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Path 2 > neoplasm 3 > Flashcards

neoplasm 3 Flashcards

1
Q

what are the 4 steps of invasion of ECM

A

1) Detachment
2) attachment to matrix component
3) degradation of ECM
4) Migration of tumor cells

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2
Q

describe the detachment of tumor cells

A
  • tumor cells remain attached to each other by adhesion molecules (E-cadherins)
  • In many malignant tumors, E-Cadherin is NOT produced
  • Cohesiveness of tumor cells is reduced
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3
Q

describe the attachment to matrix component

A
  • laminin/laminin receptor

- tumor cells have laminin receptors in order for it to attach to matrix

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4
Q

describe the degradation of ECM (penetration)

A
  • tumor cells or fibroblasts/inflammatory cells release collagenases (MMP) to degrade type IV Basement membrane collegen
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5
Q

describe the migration of tumor cells

A
  • binding of fibronetin/its receptor help migration

- tumor cell secreted motility factor plays a critical role in migration (locomotion)

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6
Q

define metastasis

A
  • tumor implants discontinuous with primary tumor
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7
Q

what is the metastatic cascade

A
  • ability to invade and metastasize
    1) invasion of basement membrane
    2) movement through extra-cellular matrix
    3) vascular dissemination
    4) homing
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8
Q

what are the factors involved in vascular dissemination

A
  • NK cells kill many cells in circulation
  • tumor cells are more protected in clumps and may clump with platelets
  • must arrest and extravasate to set up viable metastasis
  • Expression of CD44 on tumor cells seem to favor metastasis
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9
Q

what are the three routes of metastasis

A
  • seeding of body cavities
  • lymphatic spread
  • hematogenous spread
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10
Q

describe seeding of body cavities

A
  • malignant cells exfoliate and implant and invade tissue in a body cavity
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11
Q

describe lymphatic spread

A
  • most common type of metastasis
  • more typical in carcinomas rather than sarcomas
  • -> lymphatics empty into blood vessels –> eventual spread is hematogenous
  • pattern of nodal spread reflects normal lymph drainage
  • -> e.g. lung Carcinoma –> bronchial nodes –> tracheal nodes
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12
Q

what carcinomas do NOT spread through lymphatics

A
  • Follicular carcinoma (local invasion)
  • renal cell carcinoma (blood)
  • hepato-cellular carcinoma (blood)
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13
Q

describe hematogenous spread

A
  • Typical sarcomas or in carcinomas that are in late stages
  • arteries are more difficult for tumor to penetrate than veins (in venous invasion, blood-borne cells follow venous flow to other organs
  • frequently occurs in liver and lungs
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14
Q

define sentinel lymph node

A
  • 1st node in a regional lymphatic system that receives lymph flow from priamry tumor
  • detected by radio labeled tracers or blue dyes
  • used to detect spread of melanomas, breast cancer, colon cancer and other cancers
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15
Q

describe bone metastasis

A
  • most common site for bony metastasis is vertebral column because of batson paravertebral venous plexus connects vena cava and vertebral bodies
  • Pain is the most common symptom of bone metastasis (best relieved by local radiation therapy)
  • 2 types:
  • -> osteoblastic metastasis
  • -> osteolytic metastasis
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16
Q

describe osteoblastic metastasis

A
  • RADIO-DENSE loci noted on X-rays
  • Increase serum alk phosphatase: indicate reactive bone formation
  • e.g prostate cancer (most common type)
17
Q

Describe osteolytic metastasis

A
  • produce lucencies in bone on X ray - Pathologic fractures
  • tumors produce factors that activate OSTEOCLASTS
  • -> PGE2, Osteoclast activating factor (IL-1)
  • potential for hypercalcemia in blood
  • common cause is breast or colon cancer
18
Q

describe the 4 grades of tumors

A

I) well differentiated
II) moderately differentiated
III) poorly differentiated
IV) nearly anaplastic

19
Q

describe the TNM system of staging

A 
T =  size of primary tumor (T0-T4)
N = nodal involvement (N0-N3)
M = distant metastases ( M0 - M2)
20
Q

what do the Dukes system grade

A
  • colorectal cancers
21
Q

what does the ann Arbor system grade

A
  • for hodgkin and non Hodgkin lymphomas
22
Q

what are the most common tumors in males

A
  • prostate
  • lung
  • colorectal cancers
23
Q

what are the most common tumors in females

A
  • breast
  • lung
  • colon
  • rectum
24
Q

describe the geographic factors involved in gastric cancer and skin cancers

A
  • gastric cancer = high incidence in japan
  • skin cancer = more common in new zealand than in iceland
  • -> due to race: persons with fair skin, light hair, and blue or green eyes are more likely
25
Q

what influences the chances of getting bladder cancer

A
  • patients working in industries involving ANILINE dyes, textiles or rubber
26
Q

what influences the chances of getting mesothelioma

A
  • in patients exposed to asbestos (pipe fitters, ship builders)
27
Q

what influences the chances of getting carcinoma of oropharynx and lung

A
  • cigarette smoking
28
Q

describe the influenze of age on cancer

A
  • frequency of cancer increases with age (carcinomas)
29
Q

what are the type of tumors that develop in young adults

A
  • leukemia
  • lymphoma
  • CNS and soft tissue tumors
30
Q

what are the types of tumors that develop in infancy and childhood

A
  • blastomas, neuro-, retino-, nephro-
  • acute leukemia
  • rhabdomyosarcoma (does not go to blood in early stage)
31
Q

what are the characteristics of lymph node metastasis

A
  • enlarged, non-tender, hard in consistency

- multiple mass lesions with central areas of umbilication (ischemic necrosis)

32
Q

What kind of cancer does radon exposure form

A
  • lung

- radon + smoke is synergistic (elevate chances of developing cancer by a factor of 10)

33
Q

what kind of cancer does nickel exposure form

A
  • nose, lung
34
Q

what kind of cancer does vinyl chloride form

A
  • angiosarcoma of liver

Path 2 (11 decks)

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