Pathology Flashcards
apprendre les millions d'affaires de la section pathologie de marde
what are cancer stem cells ?
a parody of a normal stem cell : must be eliminated to cure a cancer, but are resistant to therapy because of low rate of replication and express factor of drug resistance
what are the systemic effects of inflammation ?
- fever
- production of acute-phase proteins
- leukocytosis (production of leukocytes)
- maybe fall in blood pressure (because chemokines induce vasodilatations)
What do cyclins oncogens act ?
they mediate entry into the cell cycle G1-S = super cell proliferation
list and briefly describe the sequence of development of a squamous carcinoma (in the cervix)
- normal mucosa
- dysplasia
- carcinoma-in-situ (all look neoplastic, but no highway for metastase)
- invasive squamous cell carcinoma (neoplastic cells can get to the lymphatic vessels)
compare benign and malignant neoplasm in terms of behavior
B - no matastases (no invasion, slow growth, few systemic effect)
M - potential for metastases (invasion, rapid growth, augmentation of systemic effects)
how does a pathologist do a urgent diagnosis ?
freeze the tissue on a cryostat at -20oC, do a frozen section and stain with H&E
Name the broad overall caracteristics of a disease
- predisposition factors/ history of the disease
- etiology
- pathogenesis
- pathological alterations
- pathophysiology
- clinical manifestations/imaging and laboratory
- diagnosis
- complications
- prognosis and predictives factors
- therapy
what do you call a malignant neoplasm of the breast
phyllodes tumor
What are the 3 most common cancer in men (incidence) ?
- prostate
- lungs & bronchus
- colon and rectum
what do we mean by monoclonal in term of malignant neoplasm transformation ?
neoplastic cells arise from a single transformed cell
general chemicals reactions and specificities of periodic acid Schiff (PAS)
- stains complex carbohydrates
- can digest glycogen if add diastase
what are the Ziehl-Neelsen and Grocott stains useful for ?
microorganisms stains
- ziehl-neelsen = acid-fast bacilli (TB)
- grocott = fungal (aspergillus)
describe the mechanism for invasion and metastases if malignant carcinoma
- carcinoma-in-situ cells
- loosen intercellular junctions between neoplasm cells
- the malignant cell attach and degrade BM
- migrate thru the BM to stroma via cytokines
- go either from lymphatic vessels to lymph nodes, to blood vessels or transcoelomic
List one parasite, one bacterium and 5 viruses that are carcinogenesis by biological agents
- Parasites = clonorchis sinensis
- bacteria = H. pylori
- Virus = RNA, DNA (sarcomas)
Define papilla
(usually microscopic term) = finger-like projection consisting of surface epithelium over core of connective tissue ≈ villus
etiology
CAUSE of the disease
difference between chronic and acute inflammation ?
the predominant neutrophilic infiltration is replaced by infiltration with mononuclear cells (lymphocytes, plasma cells, macrophages)
the definition of pathology : the study of diseases, all the way from molecules to the patient and divided into ?
- general pathology (cell injury, inflammation, immunopathology, neoplasia)
- systemic or “systematic” (organ-based) pathology (heart, lungs, …)
what do you call a malignant neoplasm of the adipocytes ?
liposarcoma
general chemicals reactions and specificities hematoxylin
- dark blue
- is a base
- binds to basophilic substances (acides) like DNA in nuclei
What are the 3 most deadly cancer in women (mortality) ?
- lungs and bronchus
- breast
- colon and rectum
general chemicals reactions and specificities Prussian blue stain for iron
- stains ferric deposits (in liver if a lot of blue, blue is bad)
atrophy (what + mechanism)
- decrease in cell SIZE
- mechanism : lysosomal enzyme pathway, ubiquitin-proteasome pathway, autophagic vacuoles
what do you call a malignant neoplasm of the fibroblast (mesenchymal)
fibrosarcoma
what are the different grades of malignant neoplasm done ?
Grade I : > 75% differentiated
Grade II : 50-75% differentiated
Grade III : 25-50% differentiated
Grade IV : <25% differentiated
carcinomas or sarcomas ? macroscopy variably hard (vs fleshy, firm)
carcinomas
What are the phases of development of malignant neoplasm ?
- transformation
- growth (proliferation of transformed cells)
- diversification/clonal expansion of neoplastic cells
- local invasion
- distant metastases
general chemicals reactions and specificities Masson trichrome
- for collagen + fibrosis
- blue collagen, red muscle
- -> help to see how much fibrosis there’s to know if you need a transplant
what are the different kinds of necrosis and their main caracteristics ?
- COAGULATIVE .- cellular outline maintained, protein degradation
- LIQUEFACTIVE - loss cellular outlines and pus
- CASEOUS - special in mycobacterial infections
- FAT - chalky white areas (fat destroyed through action of lipases)
difference between monocyte and macrophages ?
monocyte change into macrophages after entering the tissue spaces (phagocytosis)
metaplasia (what + mechanism)
- REPLACEMENT of one cell type by another
- mechanism : reprogramming of stem cells or undifferentiated cells
what do you call a benign neoplasm of the salivary glands (mixed tumor)
pleomorphoic adenoma
how PAS-D help make a diagnosis ?
highlight PAS-D positive globules of alpha-1-antitrypsin deficiency (genetic disease predisposing to asthma and cirrhosis)
compare benign and malignant neoplasm in terms of necleus
B- more regular, differentiated
M - anaplastic, large, bizzare, large, abnormal
Intracellular accumulation is produced in response to what ?
Non-lethal persistent cell stress (metabolic alterations/chronic injury)
what’s the only type of cellular adaptive responses that is always PATHOLOGIC
metaplasia
What do we mean by multistep carcinogenesis ?
frequently a multi-step process with sequentially added mutations
Explain the 4 descriptors of carcinogenicity of the IARC/WHO
- Group 1 : carcinogenic to humans (120 agents)
- Group 2 : A- probably (81) and B- possibly carcinogenic to humans (299)
- not classifiable
- probably not carcinogenic to humans (1)
What is immunohistochemistry ?
Using the same principle of Ag-Ab binding to identify specific cellular macromolecules (often proteins).
- Usually purify the Ab and applied to a histologic section along with a brown stain
DIAGNOSTIC MARKERS
Classify the etiologies of human cancer
They’re either exogenous (chemical carcinogens, physical agents, biological agents) or endogenous (heredity, gender and hormones, altered immunity)
what nuclear changes are associated with necrosis ?
- karyolysis (nucleus is starting to break down)
- karyorrhexis (fragmentation of the nucleus)
- pyknosis (rétraction du noyau)
- complete loss of nucleus
3 leading causes of cancer ?
- tabacco
- diet
- sexual behaviour, infections
what do you call a benign neoplasm of the smooth muscle (mesenchymal)
leiomyoma
what do you call a malignant neoplasm of the melanocytes ?
melanoma
Define oncology
1) study of neoplasms, malignancies;
2) medical specialties treating patients with cancer
role of mannose receptor ?
recognition and attachement of the particule to be ingested by the leukocyte (phagocytosis)
carcinomas or sarcomas ? immunohistochemistry vimentin, muscle actin (vs keratins, prostate-specific antigen)
sarcomas
what do you call a benign neoplasm of the hematopoietic cells (bone marrow/lympphoid)
none-existant
2 types of pathologic calcification and differences
- DYTROPHIC : occurs at sites of previous necrosis
- METASTATIC : occurs in setting of hypercalcemia
what do you call a malignant neoplasm of the salivary gland
malignant mixed tumor
name factors that can delay tissue repair
- infections
- protein deficiency
- treatments : glucocorticoids
- poor perfusion
- increased ECM production in keloids (collagens)
what do you call a benign neoplasm of the melanocytes ?
nevus
why should you take care of benign neoplasm ?
- cosmetic
- local symptoms/signs : obstruction, pressure, pain
- distant endocrine effects
- complications : bleeding, necrosis, ulceration, perforation
- some have potential for malignant transformation
Define angiogenesis and distinguish it from vasculogenesis and arteriogenesis
- VASCULOGENESIS : process of blood vessel formation from endothelial progenitor cells (mesenchyme), generally during
embryogenesis, but also in adult - ANGIOGENESIS: process of blood vessel
neoformation from preexisting vasculature - ARTERIOGENESIS: growth and remodeling of preexisting collateral arterioles leading to formation of large well-muscularized conductance arteries and arterioles to compensate for loss of function of occluded arteries
5 cardinals signs of inflammation
- redness
- swelling
- heat
- pain
- loss of function
carcinomas or sarcomas ? Chances increase with age
carcinoma
disadvantages of urgent diagnostic ?
freezing artefacts
Describe 3 radiation-induced cancers and the type of radiation implicated
- ionizing, radioactive elements (x and gamma-rays, alpha et beta particules)
- UV
- electromagnetic fields (low-frequency)
carcinomas or sarcomas ? histochemistry mesenchymal : fat, etc. (vs epithelial: mucin)
sarcomas
compare benign and malignant neoplasm in terms of immunohitochemistry
B - close to normal cell
M - variable loss expression
what are the clinical manifestation of a disease ?
signs and symptoms
carcinomas or sarcomas ? Etiology viral or unknown (versus generally known, environnemental, viral)
sarcomas
what do you call a benign neoplasm of the endothelium (mesenchymal)
hemangioma