Neoplastic Growth Flashcards by alix pruzansky

How do we assess monoclonality in tumors?

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

Fibroadenoma

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

Infiltrating Ductal Carcinoma

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What kind of tumor will show atypical mitotic figures?

Malignant tumor

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

Cellular Atypia

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

WELL-DIFFERENTIATED squamous cell carcinoma

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What type of malignant tumor shows intracellular keratin only?

Moderately-differentiated squamous cell carcinoma

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

Poorly-differentiated squamous cell carcinoma

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IHC stains ordered for a Carcinoma?

Keratin, cytokeratin

Epithelial Membrane Antigen (EMA)

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IHC stain ordered for a Sarcoma?

Vimentin

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IHC stains ordered for a Rhabdomyoma, Rhabdomyosarcoma?

Desmin

Muscle-specific Actin

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IHC stain ordered for Leukemia, Lymphoma?

Leukocyte Common Antigen (LCA)

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

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

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IHC stains ordered for Melanoma?

S-100
Melanin
HMB-45

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IHC stain ordered for a Glioma?

Glial Fibrillary Acidic protein (GFAP)

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IHC stain ordered for suspected Thyroid cancer?

Thyroglobulin

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IHC stain ordered for suspected Acute Lymphoblastic Leukemia

B-cell-CD10 (CALLA)

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IHC stains ordered for suspected Seminoma?

Placental Alkaline Phosphatase (PLAP)

beta-HCG

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IHC stain ordered for suspected Yolk Sac tumor?

Alpha-fetoprotein (AFP)

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IHC stains ordered for suspected Vascular neoplasms?

vWF

CD31

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EM studies of Squamous cell carcinomas will show what?

Tonofilaments

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

Weibel Palade bodies

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EM studies of a Small cell carcinoma will show what?

Neuro-secretory granules

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EM studies of a Malignant melanoma will show what?

Melanosomes

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EM studies of a Histiocytosis X tumor will show what?

Birbeck granules

Which factors/proteins induce angiogenesis in tumors?

VEGF, bFGF | Hypoxia inducible factor (HIF)- stimulates VEGF production

Name the two malignant tumors that DO NOT metastasize

Basal cell carcinoma (local invasion | Glioma (invasion and seeding)

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

E-cadherin

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

MMPs Cathepsin D Collagenase

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

Laminin Fibronectin Integrins

Which route of metastasis is more common in carcinomas? | Name the 3 exceptions

Lymphatic spread Follicular carcinoma Renal cell carcinoma Hepato-cellular carcinoma

Which route of metastasis is more common in sarcomas?

Hematogenous spread

What is a common metastatic site for Stomach adenocarcinoma?

Virchow's left supraclavicular node

What is a common metastatic site in breast cancer?

Lung | Bone

Common metastatic site in prostate cancer?

Bone

Common metastatic site in testicular tumor?

Para-aortic nodes

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

OSTEOBLASTIC metastases (appear as radio-dense loci) serum alkaline phosphatase indicates reactive bone formation

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

OSTEOLYTIC metastases (appear as radio-lucent loci) PGE2 and IL1 produced by tumor

What cytokine is responsible for the effects of Cancer Cachexia?

TNF-alpha

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

Eaton-Lambert syndrome (dermatomyositis)

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

SIADH

What is the underlying cancer and mechanism of Cushing syndrome?

Small cell carcinoma OF LUNG | ACTH

What is the underlying cancer and mechanism of SIADH?

Small cell carcinoma OF LUNG | ADH

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

Small cell carcinoma OF LUNG | Immunological/autoimmune

What is the underlying cancer and mechanism of Hypercalcemia?

Squamous cell carcinoma of lung MOA: PTH-related protein (PTHRP)

What is the underlying cancer and mechanism of Polycythemia?

Renal cell carcinoma | Erythropoietin

What is the underlying mechanism of Carcinoid syndrome?

Serotonin

What is the underlying cancer of Acanthosis nigricans?

Visceral malignancy, Gastric carcinoma

What is the underlying cancer of Hypertrophic osteoarthropathy?

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

What is the underlying cancer of Trousseau phenomenon?

Pancreatic carcinoma (tumor products activate clotting)

What is the underlying cancer and mechanism of Hypocalcemia?

Medullary carcinoma of thyroid | Calcitonin

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

Grade 1 tumor (well differentiated)

For adenocarcinoma, "poorly formed glands" and "occasional glands" indicate what?

Grade 3 tumor (poorly differentiated)

For adenocarcinoma, "bizarre multinucleate giant cells" indicate what?

Grade 4 tumor (anaplastic/undifferentiated)

For squamous cell carcinoma, "keratin pearls" indicates what?

Grade 1 tumor (well differentiated)

For squamous cell carcinoma, "poorly formed squamous cells" indicates what?

Grade 3 tumor (poorly differentiated)

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

Grade 4 tumor (anaplastic/undifferentiated)

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

Stage 0

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?

Stage I

If cancer shows distant metastasis, what stage is it?

Stage IV

What tumor marker will be present in prostate cancer?

Prostate-specific antigen (PSA)

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

beta-hCG

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

Carcino-embryonic antigen (CEA)

What tumor marker will be present in Ovarian carcinoma?

Cancer antigen-125 (CA-125)

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

alpha-fetoprotein (AFP)

what are the two malignant tumors that do not metastasize?

1) Basal Cell Carcinoma | 2) Glioma

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

Neuron specific enolase (NSE) neuro-endocrine

what tumor marker is present for medullary carcinoma of thyroid?

calcitonin

what tumor marker is present for colon or pancreatic cancer?

cancer antigen 19-9 (CA 19-9)

what tumor marker is present for breast carcinoma?

cancer antigen 15-3 (CA 15-3)

where does colorectal cancer metastasize to?

liver

where does melanoma commonly metastasize to?

liver, lung

where does renal adenocarcinoma metastasize to?

lung

where does lung cancer metastasize to?

adrenal, liver

what is a lab test marker for hepatocellular carcinoma?

alpha-fetoprotein DON'T YOU FORGET THIS!

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

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

most common site of bone metastasis?

1) vertebral column | 2) proximal femur