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MSK Summative > Pathology of Benign and Malignant Lumps > Flashcards

Pathology of Benign and Malignant Lumps Flashcards

1
Q
  • Definition of Hemangioma ?
    • common site
A
  • Abnormal proliferation of blood vessels
    • Increased numbers of normal blood vessels filled with blood
      • head and neck is a common site
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2
Q
  • Strawberry hemangioma affects who?
  • How does it grow and regress?
A
  • Benign capillary hemangioma of infancy
    • appears in first few weeks of life
  • Grows rapidly
  • Regress spontaneously
    • by 5-8 years old
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3
Q
  • Appearance of cavernous hemangioma?
    • can involve?
  • Does it regress?
A
  • Appearance:
    • large, dilated vascular channels
      • large cavernous blood filled vascular spaces
    • can involve deep structures
  • NO tendency to regress
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4
Q
  • What is pyogenic granuloma?
  • Where is it found?
    • what is it associated with?
A
  • Polypoid (tumor on a stalk) lobulated capillary hemangioma (benign)
    • can ulcerate and bleed
  • Found on:
    • skin, gingiva or oral mucosa
  • Associated with:
    • trauma
    • pregnancy
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5
Q

How can lymphangiomas be differentiated from hemangioma?

A

absence of RBC

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6
Q
  • What is cystic hygroma?
    • What is it associated with?
A
  • Cystic Hygroma:
    • cavernous lymphangioma (increase lymphatic space)
      • always in head or neck
  • Associated with:
    • Turner’s Syndrome (Monosomy X)
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7
Q
  • What muscle type does Glomus tumor arise from?
  • Where is it commonly found?
A
  • Benign, painful, red-blue tumor
  • Arises from:
    • modified smooth muscle cells of the thermoregulatory glomus body
  • Found:
    • commonly under fingernails
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8
Q
  • How is Nevus Flammeus described?
    • aka?
  • Associated with?
A
  • Benign flat lesion on head and neck (birthmark)
    • a congenital vascular malformation involving mature capillaries, present at birth.
      • Port wine stain
  • Associated with:
    • Sturge-Weber syndrome
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9
Q
  • Hereditary hemorrhagic telangiectasia is also know as Osler-Weber- Rendu syndrome?
    • inherited disorder of?
    • findings?
A
  • Inherited disorder of blood vessels (abnormal blood vessel formation)
    • autosomal dominant
  • Findings:
    • branching skin lesions (telangiectasias)
    • recurrent epitaxis (nose bleed)
    • skin discolorations
    • GI bleeding
    • hematuria
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10
Q
  • Bacillary angiomatosis is?
    • Found in who?
  • Caused by?
  • Frequently mistaken for/ distinguished by?
A
  • Benign capillary skin papule
    • Found in AIDs patients
  • Caused by:
    • Bartonella henselae infections
      • opportunistic infection
  • Frequently mistaken with:
    • Kaposi sarcoma
      • BUT has nuetrophilic infiltrate
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11
Q

What is seen microscopically in Bacillary Angiomatosis?

A

Is a vascular proliferation

  • Granulomatous inflammation
  • Neutrophils
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12
Q
  • Lipoma is?
  • Most common in?
A
  • Benign tumor of adipose tissue
    • Lipo= fat
  • Most common benign soft tissue tumor in adults
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13
Q
  • Nodular Fasciitis is what kind of proliferation?
  • What does it look like microscopically?
A
  • Benign soft tissue lesion most common in upper fascia
    • reactive proliferation of fibroblasts
    • unknown etiology
  • Microscopically
    • plump, randomly oriented spindle cells
    • surrounded by myxoid stroma
    • lots of mitotic activity
    • extravasated (leaked out) RBC
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14
Q
  • What is myositis ossificans?
    • occurs after?
  • Most often seen where on the body?
  • How does it present?
A
  • Heterotropic ossification (presence of bone in soft tissue where bone does NOT exists) of skeletal muscle
    • following muscular trauma
  • Most often seen in:
    • upper or lower extremity
  • May present as:
    • suspicious “mass” at site of known trauma
    • or as incidental finding on radiography
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15
Q
  • What is osteoma?
  • Where does it most commonly arise on?
  • What does it associate with?
A
  • Benign tumor of bone
  • Most commonly arise on:
    • surface of facial bones
  • Assocaited with:
    • Garnder syndrome
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16
Q
  • What is leiomyoma?
    • where is it commonly found?
  • Microscopically see?
A

Benign tumor of smooth muscle

Often arises in:

  • uterus of women
  • skin
  • muscularis of gut

Microscopically

  • whorled pattern of smooth muscle cells
    • well demarcated borders
17
Q
  • What is Baker cyst?
  • Commonly communicates with?
  • Related to?
A
  • Baker cyst:
    • popliteal fluid collection in gastrocnemius-semimembranous bursa in knee
      • herniation of synovium through a join capsule
  • Commonly communicate with:
    • synovial space
  • Related to:
    • chronic joint disease
18
Q
  • Tenosynovial Giant Cell tumor is associated with which translocation?
    • what is overexpressed?
    • result?
  • Where does it commonly affect?
A
  • Chromosomal translocation t(1;2)
    • M-CSF overexpressed
    • tumor infiltrated with lots of macrophages
      • ​macrophage may coalesce into multinucleated giant cells
  • Diffuse type:
    • knee (80%)
    • painful
  • Localized type
    • tendon sheaths along wrist and fingers
    • slow growing, painless
19
Q

Definitions of/ from what tissues:

  • Carcin-
  • Adenocarcin-
  • Sarc-
A
  • Carcin-
    • epithelial cell origin
    • derived from any of the three germ layers
  • Adenocarcin-
    • epithelial cells with glandular growth
  • Sarc-
    • fleshy mesenchymal tissue
20
Q

Sarcoma is?

A

Tumors arising in solid/mesenchymal tissues

21
Q

As a general rule:

  • Sarcomas are usually positive for?
  • Carcinomas are usually positive for?
A
  • Sarcomas positive for vimentin
  • Carcinomas positive for pan-cytokeratin
22
Q
  • Liposarcoma?
  • Most common in?
  • Characteristic cell?
A
  • Malignant tumor of adipose tissue
    • Lipo= fat; sarcoma= malignant mesenchymal tumor
  • Most commom malignant soft tissue tomor in adults
    • 50-60
  • Lipoblast is characteristic cell type
23
Q
  • Fibromatosis refers to?
    • what 3 characteristics do they have in common?
A
  • refers to:
    • a group of benign soft tissue tumors which have certain characteristics in common, including:
      1. proliferation of well-differentiated fibroblasts
      2. an infiltrative growth pattern
      3. aggressive clinical behavior with frequent local recurrence.
  • fibrous overgrowths of dermal and subcutaneous connective tissue develop tumours called fibromas.
    • These fibromas are usually benign (non-cancerous).
24
Q
  • Fibrosarcoma is?
  • Where can it occur?
A
  • Malignant tumor of fibroblasts
  • Can occur anywhere in the body
    • deep soft tissue
25
Q

Rhabdomyoma is?

A
  • Benign tumor of skeletal muscle
26
Q
  • Rhabdomyosarcoma is?
  • Most common in?
  • What is characteristic cell?
  • Where on the body is it most common?
A
  • Malignant (aggressive) tumor of skeletal muscle
    • most common malignant soft tissue tumor in children
  • Rhabdomyoblast is the characteristic cell
    • ​desmin positive
  • Common site is head and neck
    • vagina is classic site in young girl (5 yrs)
27
Q
  • Leiomyosarcoma is?
  • Who does it typically effect?
  • Where does it tend to metastisize?
A
  • Malignant tumor of smooth muscle
  • Affects adults and women more frequently
  • Metastatic spread especially to lungs
28
Q

Neurofibromatosis Type 1 (von Recklinghausen disease):

  • Disorder?
  • Characterized by?
  • Mutation in what gene?
  • Penetrance and expressivity?
A
  • malignant peripheral nerve sheath tumor
  • Characterized by:
    • cafe-au-lait spots
    • cutaneous neurofibromas
    • optic gliomas
    • pheochromocytomas
    • Lisch nodues (pigmented nodules on iris)
  • Caused by mutations in the NF1 gene on chromosome 17
    • RAS is trapped in the active state

High penetrance but variable expressivity

30
Q

Neurofibromatosis Type 2:

  • result in what kind of tumors?
  • Mutation?
    • gene product?
A
  • Result in range of tumors, findings include:
    • bilateral acoustic Schwannomas
    • multiple meningiomas
    • Gliomas
    • ependymomas of spinal cord
    • juvenile cataracts
  • Mutation in NF2 gene on chromosome 22
    • ​product is merlin, cytoskeleton protein that regulate membrane receptor signaling
31
Q

What are 4 associated syndromes of Rhabdomyosarcoma?

A
  1. Li-Fraumeni
    • TP53 gene mutation
  2. Beckwith-Weidemann
    • Uniparental Disomy in 11p15
  3. Neurofibromatosis
    • NF1 gene mutation
  4. Gorlin syndrome
    • PTCH gene mutation

skeletal muscle neoplasm

32
Q
  • Kaposi sarcoma is a malignancy of?
  • Caused by?
  • Presents with?
  • Associated with/ 3 Typical patients ?
  • Commonly mistaken for?
    • how to differentiate?
A
  • low grade malignant proliferation of endothelial cells
    • due to dysregulation of VEGF
  • ​characterized by:
    • Purple patches, plaques and nodules on skin;
      • can also involve visceral organs (GI)
  • Caused by:
    • HHV-8 Infection
  • Associated with:
    • HIV
    • Older European males
    • Transplant Patient
  • Mistaken for:
    • Bacillary angiomatosis (neutrophilic infiltrate)
      • Kaposi has lymphocytic infiltrate
33
Q

What is a KS flare?

A
  • Kaposi sarcoma (KS) flare may occur following therapy with corticosteroids
    • as part of the immune reconstitution inflammatory syndrome seen with highly active antiretroviral therapy (HAART), and after rituximab therapy
  • The exact mechanism responsible for iatrogenic KS flare is unclear.
34
Q
  • What is the mechanism of p53 in apoptosis?
    • What happens if DNA repair fails?
    • If it succeeds?
A
  • DNA damage or hypoxia causes phosphorylation of p53 by ATM/ATR kinases
    • this releases p53 from MDM2
  • p53 activates CDK inhibitor p21
  • cell cycle arrest in G1
  • p53 cell apoptosis or senescence results if:*
  • DNA repair fails
  • p53 ubiquination and degredation in proteosome if:*
  • DNA repair succeeds
35
Q
  • Li-Fraumeni syndrome has abnormalities in which gene?
    • increases risk for?
    • associated with which malignancies?
  • Inheritance pattern?
A
  • Abnormalities in TP53
    • multiple malignancies at an early age
  • Also know as SBLA cancer syndrome
    • sarcoma, breast, leukemia, adrenal gland

Inheritance:

  • autosomal dominant
36
Q
  • Angiosarcoma is what kind of proliferation?
  • Common sites?
  • Associated with exposure to?
A
  • Malignant proliferation of endothelial cells (that line blood vessels)
    • highly aggressive
  • Common sites:
    • skin, breast and liver
  • Associated with exposure to:
    • Polyvinal Chloride (PVC), arsenic and Thorotrast

MSK Summative (8 decks)

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