Pathology of Neoplasia

Question 1

list the most common cancers by incidence vs. death

Answer 1

• incidence:
  
  1. breast/prostate
  2. lung
  3. colorectal
• death:
  
  1. lung
  2. breast/prostate
  3. colorectal

Question 2

give causes and examples of hyperplasia

Answer 2

• increased functional demand
  
  • increased RBCs in high altitude
• persistent cell injury: skin in calluses
• hormonal stimulation: endometrium

Question 3

give causes and examples of hypertrophy

Answer 3

• increased functional demand
  
  • myocardial hypertrophy in HT
• physiologic (hormonal) hypertrophy
  
  • sex organs at puberty

Question 4

describe what is seen in the images

Answer 4

Question 5

describe the nomenclature for benign tumors

Answer 5

• in general, benign tumors have the suffix “-oma” following tissue (cells) type
• e.g. lipoma, fibroma, angioma
  
  • exceptions: melanoma, lymphoma

Question 6

describe the names of benign tumors

Answer 6

• adenoma: benign tumor that forms gland
• cystadenoma: an adenoma with cystic (fluid-filled spaces) areas
• papilloma: benign tumors with finger-like projections
  
  • polyp: elevated mucosal lesions

Question 7

Answer 7

Question 8

describe what is seen in the images

Answer 8

Question 9

___ are tumor cells representative of 2 or more germ layers (commonly ovary and testes)

Answer 9

teratoma are tumor cells representative of 2 or more germ layers

Question 10

describe the rate of growth of benign vs malignant tumors and name an exception

Answer 10

benign = slow growing

malignant = fast growing

exception: growth of leiomyoma (benign) during pregnancy is fast

Question 11

describe the rate of growth of tumors and how it can be measured microscopically

Answer 11

• rate of growth correlates with blood supply
• rate of growth inversely correlates with differentiation
  
  • poorly differentiated tumor –> fast growth
  • fast-growing tumors may undergo central necrosis due to rapid growth
• can be measured microscopically
  
  • mitotic count
  • proliferation markers = Ki67

Question 12

describe metastasis pathways

Answer 12

• seeding via body cavities:
  
  • peritoneal cavity is the most common site
    
    • ovarian carcinoma
  • pericardial/pleural/subarachnoid cavities
• lymphatic spread
  
  • most common initial dissemination for carcinomas
  • follows natural drainage
• hematogenous spread
  
  • favored by sarcoma
  • liver and lungs are frequent sites