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onco-intro-neoplasia Flashcards

0
Q

Is neoplasm monoclonal in origin?

A

Yes, it arises from a single progeny tumor cell

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1
Q

Abnormal mass of tissues, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change

A

Neoplasm

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2
Q

Neoplasm are heritable (genetic) changes that allow excessive and unregulated proliferation that is independent of…

A

Independent of physiologic growth-regulatory stimuli

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3
Q

A characteristic of neoplastic cells which said to be transformed because they continue to replicate, apparently oblivious to the regulatory influences that control normal cell growth.

A

Cellular autonomy

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4
Q

T/F: some neoplasms require endocrine support, and such dependencies sometimes can be exploited to the disadvantage of the neoplasm

A

True

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5
Q

Types of neoplasm are based on…

A

Neoplasm’s potential clinical behaviour

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6
Q

T/F: benign tumors are sometimes responsible for serious disease.

A

True

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7
Q

T/F: benign tumors can not produce more than one localized lumps

A

False. It can produce more than one localized lump

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8
Q

Malignant tumors are collectively known as

A

Cancers

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9
Q

T/F: all cancers pursue to deadly course

A

False. Not all cancers are deadly, some are less aggressive and are treated successfully, but the designation MALIGNANT constitutes a RED FLAG.

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10
Q

Basic components of tumor

A

Parenchyma and stroma

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11
Q

Component of tumor that is made up of transformed or neoplastic cells

A

Parenchyma

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12
Q

Component of tumor that largely determines its biologic behaviour

A

Parenchyma

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13
Q

Component of tumor from which derives its name

A

Parenchyma

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14
Q

T/F: parenchymal cells in a neoplasm, whether benign or malignant, are different from each other.

A

False, they resembles each other, as though all had been derived from a single progenitor.

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15
Q

Component of tumor that is supporting, host-derived, non neoplastic.

A

Stroma

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16
Q

Component of tumor that is made up of connective tissue, blood vessels, and host-derived inflammatory cells.

A

Stroma

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17
Q

Component of tumor that Determines its growth and evolution.

A

Stroma

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18
Q

Benign epithelial neoplasm producing gland patterns. Or neoplasms derived from glands but not necessarily produce gland patterns

A

Adenoma

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19
Q

Benign epithelial neoplasms, growing on any surface, that produce microscopic finger like fronds

A

Papilloma

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20
Q

Malignant neoplasm arising in mesenchymal tissue or its derivatives.

A

Sarcoma

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21
Q

Malignant neoplasm of epithelial cell origin

A

Carcinoma

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22
Q

Malignant neoplasm of epithelial cell origin that grow in a glandular pattern

A

Adenocarcinoma

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23
Q

Malignant neoplasm that produces squamous cells.

A

Squamous cell carcinoma

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24
Q

Tumors that are characterized by divergent differentiation

A

Mixed tumor

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25
Q

Preferred designation of mixed tumors

A

Pleomorphic adenoma

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26
Q

Mixed tumor with obvious epithelial components dispersed throughout a fibromyxoidstroma, sometimes harboring islands of glands, cartilage or bone.

A

Pleomorphic adenoma - mixed tumor of salivary gland

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27
Q

Mixed tumor which is benign and contains mixture of proliferated Ductal elements(adenoma) embedded in a loose fibrous tissue

A

Fibroadenoma of female breast

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28
Q

Tumor that contain recognizable mature or immature cells or tissues representative of more than one germ cell layer and sometimes all three.

A

Teratoma

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29
Q

Teratoma originates from what kind of stem cells

A

Totipotential stem cells (that normally presented in the ovary and testis and abnormally present in sequestered midline embryonic rests

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30
Q

Tumor that has the capacity to differentiate into any of the cell types found in the adult body

A

Teratoma

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31
Q

Tumor that may give rise to neoplasms that mimic, in a helter-skelter fashion, bits of bone, epithelium, muscle, fat, nerve and other tissue

A

Teratoma

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32
Q

Malformation that presents as a mass of disorganized tissue indigenous to the particular site

A

Hamartoma

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33
Q

Heterotopic rest of cells

A

Choristoma

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34
Q

Choristoma may be replete or filled with..

A

Islets of langerhans and endocrine glands

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35
Q

Benign tumor of fibrous tissue

A

Fibroma

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36
Q

Malignant tumor of fibrous tissue

A

Fibrosarcoma

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37
Q

Benign tumor of fat cells

A

Lipoma

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38
Q

Malignant tumor of fat cells

A

Liposarcoma

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39
Q

Benign tumor of cartilage

A

Chondroma

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40
Q

Malignant tumor of cartilage

A

Chondrosarcoma

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41
Q

Benign tumor of bone

A

OSTEOMA

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42
Q

Malignant tumor of bone

A

Osteogenic sarcoma

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43
Q

Benign tumor of blood vessels

A

Hemangioma

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44
Q

Malignant tumor of blood vessels

A

Angiosarcoma

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45
Q

Benign tumor of lymph vessels

A

Lymphangioma

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46
Q

Malignant tumor of lymph vessels

A

Lymphangiosarcoma

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47
Q

Benign tumor of synovium

A

None

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48
Q

Malignant tumor of synovium

A

Synovial sarcoma

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49
Q

Benign tumor of mesothelium

A

None

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50
Q

Malignant tumor of mesothelium

A

Mesothelioma

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51
Q

Benign tumor of Brain coverings

A

Meningioma

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52
Q

Malignant tumor of Brain coverings

A

Invasive meningioma

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53
Q

Benign tumor of hematopoietic cells

A

None

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54
Q

Malignant tumor of hematopoietic cells

A

Leukemia

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55
Q

Benign tumor of lymphoid tissue

A

None

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56
Q

Malignant tumor of lymphoid tissue

A

Lymphoma

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57
Q

Benign tumor of smooth muscles

A

Leiomyoma

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58
Q

Malignant tumor of smooth muscle

A

Leiomyosarcoma

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59
Q

Benign tumor of striated muscle

A

Rhabdomyoma

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60
Q

Malignant tumor of striated muscle

A

Rhabdomyosarcoma

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61
Q

Benign tumor of stratified squamous

A

Squamous cell papilloma

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62
Q

Malignant tumor of stratified squamous

A

Squamous cell / epidermoid carcinoma

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63
Q

Benign tumor of basal cells of skin or adnexa

A

None

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64
Q

Malignant tumor of basal cells of skin or adnexa

A

Basal cell carcinoma

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65
Q

Malignant counterpart of adenoma

A

Adenocarcinoma

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66
Q

Malignant counterpart of papilloma

A

Papillary carcinoma

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67
Q

Malignant counterpart of cystadenoma

A

Cystadenocarcinoma

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68
Q

Benign tumor of respiratory passage

A

Bronchial adenoma

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69
Q

Malignant tumor of respiratory passage

A

Bronchogenic carcinoma

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70
Q

Benign tumor of renal epithelium

A

Renal tubular adenoma

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71
Q

Malignant tumor of renal epithelium

A

Renal cell carcinoma

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72
Q

Benign tumor of liver cells

A

Liver cell adenoma

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73
Q

Malignant tumor of liver cells

A

Hepatocellular carcinoma

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74
Q

Benign tumor of urinary tract epithelium

A

Transitional cell / urothelial papilloma

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75
Q

Malignant tumor of urinary tract epithelium

A

Transitional cell / urothelial carcinoma

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76
Q

Benign tumor of placental epithelium

A

Hydatidiform mole

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77
Q

Malignant tumor of placental epithelium

A

Choriocarcinoma

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78
Q

Benign tumor of testicular epithelium (germ cells)

A

None

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79
Q

Malignant tumor of testicular epithelium (germ cells)

A

Seminoma

Embryonal carcinoma

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80
Q

Benign tumor of melanocytes

A

NEVUS

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81
Q

Malignant tumors of melanocytes

A

Malignant melanoma

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82
Q

More than one neoplastic cell type: Mixed tumors, usually derived from one germ layer
Benign tumor of salivary gland

A

Pleomorphic adenoma

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83
Q

More than one neoplastic cell type: Mixed tumors, usually derived from one germ layer
Malignant tumor of salivary gland

A

Malignant mixed tumor of SG origin

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84
Q

More than one neoplastic cell type: Mixed tumors, usually derived from one germ layer
Benign tumor of renal anlage

A

None

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85
Q

More than one neoplastic cell type: Mixed tumors, usually derived from one germ layer
Malignant tumor of renal anlage

A

Wilms tumor

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86
Q

More than one neoplastic cell type: Teratogenous-derived from more than one germ layer
Benign tumor of totipotential cells in gonads/ embryonic rests

A

Mature teratoma, dermoid cyst

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87
Q

More than one neoplastic cell type: Teratogenous-derived from more than one germ layer
Malignant tumor of totipotential cells in gonads/ embryonic rests

A

Immature teratoma, teratocarcinoma

88
Q

Four fundamental features of benign and malignant tumors

A
  1. Differentiation and anaplasia
  2. Rate of growth
  3. Local invasion
  4. Metastasis
89
Q

Which component of tumor is referred in differentiation and anaplasia?

A

Parenchymal cells (which constitutes the transformed elements of neoplasm)

90
Q

It refers to the extent to which cells resemble their normal forebears morphologic ally and functionally.

A

Differentiation

91
Q

T/F: stroma does not aid in the separation of benign from malignant ones

92
Q

It determines the consistency of a neoplasm

93
Q

Cancers which induce a dense, abundant fibrous stroma (desmoplasia), making them hard

A

Scirrhous tumor

94
Q

T/f: in well diff benign tumors, mitosis are extremely scant in number and are of normal configuratio

95
Q

Benign/malignant tumors are composed of well-diff cells that closely resembles their normal counterparts.

96
Q

Benign/malignant tumors are characterized by a wide range of cell differentiation, form well-diff to completely undiff.

97
Q

The better the differentiation of the cell, the more completely it retains the ____ found in its normal counterparts.

A

Functional capabilities

98
Q

Exception to the the principle of retaining functional capabilities as having better differentiation.

A

Certain lung carcinomas

99
Q

T/f: the more rapidly growing and the more anaplastic tumor, the less likely to have specialized functional activity

100
Q

“To form backward”

101
Q

It impose de differentiation, or loss of structural and functional differentiation of normal cells

102
Q

It is the most extreme disturbance in cell growth encountered in the spectrum of cellular proliferations

103
Q

Hallmark of malignancy

104
Q

Anaplastic cells displays marked…

A

Pleomorphism (variation in size and shape)

105
Q

Marked pleomorphism do anaplasia is characterized by:

A
  1. Nuclei are variable and bizarre in size and shape
  2. Hyperchromatic and large nuclei
  3. 1:1 nuclear-to-cytoplasmic ratio (normal 1:4 / 1:6)
  4. Coarse and clumped chromatin and large nucleoli
  5. Atypical and numerous mitosis
  6. Presence of Tripolar or quadripolar forms of anarchic multiple spindles
  7. Fails to develop recognizable patterns of orientation to one another (lose normal polarity)
106
Q

Describes disorderly but non neoplastic proliferation

107
Q

DYSPLASIA is encountered principally in..

108
Q

It is loss of uniformity of individual cells and in their architectural orientation.

109
Q

Characteristics do dysplastic cells

A
  1. Pleomorphic
  2. Hyperchromatic and large nuclei
  3. Mitotic figures are abundant than usual
  4. Mitosis appear in abnormal locations within the epithelium
  5. Considerable architectural anarchy
110
Q

Refers to marked dysplastic changes involving the ENTIRE thickness of the epithelium

A

Carcinoma-in-situ

111
Q

Pre-invasive stage of cancer

A

Carcinoma-in-situ

112
Q

T/F: dysplasia without qualifications does not indicate cancer

113
Q

T/F: dysplasia do not necessarily progress to cancer

114
Q

T/F: Mild to moderate changes that do not involve entire thickness of epithelium may be reversible, but even with the removal of the putative inciting causes, the epithelium can’t revert to normal.

A

It is TRUE that it is reversible however, with the removal of the inciting cause, it CAN REVERT to NORMAL.

115
Q

Factors affecting the rate of growth of neoplasms

A
  1. Hormones
  2. Blood supply
  3. Location
116
Q

T/F: rate of growth of malignant tumors correlates in general with their level of differentiation.

A

True. Rapidly growing tumors tend to be poorly diff.

117
Q

T/F: most, if not all, cancers take years and sometimes decades to evolve into clinically overt lesions

118
Q

Why is that growing malignant tumor often contain a central ischemic necrosis?

A

Because the blood supply of tumor, which is derived form the host, fails to keep pace with the oxygen needs of the expanding mass of cells.

119
Q

T/F: not all benign tumors are encapsulated

A

True. As leiomyoma of uterus

120
Q

T/F: lack of capsule implies that the tumor is malignant.

A

False. Some benign tumors neither encapsulated nor demarcated, such as benign tumor of dermis.

121
Q

Cancers grow by progressive…

A

Infiltration, invasion, destruction and penetration of the surrounding tissues.

122
Q

Ned to the development of metastasis, what is the most reliable feature that distinguishes malignant from benign?

A

Local invasiveness

123
Q

what is the most reliable feature that distinguishes malignant from benign?

A

Metastasis

124
Q

It connotes the development of secondary implants discontinuous with the primary tumor in remote tissues.

A

Metastasis

125
Q

Not all of the cancer have equivalent ability to metastasize. What are the examples?

A

Basal cell carcinoma of skin - highly invasive in primary site but rarely metastasize;
Osteogenic sarcoma - usually metastasize to lungs at the time of initial discovery

126
Q

In general, the more anaplastic and large the primary neoplasm, the more likely is metastatic spread

A

However some small cancers have been known to metastasize and conversely, some large and ominous-looking lesions may not spread.

127
Q

Malignant neoplasms disseminate by..

A
  1. Spread by seeding
  2. Hematogenous spread
  3. Lymphatic spread
128
Q

Metastasis that occurs when neoplasm invades a natural body cavity.

A

Spread by seeding

129
Q

Sample of cancers that spread by seeding

A

Cancers of ovary

Medulloblastoma or ependymoma (cerebral ventricles, may be carried by CSF to re implant on meningeal surface)

130
Q

Metastatic spread by carcinoma

A

Lymphatic spread

131
Q

Metastatic spread by sarcoma

A

Hematogenous spread

132
Q

The pattern of lymph node involvement depends principally on…

A

On the site of primary neoplasm and natural pathways of lymphatic drainage of the site

133
Q

Lymphatic spread of lung carcinoma

A

Arising form respiratory passages metastasize first to regional bronchial lymph nodes, then tracheobronchial and hilar nodes

134
Q

Lymphatic spread of breast carcinoma

A

Arising in the upper outer quadrant and first spreads to axillary nodes. Median breast lesion may spread through chest wall to the nodes along the internal mammary artery. Thereafter, in both instances, supraclavicular and infraclavicular node may be seeded.

135
Q

First lymph node in a regional lymphatic basin that receives lymph flow from a primary tumor.

A

Sentinel lymph node

136
Q

Sentinel lymph nodes can be delineated by injection of..

A

Blue dyes or radiolabelled tracers

137
Q

T/F: sentinel lymph nodes allow determination of the extent of spread of tumor, and can be used to plan treatment

138
Q

T/F: enlargement of nodes near a primary tumor should arouse strong suspicion of metastatic spread and will always imply cancerous involvement.

A

False. Does not always imply cancerous involvement

139
Q

The necrotic changes in the neoplasm and tumor antigens often evoke reactive changes in the nodes.. Such as

A 
Lymphadenitis (enlargement and hyperplasia of follicles) and
Sinus histiocytosis (proliferation of macrophages in the sub capsular sinuses)
140
Q

Most feared consequence of cancer

A

Hematogenous spread

141
Q

In hematogenous spread, which is less readily penetrated? Arteries or veins?

142
Q

With venous invasion, the blood-borne cells follow the venous flow draining the site of neoplasm, with the tumor cells often stopping in …

A

The first capillary bed they encounter

143
Q

Most frequently involved secondary sites in hematogenous dissemination.

A

Liver and lungs

144
Q

Why is that the liver and lungs are the most frequently involved secondary sites in hematogenous spread?

A

Because all portal area drainage flows to the liver and all caval blood flows to the lungs

145
Q

Cancers arising near the vertebral column often embolize through the …

A

Paravertebral plexus

146
Q

Cancers arising near the vertebral column often embolize thru paravertebral plexus; this pathway is involved in the frequent vertebral metastasis of carcinoma of..

A

Thyroid and prostate

147
Q

Hematogenous spread of renal cell carcinoma

A

Invades the Rena veins to grow to snake like fashion up to IVC, reaching the right side of heart

148
Q

Prostatic carcinoma preferentially spreads to

149
Q

Bronchogenic carcinoma tend to involve

A

Adrenals and brain

150
Q

Neuroblastoma spread to

A

Liver and bones

151
Q

T/F: skeletal muscles are rich in capillaries therefore it is commonly the site if secondary deposits.

152
Q

Benign tumor with hollow spaces inside

A

Cystadenoma

153
Q

Carcinoma/sarcoma: they are fleshy because it has little connective tissue

154
Q

Benign tumors that projects upward forming a lump. It is macroscopically visible projection.

155
Q

Next step after Carcinoma in situ

A

Invasive carcinoma

156
Q

Differentiation: any cell type/only epithelial cells
Dysplasia: only neoplastic/non neoplastic cells

A

Differentiation: only neoplastic cells of any cell type
Dysplasia: only epithelial cells of non neoplastic cells

157
Q

Lymph node that is first to be affected

A

Sentinel lymph node

158
Q

T/F: the entire population of cells within a tumor arises from a single cell that has incurred genetic changes

159
Q

Well diff/ undiff cancers:

Cells evolve from maturation / specialization as they proliferate.

160
Q

Well diff/ undiff cancers:

Cells are derived from proliferation without complete maturation of transformed cell.

161
Q

Cancer stem cell characteristics

A

Self renewing capacity

162
Q

Malignant tumor that do not or rarely metastasize

A

Glioma

Basal cell carcinoma

163
Q

T/f: fast growing tumor have high cell turnover (cell prolif=apoptosis)

164
Q

Fraction of cells that are Actively proliferating

A

Growth fraction

165
Q

Clinically detectable tumor contains ____ cells

A

10 billion cells

166
Q

Cancer occurs mostly at age >55 because of accumulation of somatic mutation and decline of Immune surveillance. It is the main cause of death in women in ages… And in men in ages…

A

Women: 40-79
Men: 60-79

167
Q

RB gene

A

Retinoblastoma

168
Q

p53

A

Li-fraumeni syndrome

169
Q

P16/INK4A

170
Q

APC

A

Familial adenomatous polyposis colon Ca

171
Q

NF1, NF 2

A

Neurofibromatosis

172
Q

BRCA1 and BRCA2

A

Breast, and ovarian Ca

173
Q

MEN1 and RET

A

Multiple endocrine neoplasia 1&2

174
Q

MSH2&6, MLH1

A

Hereditary non polyposis colon Ca

175
Q

PTCH

A

Nevoid BCC syndrome

176
Q

PTEN

A

Cowden syndrome

177
Q

LKB1

A

Peutz-Jegher syndrome

178
Q

VHL

179
Q

WT1

A

Wilms tumor

180
Q

Chronic inflammation of Ca

A
  1. Increases the pool of stem cells that can be subject to the effects of mutagens
  2. Produces cytokines and GF to drive cell survival and proliferation
  3. Promotes genome instability by producing ROS
181
Q

Nomenclature of specific malignant tumors is based in their appearance and presumed cell of origin

A

Precancerous condition is a misnomer. There is no malignant transformation that occurs, most malignant tumors arise de novo.

182
Q

Fundamental principles in molecular basis of Ca

A
  1. Non-lethal genetic damage underlies carcinogenesis
  2. tumor develops as a clonal progeny of a single genetically damaged progenitor cell
  3. 4’classes of normal regulatory genes are targeted by genetic damage
183
Q

4’classes of normal regulatory genes are targeted by genetic damage

A
  1. Growth promoting proto oncogenes
  2. Growth inhibiting tumor suppressor genes
  3. Genes for apoptosis
  4. Gens for DNA repair
184
Q

Essential alteration for malignant transformation

A
  1. Self sufficiency in growth signals
  2. Insensitivity to growth inhibitory signals
  3. Evasion of apoptosis
  4. Limitless replicative potential
  5. Sustained angiogenesis
  6. Ability to invade and metastasize
  7. Ability to escape immune recognition and regulation
185
Q

Cancer is characterized by proliferation in the absence of…

A

Growth promoting signals

186
Q

Oncogenes promotes..

A

Autonomous cell growth

187
Q

DNA repair genes are not directly carcinogenic. Defects can occur in 3 types of DNA repair system:

A
  1. Mismatch repair (eg. Hnccs)
  2. Nucleotide excision repair (xeroderma pigmentosa)
  3. Recombination repair (p53, brca1&2)
188
Q

Cancer cells preferentially utilize glycolysis rather than oxidative phosphorylation. It is to shun important precursor molecule into new lipid and nucleotide synthesis

A

Metabolic alteration - Warburg effect

189
Q

Hypercalcemia

A

SCC
Breast Ca
RCC

190
Q

Cushing’s syndrome

A

SCLC

Pancreatic Ca

191
Q

SIADH

192
Q

Hypoglycemia

A

Ovarian Ca

Fibrosarcoma

193
Q

Carcinoid syndrome

A

HCC
Bronchial adenoma
Pancreatic Ca

194
Q

Polycythemia

A

Gastric Ca
RCC
HCC

195
Q

Myasthenia

A

Bronchogenic Ca

196
Q

Disorder of cns and pns

197
Q

Acanthosis nigricans

A

Gastric Ca
Bronchogenic Ca
Uterine Ca

198
Q

Dermatomyositis

A

Bronchogenic Ca

Breast Ca

199
Q

Osteoarthropathy

A

Bronchogenic Ca

200
Q

Vascular and hematologic

A

Pancreatic Ca

Bronchogenic Ca

201
Q

Grading is based on

A

The degree of differentiation and architectural features and no of mitosis.
Used as parameters of clinical gravity of the disease.

202
Q

Staging is based on…

A

Tumor size, lymph node involvement and extent of spread.

It aids in treatment choice and prognostication

203
Q

Most important method of diagnosis

A

Histologic examination

204
Q

T/F. False negative result is more common in histo.exam.

205
Q

Lab diagnosis which involves monoclonal ab to identify cell products or surface markers

A

Immunohistochemistry

206
Q

Use of immunohistochemistry

A
  1. Categorize undiff tumors
  2. Determine site of origin of metastatic tumors
  3. Detect prognostic and therapeutic markers
207
Q

Serum tumor markers

A

Carcinoembryonic ag (Ca of colon, pancreas, stomach, breast)
Alpha-fetoprotein (yolk sac and liver)
Prostate-specific ag

208
Q

In inherited Ca syndrome, a single mutant gene increases cancer risk by..

A
  1. Pt mutation of 1 allele (RB, APC)

2. Silencing of 2nd allele somatically (C deletion or recombination)

209
Q

Prototypic anti apoptotic protein which limits the exit of cytochrome c from mitochondria

210
Q

Doubling time of normal cell

A

60-70 doublings

211
Q

Sustained angiogenesis is achieved thru:

A

Neurovascularization, ILGF, PDGF

212
Q

Tumors can’t grow___ cm without new blood vessels

213
Q

Angiogenesis factors

A

Thrombospondin-1
Angiostatin
Endostatin

214
Q

Carcinogenic agents

A
  1. Chemical carcinogens
  2. Radiant energy
  3. Oncogenic viruses and other microbes
215
Q

Cause of ionizing radiation

A

Chromosome breakage, translocation

216
Q

Cause of UV light

A

Causes formation of pyrimidine dimers

217
Q

Most common Ca that is caused by ionizing radiation

A

Myeloid leukemia>thyroid Ca

218
Q

Least common Ca caused by ionizing radiation

A

Skin, bone, gut

Med Prep (52 decks)

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