Pathology Flashcards
LAD 2
Low Sialyl Lewis – margination/rolling defece
E selectin involved in
Margination/rolling – vascular
E selectin upregulated by
TNF and IL1
P selectin involved in
Margination/rolling – vascular
P selectin released from
Weibel Palade bodies
GlyCAM-1 involved in
Margination/rolling – vascular
CD34 involved in
Margination/rolling – vascular
Binds selectins on vascular surface
Sialyl-Lewis
Binds GlyCAM1/CD34
L selectin on WBCs
ICAM 1 (CD54)
Tight binding – vasculature
VCAM-1 (CD106)
Tight binding – vasculature
CD11/18 integrins
Tight binding – leuk (binds ICAM)
VLA4 integrin
Tight binding – leuk (Binds VCAM)
LAD 1
Defective tight adhesion – CD18 low
PECAM-1 (CD31)
On both leuks and vasculature – diapedisis
PDGF
Secreted by activated plts/macs
Induces vascular remodeling, smooth muscle cell migration, stimulates fibroblast growth for collagen synth
FGF
Stims angiogenesis
EGF
Stimulates cell growth via TKs (EGFR/ErbB1)
TGFB
Angiogenesis, fibrosis
Metalloproteinases
Tissue remodeling
VEGF
Stimulates angiogenesis
Proliferative phase healing – what deficiencies will prolong?
Vitamin C, copper
Remodeling phase healing – what deficiencies will prolong?
ZInc
Granuloma formation
Th1 release IFN gamma –> activates macs who release TNF –> maintains granuloma
Acanthosis nigricans as pnp syndrome
Gastric adenocarcinoma (more often obesity/insulin resistance)
Sign of leser-trelat
Multiple suddent seborrheic keratoses associated w/ gastric adenocarinoma
Hypercalcemia due to PTHrP
Squamous cell carcinoma of lung, head, neck; renal, bladder, breast, ovarian carcinomas
Hypercalcemia due to high 1,25 Vit D
Lymphoma
Cushing syndrome as pnp syndrome
Small cell lung cancer
SIADH as pnp syndrome
Small cell lung cancer
Polycythemia as pnp syndrome
High EPO from renal cell carcinoma, hepatocellular carcinoma, hemangioblastoma, pheochromocytoma, leiomyoma
Pure red cell aplasia
Anemia with low retics – thymoma
Good syndrome
Hypogammaglobulinemia – thymoma
Trosseau syndrome
Migratory superficial thrombophelbitis – adenocarcinoma, esp. pancreatic
Nonbacterial thrombotic (marantic) endocarditis
Deposition of sterile plt thrombi on hrt valves as in adenocarcinoma, esp. pancreatic
Anti NMDA receptor encephalitis
Psychiatric disturbance, memory deficits, seizures, dyskinesias, autonomic instability, seen in ovarian teratoma
Opsoclonus myoclonus ataxia syndrome
Dancing eyes/feet as in neuroblastoma in children and small cell lung CA in adults
Paraneoplastic cerebellar degeneration
Abs to Purkinje cells as in Small cell lung cancer (Hu), gynecologic/breast cancers (Yo), Hodgrikin lymphoma (Tr)
Anti-Hu
Small cell lung cancer – paraneoplastic cerebellar degeneration
Anti-Yo
Gynecologic/breast cancers – paraneoplastic cerebellar degeneration
Anti-Tr
Hodgkin lymphoma – paraneoplastic cerebellar degeneration
Paraneoplastic encephalomyelitis
Anti-Hu in small cell lung cancer against neurons
Lambert-Eaton mysasthenic syndrome
Abs against presynaptic Ca channels at NMJ – in small cell lung cancer
Myasthenia gravis
Abs against postsynaptic ACh receptors at NMJ – thymoma
ALK
Oncogene receptor tyrosine kinase – lung adenocarcinoma
BCR-ABL
Oncogene tyrosine kinase – CML, ALL
BCL2
Oncogene antiapoptotic molecule – follicular and diffuse large B cell lymphomas
BRAF
Oncogene serine/threonine kinase – melanoma, non-Hodgkin lymphoma, papillary thyroid carcinoma
c-KIT
Oncogene cytokine receptor – Gastrointestinal stromal tumor
c-MYC
Oncogene transcription factor – Burkitt lymphoma
HER2/neu (c-erbB2)
Oncogene receptor tyrosine kinase – breast and gastric carcinomas
JAK2
Oncogene TK – Chronic myeloprolif disorders
KRAS
Oncogene GTPase – colon cancer, lung cancer, pancreatic cancer
MYCL1
Oncogene transcription factor – lung tumor
MYCN
Oncogene transcription factor – neuroblastoma
RET
Oncogene rTK – MEN2A, MEN2B, medullary thyroid cancer
APC
Tumor suppressor that negatively regulates b-catenin/WNT — colorectal CA (assc w/ FAP)
BRCA1/BRCA2
Tumor suppressor DNA repair protein – breast, ovarian, pancreatic cancer
CDKN2A
Tumor suppressor p16 that blocks G1–>S – Melanoma, pancreatic cancer
DCC
Tumor suppressor (deleted in colon cancer) – colon cancer
DPC4/SMAD4
Tumor suppressor (deleted in pancreatic cancer) – pancreatic cancer
MEN1
Tumor suppressor menin – MEN1
NF1
Tumor suppressor neurofibromin (Ras GTPase activating protein) – NF1
NF2
Tumor suppressor merlin (schwannomin) – NF2
PTEN
Tumor suppressor tyrosine phophatase of PIP3 (protein kinase B activation) – breast cancer, prostate cancer, endometrial cancer
Rb
Tumor suppressor inhibits E2F to block G1–>S – retinoblastoma, osteosarcoma
TP53
Tumor suppressor for p53 which activates p21 to block G1–>S – most human cancers, assc w/ Li-Fraumeni syndrome (multiple malignancies at early age – SBLA: sarcoma, breast, leukemia, adrenal gland)
TSC1
Tumor suppressor hamartin protein – tuberous sclerosis
TSC2
Tumor suppressor tuberin protein – tuberous sclerosis
VHL
Tumor suppressor that inhibits hypoxia inducible factor 1a – assc w/ VHL
WT1
Tumor suppressor transcription factor that regulates urogenital development – Wilms tumor (nephroblastoma)
EBV cancer
Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, 1o CNS lymphoma in immunocompromised
HBV/HCV cancer
Hepatocellular carcinoma
HHV-8 cancer
Kaposi sarcoma
HPV cancer
Cervical, penile/anal carcinoma, head and neck
H pylori cancer
Gastric adenocarinoma and MALT lymphoma
HTLV1 cancer
Adult T-cell leukemia/lymphoma
Liver fluke (clonorchis sinesis) cancer
Cholangiosarcoma
Shicstosoma haematobium cancer
Bladder CA (squamous cell)
Aflatoxins (aspergillus) CA
Hepatocellular carcinoma
Alkylating agents CA
Leukemia/lymphoma
Aromatic amides (e.g. benzidines, 2 napthylamine) CA
Transitional cell carcinoma (bladder)
Arsenic CA
Liver angiosarcoma, lung cancer, squamous cell carcinoma
Asbestos CA
Bronchogenic carcinoma>Mesothelioma
Carbon tetrachloride CA
Liver centrilobular necrosis/fatty change
Cigarette CA
Bladder transitional cell carcinoma,
Cervical carcinoma
Esophageal squamous cell carcinoma/adenocarcinoma
Renal cell carcinoma
Laryngeal squamous cell carcinoma
Lung squamous cell and small cell carcinoma
Pancreatic adenocarcinoma
Ethanol CA
Esophageal squamous cell carcinoma
Hepatocellular carcinoma
Ionizing radiation CA
Papillary thyroid carcinoma
Nitrosamines CA
Gastric CA
Radon CA
Lung cancer
Vinyl chloride CA
Liver angiosarcoma
Psamomma body CAs
Papillary carcinoma of thyroid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Malignant mesothelioma
ALP CA
Metastases to bone or liver, Paget disease of bone, seminoma (placental) – exclude hepatic origin by checking LFTs and GGT
AFP CA
Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus), mixed germ cell – normally made by fetus and transiently high in pregnancy (high – NTD, abdominal wall defect, low – tri21)
B-hCG CA
Hydatidiform moles and choriocarcinomas (gestational trophoblastic disease), testicular CA, mixed germ cell – made by syncytiotrophoblasts of placenta
CA153/CA 27-29 CA
Breast cancer
CA 19-9 CA
Panceratic adenocarcinoma
CA125 CA
OVarian cancer
Calcitonin CA
Medullary thyroid carcinoma
CEA CA
MAJOR – colorectal and pancreatic
Minor – gastric, breast, medullary thyroid carcinomas
Chromogranin CA
Neuroendocrine tumors (e.g. pheochromocytoma, lung carcinoid tumor)
PSA
Prostate cancer (but can also be elevated in BPH and prostatitis)
P-glycoprotein
MDR1 – adrenocortical carcinoma (and others like colon, liver) – pumps out chemo agents)
Cytokines mediating cachexia
TNF, IFN gamma, IL1, IL6
Sarcoma spread
Hematogenous
Carcinoma spread
Lymphatic
Carcinomas that spread hematogenous
Follicular thyroid carcinoma, Choriocarcinoma, Renal cell carcinoma, Hepatocellular carcinoma
Four Carcinomas Route Hematogenously
Brain met origins
- lung 2. breast 3. melanoma/kidney
Often multiple well circumscribed at grey/white jxn
Liver met origins
- colon 2. stomach 3. pancreas
Bone met origins
- prostate (blastic)/breast(mixed), 2(all lytic). lung, thyroid, kidney
Usually axial skeleton