer causing genes

153
Q

Proto oncogenes

A

Genes that promote growth and differentiation

154
Q

Activation of proto oncogenes

A

Change in structure which produce proteins with aberrant gene

Changes in regulation of genre which produce excessive amount of protein

155
Q

Types of proto oncogenes

A

Growth factors
Gf receptors
Signal transducers
Cell cycle regulators

156
Q

Ras oncogenes

A

Ras proteins with reduced gtpase activity , mutant GAP remains in active form

157
Q

How can Translocation of chromosomes participate in cancer ceeation

A

Over expression of proto oncogenes by making it under regulatory gene influebcr

Formation of hybrid genes that code for GF
(C-abl-bcr)

158
Q

Mantle cell lymphoma

A

Translocation occur t(11:14) , disregulate cyclin D1 allowing passage from g1 to s phase

159
Q

Gêne amplification in oncogenesis

A

Protooncogene reduplicated to form multiple of its copy

L-myc in lung ca , n-Myc in neuroblastoma, cerb b2 in breast ca

160
Q

Tumor suppressor genes

A

Regulate cell proliferation acting like brakes

161
Q

Are tumor suppressor genes recessive or dominant

A

Recessive so require 2 copiers to be activated

162
Q

What type of cancer do you see tumor suppressor gene 2 hit hypothesis

A

Retinoblastoma ( inherits one mutated allele and loses the normal allele after birth) familial type

163
Q

P53

A

Tumor suppressor gene involved in more than 50 % of tumors

164
Q

P53 action

A 
Arrest cell cycle ( at g1)
Promote apoptosis ( activates bax, bad, bak)
165
Q

Genes that prevent apoptosis

A

Bcl1, bcl2, bcl xl

166
Q

Genre that promotes apoptosis

A

Bax
Bad
Bak
Bcl xs

167
Q

Genomic instability syndrome

A

Disease occurring to damage to genes responsible of dna repair regulation

168
Q

What enzyme wrongful activation can give immortality to tumor cells

A

Telomerase

169
Q

Gatekeeper genes

A

Genes that directly affect cell growth and when mutated allow entry in carcinogenic

170
Q

Types of gatekeeper genes

A

APC
RB
NF1
P53

171
Q

Caretaker genes

A

Genes that do not directly control cell growth but affect genomic stability and DNA repair and protect entire genome

172
Q

Tumor specific antigens

A

Unique tumor antigen

Oncofetal antigens

Differentiation antigens

173
Q

Oncofetal antigens

A

Produced normally only by embryonic tissue but can appear in tumor ( alpha feto protein)

No immune response but useful in diagnosis and follow up

174
Q

Differentiated antigens

A

Peculiar to differentiation state of cancer cells
CD10 for B CELL leukemia
PSA for prostate cancer
Viral antigens

175
Q

Cellular arm of immune response against tumors

A

CytTCell in MHC I - direct cell to cell killing

NK cells which kill without sensitization

Macrophages which kill by cytotoxic products

176
Q

Humoral mechanism against tumor

A

Some antibodies can play a role

MAC complex can help lyse cells

Opsonization of tumors

177
Q

Immuno surveillance theory

A

Tumors cells constantly produced but being killed by immune system

So more risk of cancers in immunodeficient (x200)

Immunosuppressive therapy causes malignancy

178
Q

Escape mechanism of tumors against immune system

A

Loss or reduced expression of MHC

Lack of co stimulation moleculei

Immunosupression by poorly defined factors

179
Q

Local effects of tumors

A

Compression ( pressure atrophy)

Invasion perforation

Ulceration

Distortion rupture of vessels

Obstruction

Replacement of specialized cells and function

180
Q

Metabolic effects of tumors

A

Cachexia - lead to anorexia and anemia ( due to low appetite and taste abnormality, high calorie expenditure due to high BMR,

Inappropriate elaboration of hormones ( insulin, thyroid adenomas , parathyroid adenomas) causes paranéoplastic syndrome

181
Q

Paraneoplastic syndrome

A

Found in carcinoma but not related to spread of tumor nor hormone production
May confound metastatic disease

182
Q

Clinical information to take when suspecting a tumor

A 
Name 
Age 
Sex
Hospital 
Ward 
Physician 
Exact anatomical site 
Duration
183
Q

Sampling technics of tumors

A 
Biopsies excision 
Incision 
Needle aspiration 
Tru cut 
Whole specimen 
Exfoliative 
Smears
184
Q

Preservatives of mass sample

A

Alcohol
Formalin
Gluteraldehyde

185
Q

Tumor markers in lab findings

A 
Hormones 
oncofetal proteins 
Enzymes 
Ig
Antigens 
Cytoplasmic proteins

mechanism of disease (22 decks)

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