Oncology Flashcards
Lymphoma that is equivalent of chronic lymphocytic leukemia
Small lymphocytic lymphoma
Presents with skin lesions that show cerebriform nuclei, can spill into blood and cause leukemia
Mycosis fungoides, in the blood its called Sezary syndrome
What disease is associated with adult T-cell lymphoma?
HTLV infection, seen in IV drug abusers or populations from Japan, West Africa, Caribbean
What diseases are associated with Marginal cell MALT lymphoma?
Sjogren syndrome, Hashimoto’s thyroiditis, H. pylori
Mantle cell lymphoma translocation
t(11;14) - cyclin D1 and heavy-chain Ig
Lymphomas associated with t(14;18)
Diffuse large B-cell lymphoma and Follicular lymphoma
-translocation of Bcl-2 and heavy-chain Ig
Translocation in Burkitt
t(8;14) - transforms c-myc oncogene to heavy-chain Ig location
Difference in sporadic and endemic Burkitt lymphoma
endemic - jaw lesion, seen in Africa
sporadic - pelvis or abdomen lesion
Starry sky appearance of lymphocytes with interspersed tingible body macrophages, endemic and sporadic form, associated with EBV
Burkitt lymphoma
Most common non-Hodgkin lymphoma in kids
Lymphoblastic lyphoma
Most common non-Hodgkin lymphoma in adults
Diffuse large B cell lymphoma
Localized, single group of enlarged non-tender lymph nodes, B-symptoms, good prognosis
Hodgkin lymphoma
Ages affected by Hodgkin lymphoma
20s and around 65
Characteristic cells seen on histology of Hodgkin lymphoma
Reed-sternberg - binucleated giant cells that look like owl’s eyes, CD15 and CD30+
-amount determines prognosis (fewer Reed-sternberg is a better prognosis)
B symptoms of Hodgkin lymphoma
fever, night sweats, weight loss
Most common leukemia in kids, tons of lymphoblasts, bone pain is common, associated with Down syndrome
ALL
Marker that is present in ALL
+ Tdt
Smudge cells, CD20+, CD19+, CD5+, associated with AI hemolytic anemia, seen in older adults >60, most common leukemia in adults
CLL (smudge cells = crushed little lymphs)
Seen in middle aged adults (around 60), Auer rods, tons of myeloblasts, + myeloperoxidase
associated with prior radiation, benzene, alkylating agents, myeloproliferative dz, Down syndrome
AML
Translocation present in some AML forms and the treatment
t(15;17) - tx with all-trans retinoic acid (ATRA)
Always have Philadelphia chromosome, dysregulated production of mature and maturing granulocytes, splenomegaly, fatigue, abdominal pain, can accelerate to blast crisis, negative for leukocyte alkaline phosphatase
CML
blast crisis - transforms to AML or ALL
What is the Philadelphia chromosome?
t(9;22) - BCR-ABL hybrid that encodes a constitutively active tyrosine kinase
-tx CML with imatinib (anti-tyrosine kinase)
Characteristic auer rods
AML-M3 subtype
What type of leukemia do myeloproliferative disorders progress to?
AML
Classic symptoms of Multiple Myeloma
Jerry is a CRAB - Calcium is high, Renal involvement, Anemia, Bone lytic lesions/back pain
What is seen on UA with MM?
nothing - have to do electrophoresis to see Ig light chains, called Bence Jones proteins (IgG)
Most common tumor arising from bone in adults
Multiple Myeloma
M spike associated with high IgM, hyperviscous blood, no bone lesions
Waldenstrom-Macroglobulinemia
Tear-drop red cells associated with fibrosis on bone marrow bx
Myelofibrosis
Headache + pruritis + plethora (red hands and feet)
Polycythemia
Cancers that metastasize to brain
“Lots of Bad Stuff Kills Glia” - Lung, Breast, Skin (melanoma), Kidney, GI (colon)
Cancers that metastasize to bone
“Permanently Relocated Tumors Like Bone” - Prostate, Renal Cell carcinoma, Thyroid, Lung, Breast
Cancers that metastasize to liver
“Cancer Sometimes Penetrates Benign Liver” - Colon, Stomach, Pancreas, Breast, Lung
Cancers that show psammoma bodies
PSaMMoma - Pheocromocytoma, Serous papillary cystadenocaricnoma of ovary, Meningioma, Malignant mesothelioma
Cancer that causes Cushing syndrome (increased ACTH)
Small cell lung cancer
Cancer that causes SIADH
Small cell lung cancer
Cancers that cause Hypercalcemia
Squamous cell lung cancer (releases PTHrP), Multiple Myeloma, Hodgkin lymphoma (increases Vit D), Other carcinomas (renal, head and neck cancers, bladder, breast)
Cancers that cause Polycythemia (increase EPO)
“Potentially Really High Hematocrit” - Pheocromocytomas, Renal Cell Carcinoma, Hepatocellular carcinoma, Hemangioblastoma
Cancer that causes muscle weakness that improves with use
Small cell lung cancer - makes abs to Ca2+ channels at NMJ, called Lambert-Eaton syndrome
Cancer associated with Hashimoto’s thyroiditis
marginal cell lymphoma
Most common tumor suppressor gene that is mutated
p53
What does p53 normally do?
acts as a check point for G1 –> S phase, G2 –> M phase; normally activates p21
What cancers is Rb associated with?
osteosarcoma, retinoblastoma
Most common oncogene
RAS - colon cancer, lung cancer, pancreatic cancer
What occurs when RAS is mutated?
constitutively active GTPase that doesn’t require receptor binding
What disease and gene are associated with bilateral acoustic schwannomas?
Neurofibromatosis 2 - NF2 tumor suppressor is mutated
What is normal function of most tumor suppressor genes?
control cell cycle progression
What protein is normally bound by Rb?
E2F transcription factor
What is normal function of many proto-oncogenes?
regulate cell proliferation and differentiation
-kinases, receptors
Top cancers for incidence and mortality in men
Incidence - Prostate > lung > colon
Mortality - Lung > prostate > colon
Top cancers for incidence and mortality in women
Incidence - Breast > lung > colon (uterine)
Mortality - Lung > breast > colon
What cancer is associated with benzene and naphthylamine exposure?
transitional cell carcinoma (bladder)
What cancers are associated with radiation?
papillary thyroid carcinoma, CML, AML
What cancers is EBV associated with?
Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma
What type of bladder cancer is smoking associated with?
Transitional cell carcinoma
What type of cancer is schistosoma haematobium associated with?
Squamous cell carcinoma (think S for schistosoma and squamous cell)
What cancer can acanthosis nigricans be a sign for?
gastric adenocarcinoma (usually associated with obesity and diabetes)
What cancer is associated with Aspergillosis?
aflatoxins - hepatocellular carcinoma
What cancers are associated with alcohol use?
squamous cell carcinoma (esophagus), hepatocellular carcinoma
Tumor marker for hepatocellular carcinoma and testicular tumors
alpha-fetoprotein
Tumor marker for ovarian cancer
CA 125
Tumor marker for pancreatic and colon cancer
CEA
Tumor marker for pancreatic cancer
CA 19-9 (and CEA)
Tumor associated with alkaline phosphatase tumor marker
mets to bone, Paget dz of bone
