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Neoplastic Growth Flashcards

1
Q

How do we assess monoclonality in tumors?

A

G6PD iso-enzyme studies

HUMARA- human androgen receptor gene

Ig Light Chain studies- only kappa or only lambda= monoclonal

T-cell Receptor Gene analysis

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2
Q

What type of breast tumor is slow growing, freely mobile/not attached to skin or chest wall, firm mass, well-circumscribed, with fibrous capsule

A

Fibroadenoma

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3
Q

What type of breast tumor is rapid growing, poorly circumscribed with infiltrating margins, fixed to underlying tissues causing dimpling

A

Infiltrating Ductal Carcinoma

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4
Q

What kind of tumor will show atypical mitotic figures?

A

Malignant tumor

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5
Q 
The following features are characteristic of \_\_\_\_?
Pleomorphism
Hyperchromasia
Increased N/C ratio
Irregular nuclear membrane
Tumor giant cells
A

Cellular Atypia

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6
Q

What type of malignant tumor shows intracellular and extracellular KERATIN PEARLS?

A

WELL-DIFFERENTIATED squamous cell carcinoma

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7
Q

What type of malignant tumor shows intracellular keratin only?

A

Moderately-differentiated squamous cell carcinoma

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8
Q

What type of malignant tumor shows numerous mitoses but no keratin?

A

Poorly-differentiated squamous cell carcinoma

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9
Q

IHC stains ordered for a Carcinoma?

A

Keratin, cytokeratin

Epithelial Membrane Antigen (EMA)

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10
Q

IHC stain ordered for a Sarcoma?

A

Vimentin

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11
Q

IHC stains ordered for a Rhabdomyoma, Rhabdomyosarcoma?

A

Desmin

Muscle-specific Actin

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12
Q

IHC stain ordered for Leukemia, Lymphoma?

A

Leukocyte Common Antigen (LCA)

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13
Q

IHC stains ordered for Neuroblastoma, Carcinoid tumor, Small cell carcinoma?

A 
Neuron-specific Enolase (NSE)
Chromogranin
Bombesin
Synaptophysin
S-100
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14
Q

IHC stains ordered for Melanoma?

A

S-100
Melanin
HMB-45

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15
Q

IHC stain ordered for a Glioma?

A

Glial Fibrillary Acidic protein (GFAP)

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16
Q

IHC stain ordered for suspected Thyroid cancer?

A

Thyroglobulin

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17
Q

IHC stain ordered for suspected Acute Lymphoblastic Leukemia

A

B-cell-CD10 (CALLA)

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18
Q

IHC stains ordered for suspected Seminoma?

A

Placental Alkaline Phosphatase (PLAP)

beta-HCG

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19
Q

IHC stain ordered for suspected Yolk Sac tumor?

A

Alpha-fetoprotein (AFP)

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20
Q

IHC stains ordered for suspected Vascular neoplasms?

A

vWF

CD31

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21
Q

EM studies of Squamous cell carcinomas will show what?

A

Tonofilaments

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22
Q

EM studies of an Angiosarcoma will show what type of structures?

A

Weibel Palade bodies

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23
Q

EM studies of a Small cell carcinoma will show what?

A

Neuro-secretory granules

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24
Q

EM studies of a Malignant melanoma will show what?

A

Melanosomes

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25
Q

EM studies of a Histiocytosis X tumor will show what?

A

Birbeck granules

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26
Q

Which factors/proteins induce angiogenesis in tumors?

A

VEGF, bFGF

Hypoxia inducible factor (HIF)- stimulates VEGF production

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27
Q

Name the two malignant tumors that DO NOT metastasize

A

Basal cell carcinoma (local invasion

Glioma (invasion and seeding)

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28
Q

During ECM invasion, loss of which molecule is required for detachment of tumor cells?

A

E-cadherin

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29
Q

During ECM invasion, which enzymes are released to degrade the basement membrane and connective tissue?

A

MMPs
Cathepsin D
Collagenase

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30
Q

During ECM invasion, increase of which proteins allow for attachment of tumor cells to the ECM?

A

Laminin
Fibronectin
Integrins

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31
Q

Which route of metastasis is more common in carcinomas?

Name the 3 exceptions

A

Lymphatic spread

Follicular carcinoma
Renal cell carcinoma
Hepato-cellular carcinoma

32
Q

Which route of metastasis is more common in sarcomas?

A

Hematogenous spread

33
Q

What is a common metastatic site for Stomach adenocarcinoma?

A

Virchow’s left supraclavicular node

34
Q

What is a common metastatic site in breast cancer?

35
Q

Common metastatic site in prostate cancer?

36
Q

Common metastatic site in testicular tumor?

A

Para-aortic nodes

37
Q

What will an X-ray likely show in a patient with PROSTATE CANCER?

A

OSTEOBLASTIC metastases (appear as radio-dense loci)

serum alkaline phosphatase indicates reactive bone formation

38
Q

What will an X-ray likely show in a patient with BREAST CANCER?

A

OSTEOLYTIC metastases (appear as radio-lucent loci)

PGE2 and IL1 produced by tumor

39
Q

What cytokine is responsible for the effects of Cancer Cachexia?

40
Q

Autoimmune response at neuromuscular junction resulting in muscle weakness and periorbital heliotrope rash?

A

Eaton-Lambert syndrome (dermatomyositis)

41
Q

Hyponatremia, cerebral edema, and neuro dysfunction are characteristic of what paraneoplastic syndrome?

42
Q

What is the underlying cancer and mechanism of Cushing syndrome?

A

Small cell carcinoma OF LUNG

ACTH

43
Q

What is the underlying cancer and mechanism of SIADH?

A

Small cell carcinoma OF LUNG

ADH

44
Q

What is the underlying cancer and mechanism of Eaton-Lambert syndrome?

A

Small cell carcinoma OF LUNG

Immunological/autoimmune

45
Q

What is the underlying cancer and mechanism of Hypercalcemia?

A

Squamous cell carcinoma of lung

MOA:
PTH-related protein (PTHRP)

46
Q

What is the underlying cancer and mechanism of Polycythemia?

A

Renal cell carcinoma

Erythropoietin

47
Q

What is the underlying mechanism of Carcinoid syndrome?

48
Q

What is the underlying cancer of Acanthosis nigricans?

A

Visceral malignancy, Gastric carcinoma

49
Q

What is the underlying cancer of Hypertrophic osteoarthropathy?

A

Bronchogenic carcinoma. (associated with clubbing of distal phalanx)!

50
Q

What is the underlying cancer of Trousseau phenomenon?

A

Pancreatic carcinoma (tumor products activate clotting)

51
Q

What is the underlying cancer and mechanism of Hypocalcemia?

A

Medullary carcinoma of thyroid

Calcitonin

52
Q

For adenocarcinoma, “well formed glands” and “mucin production” indicate what?

A

Grade 1 tumor (well differentiated)

53
Q

For adenocarcinoma, “poorly formed glands” and “occasional glands” indicate what?

A

Grade 3 tumor (poorly differentiated)

54
Q

For adenocarcinoma, “bizarre multinucleate giant cells” indicate what?

A

Grade 4 tumor (anaplastic/undifferentiated)

55
Q

For squamous cell carcinoma, “keratin pearls” indicates what?

A

Grade 1 tumor (well differentiated)

56
Q

For squamous cell carcinoma, “poorly formed squamous cells” indicates what?

A

Grade 3 tumor (poorly differentiated)

57
Q

For squamous cell carcinoma, “bizarre multinucleate giant cells” indicates what?

A

Grade 4 tumor (anaplastic/undifferentiated)

58
Q

If cancer is still near the place it started and has not invaded nearby tissues, what stage is it?

59
Q

If cancer has not spread either to LNs or other parts of the body but has grown deeply into nearby tissues, what stage is it?

60
Q

If cancer shows distant metastasis, what stage is it?

61
Q

What tumor marker will be present in prostate cancer?

A

Prostate-specific antigen (PSA)

62
Q

What tumor marker will be present in Trophoblastic tumors such as Hydatidiform moles?

63
Q

What tumor marker will be present in carcinoma of the colon, pancreas, stomach, or breast?

A

Carcino-embryonic antigen (CEA)

64
Q

What tumor marker will be present in Ovarian carcinoma?

A

Cancer antigen-125 (CA-125)

65
Q

What tumor marker will be present in Hepatocellular carcinoma and Germ cell tumor of testes or ovary?

A

alpha-fetoprotein (AFP)

66
Q

what are the two malignant tumors that do not metastasize?

A

1) Basal Cell Carcinoma

2) Glioma

67
Q

what tumor marker is present for small cell carcinoma? and what is the cell of origin?

A

Neuron specific enolase (NSE)

neuro-endocrine

68
Q

what tumor marker is present for medullary carcinoma of thyroid?

A

calcitonin

69
Q

what tumor marker is present for colon or pancreatic cancer?

A

cancer antigen 19-9 (CA 19-9)

70
Q

what tumor marker is present for breast carcinoma?

A

cancer antigen 15-3 (CA 15-3)

71
Q

where does colorectal cancer metastasize to?

72
Q

where does melanoma commonly metastasize to?

A

liver, lung

73
Q

where does renal adenocarcinoma metastasize to?

74
Q

where does lung cancer metastasize to?

A

adrenal, liver

75
Q

what is a lab test marker for hepatocellular carcinoma?

A

alpha-fetoprotein

DON’T YOU FORGET THIS!

76
Q

what are 3 examples of cancers that spread via “seeding” of body cavity

A

1) peritoneum (tumors of ovary)
2) pleural cavity (primary lung tumor)
3) sub-arachnoid (glioma)

77
Q

most common site of bone metastasis?

A

1) vertebral column

2) proximal femur

Mini II (17 decks)

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