Path Neoplasia (Bruch)

Question 1

refers to an increase in cell number that results in increased organ volume and/or weight

Answer 1

hyperplasia

Question 2

a reversible change in which one adult cell type is replaced by another adult cell type; results from the reprogramming of reserve (stem) cells within an adult tissue

Answer 2

metaplasia

Question 3

a disorderly growth of cells with loss of cellular uniformity, considered preneoplastic in adult tissues

Answer 3

dysplasia

Question 4

an abnormal mass of tissue with autonomous growth, which is uncoordinated with normal tissue

Answer 4

neoplasia

Question 5

what are the 2 key characteristics of malignant tumors that differentiate them from benign tumors?

Answer 5

ability to invade and ability to metastasize

Benign neoplasms push adjacent structures, but don’t invade.

Question 6

True or false: infiltration of adjacent tissues is early metastasis.

Answer 6

False. Infiltration of adjacent structures is not considered a metastasis. Sometimes it is difficult to tell if a tumor outside the site of origin is there by direct extension or by metastasis.

Question 7

what is the best tool for predicting neoplasm behavior and best therapy course?

Answer 7

histologic features are used to predict behavior and as a result also dictate therapy.

Question 8

normally, neoplastic proliferation occurs in the _____ and induces ____ growth; in some cases however, a tumor can have neoplastic components of both

Answer 8

parenchyma; stromal

Question 9

Which of these is a generalization of benign neoplasms?
A. fast growing
B. poorly differentiated
C. metastatic
D. destructive invasive growth
E. absent necrosis

Answer 9

E

Question 10

general term for tumor with glandular origin or characteristics

Answer 10

adenoma

Question 11

what are 2 specific problems benign neoplasms cause?

Answer 11

1. they can grow and crowd out surrounding structures (ie, compress vessels, nerves, etc)
2. they usually mimic the function of their normal neighboring cells, which may have hormone/endocrine implications, causing significant symptoms and morbidity

Question 12

complications of this type of tumor include compression of vital organs

Answer 12

meningioma

Question 13

this type of tumor is considered a precursor lesion to a malignant neoplasm, and it exhibits some degree of dysplasia

Answer 13

tubular adenoma (adenomatous polyp)

Question 14

term that refers to the growth of fibrous or connective tissue secondary to an insult

Answer 14

desmoplasia

Question 15

this term literally means “backward formation” implying dedifferentiation (or loss of the structural & functional differentiation of normal cells)

Answer 15

anaplasia

Question 16

malignant cells that are well differentiated exhibit what characteristic?

Answer 16

resemblance to cell of origin

Question 17

these cells often lose their polarity and grow as sheets, contain mitotic figures, are pleomorphic and have a high N:C (hyperchromatic)

Answer 17

malignant (specifically, anaplastic) cells

Question 18

malignancy of mesenchymal tissues (bone, muscle, vessels)

Answer 18

sarcoma

Question 19

these 2 cancers characteristically spread via the lymphatics, with the patterns of node involvement depending on the site

Answer 19

colon and breast

Question 20

these 2 cancers characteristically spread via the blood (hematogenously)

Answer 20

kidney and colon

Question 21

a proliferation of epithelial cells with cellular morphology of malignancy, but still confined within the epithelium; a pre-invasive process with no risk of metastasis

Answer 21

carcinoma in situ

Question 22

this is determined by cytologic/histologic appearance with the idea that behavior and differentiation are related (poorly differentiated -> more aggressive behavior)

Answer 22

grade

Question 23

in general, this is the most important predictor of behavior and is determined by surgical exploration and/or imaging; based on size, local and regional lymph node involvement and distant metastasis

Answer 23

stage

Question 24

this is the most commonly utilized staging system for malignant tumors, that surgeons and oncologists use to determine a treatment plan

Answer 24

TNM Staging (size of primary Tumor, involvement of lymph Nodes, hematogenous Metastasis)

Question 25

Which of these is FALSE regarding management and treatment of patients with cancer? A. Molecular diagnostic techniques include FISH and PCR B. The most useful application of morphological based testing is detection of recurrence after excision C. CEA (carcinoembryonic antigen) and AFP (alpha-fetoprotein) are serologic markers normally expressed in fetal tissue only, whose serum levels become raised in some types of cancers D. One drawback of morphologic sampling is that the sample may not represent the entire tumor adequately E. Pattern recognition is important for describing and classifying neoplasms

Answer 25

B. It is the serologic tumor marker whose best utility is for for detection of recurrences after excision.

Question 26

Most widely used marker for gastrointestinal cancers – colon, stomach, pancreas as well as breast

Answer 26

CEA

Question 27

germ cell tumors that have yolk sac-like differentiation can often be detected by this serum marker

Answer 27

AFP

Question 28

malignancy of epithelial-derived tissues; breast, colon, lung and ovary malignancies are usually this type

Answer 28

carcinoma

Question 29

malignancy of blood element-derived tissues; lymphomas and leukemias

Answer 29

hematopoietic neoplasia

Question 30

malignancy of melanocytic-differentiating cells

Answer 30

melanoma

Question 31

histologic features suggesting this type of malignancy include clustered structures called keratin pearls and intercellular bridges

Answer 31

squamous carcinoma

Question 32

histologic features suggesting this type of malignancy include discohesive cells usually all of one type and stage of maturation, with no intercellular bridges and no gland formation

Answer 32

hematopoietic tumors

Question 33

histologic features suggesting this type of malignancy include spindle cells that are often cohesive but lack intercellular bridges

Answer 33

sarcoma

Question 34

this type of malignancy is said to be the great mimic - it can have appearances similar to many neoplasms but melanin pigment is often seen

Answer 34

melanoma

Question 35

this technique allows use of specific antibodies to be reacted on tissue slides to identify markers of interest and must always be used in conjunction with morphology (histology or cytology)

Answer 35

immunohistochemistry

Question 36

Which of these is NOT a major use of immunohistochemistry? A. Categorization of undifferentiated malignant tumors B. More precise classification of malignant neoplasms C. Determination of origin of metastatic tumors D. Detection of molecules that have prognostic or therapeutic significance E. Detection of recurrence of neoplasm

Answer 36

E