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Concepts in Pathology and Tissue Morphology > Neoplasm > Flashcards

Neoplasm Flashcards

1
Q

what are 3 important characteristics of neoplasm

A

unregulated, irreversible, and monoclonal

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2
Q

define the monoclonal nature of neoplasm

A

neoplastic cells are derived from a single mother cell

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3
Q

what can be used to determine clonality of a neoplasm

A

G6PD isoforms or androgen receptor isoforms

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4
Q

what is desmoplasia

A

the presence of abundant collagen fiber in connective tissue, giving it a firmness

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5
Q

what are the 2 basic components of tumors

A
  • tumor parenchyma (neoplastic cells(

* reactive stroma (CT, fibrous tissue, blood vessels, and inflammatory cells; may be desmoplastic)

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6
Q

what is a fibroma

A

a benign tumor originating from fibrous tissue

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7
Q

what is a lipoma

A

a benign tumor originating from adipose tissue (lipid)

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8
Q

what is a chondroma

A

a benign tumor originating from cartilage

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9
Q

what is a osteoma

A

a benign tumor originating from bone

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10
Q

what is a hemangioma

A

a benign tumor originating from blood vessels

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11
Q

what is a lymphangioma

A

a benign tumor originating from lymph vessels

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12
Q

what is leiomyoma

A

a benign tumor originating from smooth muscle

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13
Q

what is a rhabdomyoma

A

a benign tumor originating from striated muscle

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14
Q

what is a fibrosarcoma

A

a malignant tumor originating from fibrous tissue

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15
Q

what is a liposarcoma

A

a malignant tumor originating from adipose tissue

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16
Q

what is a chondrosarcoma

A

a malignant tumor originating from cartilage

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17
Q

what is an osteosarcoma

A

a malignant tumor originating from bone

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18
Q

what is an angiosarcoma

A

a malignant tumor originating from blood vessels

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19
Q

what is a lymphangiosarcoma

A

a malignant tumor originating from lymph vessels

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20
Q

what is a leiomyosarcoma

A

a malignant tumor originating from smooth muscle

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21
Q

what is a rhabdomyosarcoma

A

a malignant tumor originating from striated muscle

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22
Q

what is the nomenclature for a benign neoplasm derived from glands

A

adenoma

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23
Q

what is the nomenclature for a benign neoplasm that produces fingerlike or warty projections

A

papilloma

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24
Q

what is the nomenclature for a benign neoplasm that forms large cystic masses

A

cystadenoma

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25
Q

what is the nomenclature for a benign neoplasm that forms a visible projection above mucosal surface

A

polyp

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26
Q

what is the nomenclature for a malignant tumor derived from glands

A

adenocarcinoma

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27
Q

what is the nomenclature for a malignant tumor derived from squamous epithelium

A

squamous cell carcinoma

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28
Q

what is the nomenclature for a malignant tumor derived from kidney cells

A

renal cell carcinoma

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29
Q

what is the nomenclature for a malignant tumor derived from liver cells

A

hepatocellular carcinoma (hepatoma is an old term, and it somewhat of a misnomer)

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30
Q

what is a biphasic neoplasm

A

one that is derived from both fibroblasts and glandular epithelium

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31
Q

what is a fibroadenoma

A

a benign neoplasm of breast

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32
Q

having well circumscribed borders is a common characteristic of what kind of tumor

A

benign

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33
Q

what is a teratoma

A

a germ cell tumor arising from totipotent cells in testis or ovary

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34
Q

ovarian teratomas are almost always benign this can be contrasted with…

A

testicular teratomas in adults are never benign

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35
Q

melanoma is an exception to general nomenclature because

A

they are malignant by definition

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36
Q

what is an anaplastic tumor

A

one that has no resemblance (histologically) to the tissue of origin

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37
Q

a tumor that is well differentiated…

A

closely resembles the normal cells of the tissue of origin

38
Q

tumor necrosis is a feature of malignant tumors. what happens here?

A

rapidly growing cancers can outgrow their blood supply -> ischemia -> tumor necrosis

39
Q

what are the 6 hallmarks of cancer?

A
  • sustain proliferative signaling
  • evade growth suppressors
  • resist cell death
  • enable replicative immortality
  • induce angiogenesis
  • activate invasion and metastasis
40
Q

how to malignant cells sustain proliferative signaling?

A
  • can proliferate without external stimuli

* usually consequence of oncogene activation

41
Q

what is an oncogene

A
  • originates from mutated proto-oncogene

* promotes autonomous cell growth in cancer cells

42
Q

how do malignant cells evade growth suppressors

A
  • mutated tumor suppressor genes

* 2 hit origin of cancer

43
Q

why is P53 considered the guardian of the genome?

A
  • encoded by tumor suppressor gene

* when mutated, unable to arrest cell cycle for DNA damage repair

44
Q

which protein is often called the “governor of cell proliferation” and why?

A
  • retinoblastoma protein
  • encoded by tumor suppressor gene
  • regulated G1/S checkpoint
45
Q

what are some ways that malignant cells resist cell death

A
  • mutations in TP53
  • mutations in other genes that regulate apoptosis
  • overexpression of anti-apoptotic signaling molecules (ie Bcl-2)
46
Q

how do malignant cells enable replicative immortality?

A
  • all cancer cells contain stem cells -> immortality

* also high telomerase activity

47
Q

what is an important regulator of angiogenesis, which is an important hallmark of cancer

A

VEGF

48
Q

how can malignant cells activate invasion and metastasis

A
  • loosen cell-cell adhesion mediated by cadherins
  • secrete proteases to degrade ECM
  • use adhesion molecules to migrate through ECM
49
Q

what type of gene accounts for the vast majority of familial cancer syndromes?

A

tumor suppressor genes (ie TP53, RB, P16)

50
Q

mutations leading to oncogenes (less common than tumor suppressor) lead to

A

constitutive activation (gain of function)

51
Q

what are the basic steps of polymerase chain reaction (PCR)

A
  1. denaturation of DNA
  2. anneal with primer
  3. elongation; doubled DNA with each cycle
52
Q

a carcinoma is a malignancy of

A

epithelial cells

53
Q

a sarcoma is a malignancy of

A

mesenchyme/soft tissues

54
Q

What is the TNM staging system for cancer? and which is the most important for predicting patient outcome?

A

T: tumor
N: lymph nodes
M: metastasis
*metastasis most important for determining outcome

55
Q

what test is recommended in all patients with colorectal cancer?

A

testing for lynch syndrome (and endometrial cancers in females, at least in NM)

56
Q

what is lynch syndrome

A

a hereditary cancer cause by mutation in 1 of 4 DNA mismatch repair proteins (form of tumor suppressor gene)

57
Q

what are the 4 mismatch repair proteins, and which one most commonly mutated in lynch syndrome?

A

MLH1 (most common)
MSH2
MSH6
PMS2

58
Q

which mutations are almost never seen in lynch syndrome?

A

BRAF, meaning a BRAF test could be done to rule out HNPCC

59
Q

what is the underlying mechanism of HNPCC or lynch syndrome

A

microsatellite instability

60
Q

EGFR is a proto-oncogene, and mutations can cause

A

non-small cell lung cancer

61
Q

non-small cell lung cancer is a unique lung cancer in that it is commonly seen in

A

never smokers, females, asians

62
Q

what is the idea behind a “liquid biopsy”

A

tumor fragments can enter the blood stream and can be found in serum test rather than invasive biopsy

63
Q

what is liquid biopsy commonly used for

A
  • lung cancers
  • resistance mutations
  • patients who can’t do another biopsy
64
Q

syndromic colorectal carcinoma are caused by germline mutations. examples include

A
  • HNPCC -> mismatch repair genes including MLH1

* familial adenomatous polyposis -> APC gene

65
Q

what are the signs and symptoms that usually lead to detection of cancer

A
  • physical pressure
  • organ(s) dysfunction
  • systemic effects (ie fever, peri-neoplastic effects)
66
Q

what is metastatic tropism?

A

tumors originating from a given organ preferentially seed in particular tissues

67
Q

angiogenesis in tumor formation most closely resembles what type of capillary

A

sinusoid capillaries, which have wide spaces between endothelial cells

68
Q

angiogenesis is a process seen anatomically and pathologically including

A
  • embryonic development
  • implantation of placenta
  • wound healing
  • many disease processes
  • tumorigenesis
69
Q

Receptor tyrosine kinases located on the surfaces of endothelial cells respond mainly to ___ and ___ to stimulate angiogenesis

A
  • VEGF = vascular endothelial growth factor

* bFGF = basic fibroblast growth factor

70
Q

what is the role of HIF-1α in angiogenesis?

hint: what happens to is in oxygen rich and poor states

A
  • in oxygen rich states, proline residues on HIF-1α are hydroxylated -> ubiquitination -> proteasome degradation
  • in oxygen poor states, it binds to HIF-1β, which acts as a transcription factor to stimulate VEGF production
71
Q

what do tumors resemble?

A
  • wound healing sites

* macrophages secrete many growth factors, including VEGF

72
Q

what do matrix metalloproteinases (MMPs) do?

A

they are a family of proteases involved in the degradation of capillary basal lamina that is needed for angiogenesis

73
Q

what is an important protein involved in new vessel maturation in angiogenesis?

A

angiopoietin 1 (Ang 1)

74
Q

many tumor cell populations initially lack what ability, which is necessary for tumor expansion?

A

ability to track blood vessels; the “angiogenic switch” must be turned on before tumor expansion can occur

75
Q

what does it mean to say that tumors have a heterogeneity of angiogenic activity?

A

a mix between angiogenic and non-angiogenic cells

76
Q

what transition is necessary for a neoplasm to become invasive? and what does this transition involve?

A
  • epithelial-mesenchymal transition (EMT)

* involves a transition of type of cell adhesion molecules

77
Q

what factors affect where a metastasis will seed?

A
  • blood and lymph flow from the organ of origin

* chemokines

78
Q

what factors affect the efficiency of a metastasis?

A

differentiation, developmental and growth conditions (mitogens and growth factors)

79
Q

what are the additional hallmarks of cancer that were added after the original 6?

A
  • deregulating cellular energetics
  • avoiding immune destruction
  • tumor-promoting inflammation
  • genome instability and mutation
80
Q

infection by what organism causes 90% of stomach cancers?

A

H. pylori

81
Q

infection by what causes nearly 100% of cervical cancers?

A

HPV

82
Q

what infections can account for ~77% of liver cancers?

A

HBV and HCV

83
Q

what are 3 important steps that microbes use to induce uncontrolled cellular proliferation?

A
  1. uncoupling of normal regulatory mechanisms
  2. prevention of host cells from undergoing apoptosis
  3. avoid host’s immune system
84
Q

what are the 2 major phyla normally found in the gut?

A

bacteriodetes and firmicutes

85
Q

what is the only known neoplasm that can be eliminated with abx?

A

MALT lymphoma; 80% associated with H. pylori

86
Q

what locations can develop cancer due to infection with HPV?

A

cervix, vagina/vulva, anus, penis, and oropharynx

87
Q

which HPV variants cause the most cervical cancers

A

HPV 16 and 18 cause 70% of cervical cancers and precancerous cervical lesions

88
Q

E6 and E7 are 2 important genes on the HPV genome. What do they bind to in humans?

A

E6->p53

E7->pRB

89
Q

what is the most important factor in worldwide occurrence of hepatocellular carcinoma?

A

HBV

90
Q

how is HBV transmitted?

A

perinatal, sexual, blood transfusions, IV drug use

91
Q

how is HCV transmitted?

A

blood transfusions, IV drug use

Concepts in Pathology and Tissue Morphology (10 decks)

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