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Pathology I > Neoplasms and Disturbances of growth > Flashcards

Neoplasms and Disturbances of growth Flashcards

1
Q

an abnormal mass of cells produced by excessive growth of new tissue.

A

neoplasm/tumor

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2
Q

tumor cells do not invade tissues, are non-
metastatic and usually exhibit “self-limiting” patterns of growth. These tumors are generally well differentiated and most spare the host (with certain exceptions).

A

benign tumor

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3
Q

Tumor cells that are invasive with high potential for distant spread (metastasis). They are difficult to treat and tend to be a serious threat to the life of the host.

A

malignant tumor

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4
Q

a study of the “science” of neoplasms including etiology and pathogenesis

A

oncology

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5
Q

term refers to all types of malignancy.

A

cancer

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6
Q

Non-neoplastic alterations of cell growth in tissue and organs is called _____.

A

malformations

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7
Q

inadequate or incomplete development

A

hypoplasia

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8
Q

lack of development

A

aplasia

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9
Q

a benign tumor-like mass consisting of an overgrowth of

differentiated cells and tissues that are normally present in the affected location

A

hamartoma

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10
Q

______ are not necessarily neoplastic but are likely precursors to cancer in certain circumstances.

A

Dysplasias

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11
Q

What kinds of cell growth are associated with increased cell proliferation which contributes to an elevated cancer risk?

A
  • hyperplasia
  • metaplasia
  • regeneration
  • dysplasia
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12
Q

What are some characteristics of neoplasms?

A
  • tumor cells exhibit increased capacity to survive and reproduce
  • monoclonal: arise from single cell
  • parasitic in nature and do not contribute to body homeostasis
  • all malignant tumors are invasive
  • some malignant tumors have metastatic potential
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13
Q

Virtually all tumors consist of what two essential types of tissue?

A
  • transformed (neoplastic) cells that determine specific tumor characteristics
  • non-transformed (normal) connective tissues and blood vessels that comprise the tumor stroma
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14
Q

Malignant neoplasms of epithelial and glandular tissues characterized by irregular infiltrating, no-encapsulating masses of neoplastic cells that extend into the surrounding tissues

A

Carcinoma

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15
Q

What is the most common cancer category encountered in adults?

A

carcinoma

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16
Q

Two main types of tumors:

A
  • single transformed cell type

- more than one transformed cell type

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17
Q

tumors with single cell type

A
  • benign tumors
  • malignant tumors
  • sarcomas
  • carcinomas
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18
Q

benign glandular tumor

A

adenoma

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19
Q

benign polypoid tumor

A

papilloma

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20
Q

benign epithelial tumor

A

epithelioma or papilloma

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21
Q

benign fibroblast tumor

A

fibroma

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22
Q

benign adipose tumor

A

lipoma

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23
Q

benign cartilaginous tumor

A

chondroma

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24
Q

benign blood tumor

A

angioma

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25
Q

malignant tumors of mesenchymal (supportive) tissues that produce irregular bulky growths that are sometime encapsulated

A

sarcoma

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26
Q

malignant growth of carcinoma extends through the _____

A

basement membrane

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27
Q

tumor derived from germ cells or other totipotential cells and consists of mixed tissue types derived from any (usually all) of the embryonic germ layers

A

teratoma

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28
Q

Where do teratomas usually arise?

A

gonads

- also develop in other sites where totipotential cells persist (e.g. notochord remnants, retroperitoneum)

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29
Q

rhabdo means

A

shaped like a rod

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30
Q

leio means

A

smooth muscle

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31
Q

malignant glandular tumor

A

adenocarcinoma

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32
Q

malignant epithelial tumor

A

melanoma, squamous cell carcinoma, etc.

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33
Q

malignant adipose tumor

A

liposarcoma

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34
Q

malignant fibroblast tumor

A

fibrosarcoma

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35
Q

malignant skeletal muscle tumor

A

rhabdomyosarcoma

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36
Q

bening skeletal muscle tumor

A

rhabdomyoma

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37
Q

What kind of tumors appear at a young age, are poorly differentiated and grow rapidly?

A

embryonic tumors

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38
Q

Wilm’s tumor of the kidney and retinoblastoma are examples of what?

A

embryonic tumors

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39
Q

malignant tumor of leukocytes and related cell types that arise in the marrow and infiltrate the peripheral blood, bone marrow and other structures

A

leukemia

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40
Q

malignant tumors consisting of lymphocytes, macrophages and related cells that originate in lymph nodes and other lymphoid tissues and occasionally in certain organs

A

lymphoma (Hodgkin’s disease)

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41
Q

Malignant tumor of plasma cells characterized by production of abnormal immunoglobulins (antibodies)

A

multiple myeloma

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42
Q

Malignant tumor of melanocytes in skin

A

malignant melanoma

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43
Q

As a group, benign tumors do not _____

A

metastasize

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44
Q

______ tumor cells differ from the parent tissue morphologically and
functionally

A

malignant

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45
Q

What are the typical histological characteristics of malignant tumor cells include the following:

A
  • pleomorphism (variations in size and shape)
  • enlarged nuclei
  • atypical (polyploidy) chromosomes
  • increased nucleoli size and number
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46
Q

What are some cell surface changes seen on neoplastic cells?

A
  • altered glycoproteins
  • decreased adhesive/cohesiveness
  • altered cell junction complexes
  • loss of normal antigens
  • increased turnover of membrane components
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47
Q

What are some cytoplasmic changes seen in neoplastic cells?

A
  • loss of specialized structures (microtubules, filaments, microvilli)
  • loss of normal cell products
  • production of new cell products (enzymes, hormones)
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48
Q

What are some nuclear changes seen in neoplastic cells?

A
  • primitive appearance
  • enlargement
  • large nucleolus
  • aneuploidy
  • marker chromosomes
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49
Q

what is Aneuploidy?

A

abnormal number of chromosomes

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50
Q

Most malignant tumors are ______ and present ______ margins

A

non-encapsulated: irregular

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51
Q

discontinuous spread to distant (secondary) sites. These include lymph nodes, various organs and the skeleton.

A

Metastases

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52
Q

Common physiological alterations/features observed in cancer cells include:

A
  • loss of specialized functions (contraction, secretion)
  • increased capacity for anaerobic glycolysis
  • production of enzymes and other cell products that promote tumor cell proliferation
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53
Q

During neoplastic transformation, general antigenic changes that occur are:

A
  • All tumors produced by a specific virus tend to exhibit the same neoantigens.
  • Individual tumors produced by a particular carcinogenic chemical generally express sporadically different tumor-cell antigens.
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54
Q

Decreased adhesion of tumor cells, diminished cell junctions and other alterations contribute to metastasis by causing _____

A

shedding (detachment) of cells from the primary tumor

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55
Q

How do tumor cell proteases contribute to metastasis?

A

they degrade and invade the basement membrane matrix. The cleavage products of the basement membrane have growth promoting, angiogenic and chemotactic effects of tumor cells

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56
Q

Pathogenic factors that contribute to metastasis includes the following:

A
  • shedding of cells from primary tumor
  • attachment of invading cells
  • invasion and degradation of basement membrane
  • locomotion and infiltration of tumor cells
  • degradation of vascular basement membrane
  • penetration of lymphatics and blood vessels
  • embolization and survival of metastasizing cells in the blood stream and lymph
  • exit of tumor cells at site of metastasis
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57
Q

What are the routes of spreading for metastatic tumors?

A

all pathways available to the tumor are utilized

  • local tissue infiltration
  • lymphatic vessels
  • blood vessels
  • “seeding of body cavities” as seen in GI
  • transplantation from invasive procedures
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58
Q

Factors influencing the localization of metastases:

A
  • anatomical (vascular and lymphatic drainage patterns)

- local conditions at secondary site

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59
Q

tumors of the G-I tract and pancreas favorably spread to _____

A

the liver

- poor prognosis if seen

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60
Q

tumor cells (especially sarcomas) that invade systemic veins are carried directly into ____.

A

the lungs

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61
Q

Paravertebral venous plexuses favor ______ metastasis

A

vertebral

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62
Q

Common locations for metastasis:

A
  • lymph nodes
  • liver
  • Lung
  • bone
  • CNS
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63
Q

Breast cancer commonly spreads to the ____ nodes.

A

axillary

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64
Q

The ____ and ____ are uncommon sites for metastasis.

A

spleen and striated muscle

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65
Q

General features of skeletal metastasis

A
  • Cancer cells are carried by circulation to the marrow sinusoids where they undergo invasion
  • invading tumor cells destroy and replace bone
  • Are likely to form multiple lesions- this contrasts with primary cancers which are typically “unifocal”.
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66
Q

What is osteolytic metastasis?

A

radiolucent bone defect that is the most common bone metastasis of organ cancers in which the bone proliferates adjacent to sites of lytic metastases due to activation of osteoclasts

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67
Q

What is osteoblastic metastases?

A

less common, radio dense (sclerotic) bone defect seen in skeletal metastases of prostate cancer and breast cancer where osteoblasts are activated to form bone deposits at site of metastases

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68
Q

What are clinical features of bone metastases?

A
  • pain
  • pathological fractures
  • signs of hypercalcemia
  • nerve compression syndromes due to skeletal deformities
69
Q

What is a radiation test that is done to establish the extent and location of metastasis to bone and soft tissue by picking up area of increased metabolism?

A

bone scan

MRI is preferred method

70
Q

What is the favorable soil hypothesis?

A

local conditions at a secondary site must be favorable in order for metastasis to be successful.
favorable conditions include: adequate blood supply, tissue compatibility factors

71
Q

the skeleton is affected in what percentage of late stage breast and prostate cancers?

A

70%

72
Q

what percentage of bone metastasis is osteolytic?

A

70%

73
Q

What percentage of bone metastasis is osteoblastic?

A

30%

74
Q

Residents of the US have about a one in ____ chance of dying of cancer

A

five (23%)

75
Q

What are the three most common cancers in men?

A
  1. prostate
  2. lung
  3. colon/rectum
76
Q

What is the three most common cancers in women?

A
  1. breast (then lung)
  2. lung
  3. colon/rectum
77
Q

What kind of cancer has the highest mortality rate in men and women?

A

lung

78
Q

environmental factors are implicated in up to _____ % of cancer

A

80-90

79
Q

What are environmental factors that can cause cancer?

A
  • air and water pollution
  • occupational exposure to carcinogen
  • personal habits such as tobacco or alcohol use
  • dietary factors
80
Q

What is the peak age range for cancer

A

55-74

81
Q

What cancers are most commonly seen in children?

A
  • mesenchymal (leukemia and carcoma)
  • CNS
  • embryonic
82
Q

Which gender has overall higher mortality?

A

male, about 10% higher

83
Q

What are some examples of inherited cancer syndromes?

A

familial retinoblastoma and familial colon polyposis

84
Q

Hereditary defects in DNA repair can increase cancer risk. What are some examples?

A
  • Xeroderma pigmentosum with a high incidence of skin cancer
  • familial non-polyposis colon carcinoma syndromes
85
Q

Some hormones act as promotors for tumor cell growth but are not likely to be carcinogenic. Example?

A

estrogen increasing risk of breast and endometrial cancer

86
Q

important contributing factor for several cancers including those of the oral cavity, uterine cervix, respiratory tract and skin.

A

dysplasia (abnormal metaplasia)

87
Q

What is xeroderma pigmentosum?

A

a condition where there is increased sensitivity to UV radiation and defective DNA repair. This will cause premature aging and skin cancer

88
Q

What is familial non-polyposis syndrome

A

Condition in which the patient is lacking “mismatch repair” mechanism which leads to cancer of the proximal colon

89
Q

What is leukoplakia?

A

white plaques that occur in stratified squamous mucosal (non-keratinized) tissues and consist of areas of hyperplasia, keratinization and dysplasia. This condition is associated with increased risk of cancer of the oral mucosa

90
Q

Focal areas of atypical hyperplasia, scaly (rough) and sometimes discolored plaques and underlying dermal changes that are associated with increased risk of cancer?

A

keratosis

91
Q

Mucosal changes including dysplasia, loss of parietal cells, hypochlorhydria and abnormal gastric flora that is associated with increased risk of cancer

A

atrophic gastritis

can be caused by pernicious anemia or chronic H. pylori

92
Q

Long-term chronic _____ contributes to an increased risk for colon cancer. These effects are greatest when large segments of the colon are affected.

A

ulcerative colitis

93
Q

Scarring of the liver that contributes to hepatocarcinoma, particularly when associated with chronic hepatitis.

A

cirrhosis

94
Q

the time required for progression of cells from one mitotic cycle to the next

A

cell cycle time

95
Q

the proportion of mitotically active cells

A

growth fraction (higher percentage in cancer cells)

96
Q

the time required to double the “tumor volume”

A

doubling times

97
Q

Doubling times are affected by:

A
  • tumor cell type
  • growth fraction
  • blood supply
  • cell survival
98
Q

What are some common chemical carcinogens?

A
  • polycyclic (aromatic) hydrocarbons
  • azo dyes and aromatic amines
  • aflatoxin
  • nitrosamines
  • “alkylating agents”
  • asbestos
  • vinyl chloride
  • heavy metals
  • insecticides
99
Q

Chemicals chiefly encountered in industry but also found in food that will undergo conversion to active carcinogen in the liver, be excreted in the urine and contribute to bladder cancer

A

azo dyes and aromatic amines

100
Q

Chemical derived from Aspergillus flavus which appears in damp stored grain and some root crops and is a potent hepatocarcinogen

A

aflatoxin

101
Q

Dietary nitrates and nitrites react with other dietary components to form ______ which may cause GI cancers

A

nitrosamines

102
Q

What chemicals are directly mutagenic and can destroy cancel cells by damaging DNA but have the potential for increasing risk of cancer development in normal cells?

A

alkylating agents

103
Q

What two viruses account for about 80% of virus related cancer in the human?

A

HPV and Hep B

Epstein Bar virus is a close third and contributes to Burkitt’s lymphoma

104
Q

What is schistosoma hematobium?

A

A parasite carried by snails in Africa and the Middle East that causes inflammation of the urinary blade that can cause cancer

105
Q

A tumor can potentially have the following effects on a host:

A

CAUTION

  • C hange in bowel/bladder
  • A sore throat
  • U nusual bleeding or discharge
  • T ickening or lump in tissue
  • I ndigestion of difficulty swallowing
  • O bvious change in wart or mole
  • N agging cough or hoarseness
106
Q

What are some local effects of a tumor?

A
  • destroy vital structures
  • obstruct or perforate hollow organs
  • create ulcers and necrosis
  • cause hemorrhage
  • invade or compress adjacent structures
107
Q

What are some systemic effects of a tumor?

A
  • fever
  • anemia
  • sudden weight loss
  • decreased resistance to infection
  • ectopic or inappropriate production of hormones
108
Q

Malabsorption and chronic infection in advanced stages of cancer can lead to extreme wasting and weakness known as _____.

A

Cachexia

109
Q

What is the purpose of grading and staging of cancer?

A

to determine prognosis and aid in the selection of treatment options

110
Q

correlates the degree of malignancy with the histologic appearance of tumor cells and the numbers of mitoses seen

A

grading of cancer

more useful for superficial tumors

111
Q

According to Broder’s classification of cancer, Grade I would indicate less than ____% undifferentiated

A

24

112
Q

According to Broder’s classification of cancer, Grade II would indicate ____% undifferentiated

A

25-49

113
Q

According to Broder’s classification of cancer, Grade III would indicate ____% undifferentiated

A

50-74

114
Q

According to Broder’s classification of cancer, Grade IV would indicate greater than ____% undifferentiated

A

75

115
Q

What evaluates tumors according to size, the extent of spread and metastases.

A

staging

more clinically useful

116
Q

What does TMN stand for?

A

T - tumor size, spread, etc.
M - metastasis
N - nodes involved

This is the method used to evaluate cancer for staging

117
Q

What are the basic factors that affect tumor prognosis?

A
  • clinical stage
  • type of tumor
  • duration
  • location and relationship to critical structures
  • age of patient
  • sensitivity of tumor to treatment
118
Q

What are the there modes of therapy for cancer?

A
  • surgery
  • radiation
  • chemotherapy
119
Q

How does radiation affect a tumor

A
  • directly damages dividing cells (tumor, hair, skin, etc( by formation of reactive free-radicals
  • affecting endothelium of blood vessels supplying tumor, thus disrupting blood flow.
120
Q

neoplasms of the extraskeletal non-epithelial

tissues of body excluding the meninges and the lymphoreticular system

A

Mesenchymal tumors

AKA soft tissue tumors

121
Q

benign tumor of fibrous connective tissue

A

Fibroma

122
Q

Non-neoplastic reactions to trauma and idiopathic factors that results in a mass with histological features of a sarcoma

A

Reactive proliferations (pseudosarcomatous proliferations)

123
Q

Examples of Reactive proliferations (pseudosarcomatous proliferations)

A
  • nodular fasciitis

- myositis ossificans

124
Q

solitary, rapidly growing and sometimes painful masses; trauma preceding in 10-15%

A

Nodular fasciitis

125
Q

metaplastic bone that arises in musculature and subcutaneous tissue of proximal extremities; most commonly
associated with athletic injury

A

Myositis ossificans

126
Q

Rounded, lobulated masses (firmness dependent upon amount of collagenous fibers present) found at connective tissue site, most common in extremities and retroperitoneal areas

A

Fibrosarcoma

127
Q

Large fibrosarcomas may exhibit ____ action

A

paraendocrine (produce insulin-like agents, etc.)

128
Q

nodules or bundles of
mature-appearing fibroblasts surrounded by dense collagen deposits that stabilize and do not progress, some resolve spontaneously but surgery may be required in advanced progressive forms

A

Superficial Fibromatoses

129
Q

Examples of superficial fibromatosis

A
  • Dupuytren’s contracture (palmar fibromatosis)
  • plantar fasciitis

*adhesions to surrounding strucutures and flexion contractures may appear in both

130
Q

Deep or aggressive fibromatosis is also called:

A

Desmoid tumor

131
Q

Most common soft tissue tumor of adults

A

Lipoma

132
Q

benign circumscribed masses of adipose tissue

that are usually lobular in nature

A

Lipoma

133
Q

uncommon mesenchymal tumor that

gives rise to a mucoid intercellular substance, when seen is the most common primary tumor of the heart

A

Myxoma (fibromyxoma)

134
Q

rare benign tumor of striated muscle

A

Rhabdomyoma

135
Q

malignancy of striated muscle

A

Rhabdomyosarcoma

  • Prognosis is variable, those that present in adults are often
    difficult to treat and exhibit poor prognoses
136
Q

benign tumor of smooth muscle

A

Leiomyoma

137
Q

Degenerative changes associated with leiomyoma of the uterus

A

Fibroids

138
Q

Malignancy of tumor of smooth muscle, most common in uterus

A

Leiomyosarcoma

139
Q

notochordal remnants that give rise to lobular

masses of gelatinous tissues

A

Chordoma

140
Q

Primary tumors of the skeleton are derived from osteoblasts, chondroblasts, fibroblasts, etc. What are some examples of benign tumors of bone and cartilage?

A
  • Osteoma
  • osteoid osteoma
  • osteochondroma
  • endochondroma
141
Q

Rare, benign bone tumor that is non invasive but can cause deformity and is commonly seen in the skull as a reactive response to trauma

A

Osteoma

142
Q

Small, benign bone tumor of unknown origin that is often painful (relieved by NSAIDs), contains central nidus and affects adolescents

A

Osteoid osteoma

143
Q

Uncommon benign tumors of the bone/cartilage that is characterized by a bony protuberance capped with cartilage

A

Osteochondroma

144
Q

Type of benign cartilaginous tumor where the mass is embedded within bone causing deformity, pain and fracturing

A

Endochondroma

145
Q

Most common primary malignancy of bone

(osseous) tissue

A

Osteogenic sarcoma (osteosarcoma)

146
Q

Osteogenic sarcomas usually arise in what region of the bone

A

Medullary region and then spread and extend through the cortex. This is when clinical signs of pain, swelling and redness first appear

147
Q

Large, bulky, malignant tumors of the cartilage that have a slow growth pattern

A

Chondrosarcoma

148
Q

Uncommon skeletal tumor where Lytic lesions resembling soap bubbles
appear in epiphyseal regions. Most are benign but may become locally
aggressive

A

Giant cell tumor

149
Q

Aggressive small cell tumors of marrow origin that are most common in long bones

A

Ewing’s sarcoma

150
Q

Types of vascular tumors

A

Hemangioma

Lymphangioma

151
Q

Clusters of well differentiated, thin wall capillary-like vessels

A

Capillary hemangioma

152
Q

Type of vascular tumor common at birth, that growth rapidly for 1-3 years and then regress

A

Strawberry hemangioma

153
Q

masses of large dilated sinusoid-like blood vessels

A

Cavernous hemangioma

154
Q

painfully sensitive benign masses derived from glomus bodies (specialized thermoregulatory arteriovenous anastomoses, these structures consist of well-innervated modified smooth muscle cells that surround blood vessels.)

A

Glomus body tumors (glomangioma)

155
Q

Benign neoplasm of fibrous connective tissues of nerve sheath

A

Neurofibroma

If malignant - neurofibrosarcoma

156
Q

Neoplasm of neurilemmal cells

A

Neurilemmoma (Schwannoma)

Usually benign, malignancy is rare

157
Q

What is type 1 Multiple neurofibromatosis (MNF)?

A

autosomal dominant genetic defect causing multiple neural tumors anywhere in the body

158
Q

Signs of type 1 MNF?

A
  • Numerous pigmented skin lesions (cafe’ au lait spots)
  • Pigmented iris hematomas (Lisch nodules)
  • skeletal lesions (Scoliosis, Erosive defects, Cystic bone defects)
  • risk of meningeal tumors
  • Internal tumor masses, etc.
159
Q

Signs of type 2 MNF (acoustic neurofibromatosis)

A
  • Bilateral acoustic nerve tumors
  • Cafe’ au lait spots present
  • NO Lisch nodules
160
Q

Type of epithelial tumor that arises in ducts and acini glands?

A

Adenoma

161
Q

Types of papillary tumors (AKA polyp, papilloma)

A
  • pedunculated

- sessile

162
Q

The preinvasive stage of an intra- epithelial cancer.

A

Carcinoma in situ (CIS)

163
Q

Non melanoma types of skin cancer that are common and have a good prognosis

A
  • basal cell carcinoma

- squamous cell carcinoma

164
Q

What type of malignant epithelial tumor usually arises in moles

A

Malignant melanoma

165
Q

variable quantities of fibrous stroma

appears within this type of tumor

A

Adenocarcinoma

166
Q

Type of adenocarcinoma in which stroma and parenchymal elements are present in roughly equal quantities

A

Carcinoma simplex

167
Q

Type of adenocarcinoma carcinoma in which soft, brain-like tumor masses
consisting predominantly of parenchymal tumor tissue with small amounts of stroma

A

Medullary carcinoma

168
Q

Type of adenocarcinoma in which dense, hard tumor masses containing
extensive deposits of fibrous stroma (in this instance, the tumor stimulates proliferation of collagenous tissues)

A

Scirrhous

169
Q

most commonly mucus cell tumors of

the g-i tract

A

Mucinous (colloid) carcinoma

Pathology I (10 decks)

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