Neoplasm Live - Singh Flashcards
ways benign tumor can cause harm
- spinal cord compression
- Airway compression
- Hemorrhage
- Hormone secretion
which short syllable cancers are malignant
- lymphoma
- Syndenoma
- leukemia
- melanoma
stroma is what nature in tumors
fibrous and scirrhous
is what makes primary clones and also microenvironment to survive
carcinoma has to do with
Epithelium (surface like skin and mucosa, Glands)
Sarcoma has to do with
Mesenchyme (Muscle, Fibrous tissues bone, cartilage, fat, BVs, RBCs)
Teratoma
has both mesenchymal and epithelial components, from more then 1 germ layer
Hamartoma
overgrowth of mature tissue in a place + disorganized tissue, usually one element predominating the tissue
= like jumbled building supplies instead of built house
EX: large polyp in SI (has fat, muscle, glands, vessels normal for SI only not organized right)
Choristoma
(heterotopic) wrong place normal tissue
= like built house in the wrong neighborhood
EX: polyp of pancreatic tissue in colon
metaplasia
when stress or something causes change in epithelium (like columnar to squamous), more voulnerable
dysplasia
when one cell is disorderly growing due to mutation and has past the first layer of cells, benign
carcinoma in situ
when disorderly growing due to mutation cells are in deep layers of the epithelium , Benign
which type of neoplasm is most dangerous
the one that is the most poorly differentiated and does not resemble the normal cell most
anaplasia
poorly differentiation in the cells (no good organizations)
adenocarcinoma
malignant tumor od gastric epithelium
how to assess tumor rate of growth
look at how many cells are actively dividing on microscopic image
how to see if divisions poorly differentiated
variability in cell shape and size, abnormal mitosis = you see T shape in cells, loss of polarity, anaplasia
when does staining a tissue help
when wanting to find the origin of the now malignant cells + degree of differentiation of the cells
what does immunostaining use
ABs specific to the tissue cell to stain
endocrine tumors are usually
very well differentiated, secrete a lot of the hormone that can be tumor markers at times
tumor markers
help screen for cancer or likely hood of getting something
acute leukemia you see
cancer cells stop at BLAST STAGE, you see many immature WBCs and RBCs in the circulation
chronic leukemia you see
cancer cells stop in mature stage
benign features
usually slow mitosis, not really seen on microscopic image, well differentiated
malignant features
poorly differentiated, replicating fast or slow, you see many replicating on the microscopic image, invasive
hemorrhagic leiomyosarcoma is what B or M
M
fibroadenoma is M or B
B
three ways tumors spread by
- lymphatics = most common, usually goes to LN draining that area
- Hematogenous (A or V)
- Direct seeding (free compartment like peritoneal space)
how do you know which lymph nodes to remove when getting rid of a cancer
inject tracer dye into tumor, the first nodes that gets this is the “sentinel” nodes
EX: lymphoadenectomy
Virchow node
usually left sided supraclavicular lymphadenopathy
can be due to abd or thoracic carcinoma, in carcinomas
right lymph duct drain what
right upper extremity and mid thorax
Hematogenous mets are seen when
sarcomas, some carcinomas
primary lung, liver, bone
Ex : myometrial leiomyosarcoma
trans-coelomic spread
direct seeding spreading from body cavities
TNM staging
T : size and extent of invasion
N: degree manner of nodal mets
M : distant mets present or not
besides respiratory airway what other organs can get cancer from smoking
bladder and pancreas
screens see
dysplasia before it becomes cancer
can see pre-invasive lesions
adenomatous polyp vs adenocarcinoma
adenomatous polyp is still benign
after severe dysplasia it can become malignant adenocarcinoma
do most benign tumors become the malignant form of it
no
EXCEPTIONS :
1. colon
reason some who smoke chronically longterm never get lung cancer
P450 haplotypes gene, protects some people form it
(genetics and environment play a role)
= not normal P450
paraneoplastic syndome
- tumor secretes substances (PTH, ACTH)
2. tumor activates other factors (Auto-ABs, cytokines)
2 examples of neoplastic syndrome
- Squamous carcinoma in lung : Humoral hypercalcemia, due to PTHrP increased
- Small cell neuroendocrine carcinoma in lung : Cushing syndrome due to ACTH excess secretion from hypercorticolism
Trousseau syndrome
a paraneoplastic thrombophilia : from pancreatic carcinoma
- increases TF and activates endothelium and fibrin deposition
Acute Promyelocytic Leukemia cells express what
- Tissue Factor —–> F10
- Annexin 2 R —-> plasminogens to PLASMIN
= Disseminated Intravascular Coagulation = endothelial injury leads to thrombin release due to anticoagulation dysfunction
ERBB2 amplification
breast carcinoma marker
BCR-ABL PCR
chronic myeloid leukemia
BRCA1/2 germline
breast cancer
EGFR and ALK
lung carcinoma
Philadelphia chromosome
what happens
TX:
how to monitor condition of patients
BRC-ABL forms and over active tyrosine kinase
TX: Imatinib (Gleevec) = tyrosin kinase inhibitor
you can see if the drug works by BRC-ABL PCR that can detect 1 in 100,000 cells with this BCR-ABL
people with polymorphic P450
even a small indirect carcinogen can become active ultimate carcinogenic
(P450 convert many indirect to their active form)
Pyrimidine Dimers
Thymine dimers form UVB light, keep DNA and RNA polymerase from continuing
- done by nucleotide excision repair
- excess UV exposure can overwhelm the NER = sporatic melanomas
Xeroderma pigmentosum
X Nucleotide excision repair gene
= cant get rid of pyrimidine dimers = melanomas
= freckly hyperpigmentation, nodular growths, before 10yo
ionizing radiation
can cause carcinomas even years later from initial exposure
EX: atomic bomb
EX: Chernobyl accident = radioactive iodine exposure —-> childhood thyroid cancer increase to most 30 years later
Human T-cell Leukemia virus can cause
T-cell leukemia and lymphoma
Hep B and C virus can cause
Hepatocellular cercinomas
H-pylori bacteria can cause
B-cell lymphoma in the stomach
HPV is what
can cause squamous carcinoma of cervix, anogenital area, and pharynx/larynx
- viral proteins E6 and E7 can get integrated into cell chromosome cause oncogenesis due to —-I TSG
Epstein Barr Virus (EBV)
can cause oncogenesis in B-cell lymphoma and other carcinomas (first virus seen to cause cancer)
= EBNA2 protein form the virus upregulates oncogensis (activate TF)
= LMP protein from virus —-> cell proliferation (inhibits apoptosis)
*EBV causes —-I apoptosis, and increased replication of B-cells
most common cancer or type of B-cell lymphoma EBV can cause
the Burkitt lymphoma : IgH-MYC translocation due to increased B-cell proliferation
Burkitt lymphoma is a result of what
translocation of IgH-MYC of chromosome 8 and 14
