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Pathology > Pathoma 3. Neoplasia > Flashcards

Pathoma 3. Neoplasia Flashcards

1
Q

What are isoforms that can determine clonality?

A

G6PD and Androgens

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2
Q

What’s monoclonality and how does it differ from Policlonality?

A

Mono=1 mother cell. You find only 1 isotype of G6PD=Neoplasia

Poly=ratio is maintained in Hyperplasia.

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3
Q

Clonality in Bcells is determined by

A

Ig light chain phenotype. Normal=3:1 kappa-lambda.

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4
Q

Vignette=enlarged lymph node, biopsied and seen proliferation og lymphocytes. How will the Light chain ratio be and Whats the dx?

A

for eg.20:1. Lymphoma!

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5
Q

are benign tumors monoclonal?

A

yes

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6
Q

Which cancers have a longer division/mutation time before sym show?

A

Pancreatic, Lung, Ovarian

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7
Q

Main screenings?

A
  1. PAP
  2. Mammography
  3. PSA/DRE
    Hemocult test/Colonoscopy
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8
Q

identify origin and what type of Ca these Carcinogens cause: the 5 A’s

  1. Aflatoxin
  2. Ankylating agents
  3. Alcohol
  4. Aresnic
  5. Asbestos
  6. Cigarette smoke
A
  1. Aspergillus in stored grains=hepatocarcinoma
  2. Chemotherapy=leuk/lymphoma
  3. oropharynx, upper esoph, panc, hepato
  4. Cig smoke= Sq cell skin, Lung
  5. Lung
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9
Q

identify origin and what type of Ca these Carcinogens cause: the 5 A’s

  1. Aflatoxin
  2. Ankylating agents
  3. Alcohol
  4. Aresnic
  5. Asbestos
  6. Cigarette smoke
A
  1. Aspergillus in stored grains=hepatocarcinoma
  2. Chemotherapy=leuk/lymphoma
  3. oropharynx, upper esoph, panc, hepato
  4. Cig smoke= Sq cell skin, Lung
  5. Lung
  6. kidney, bladder, lung
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10
Q

Whats the most carcinogenic agent in Cigarette smoke?

A

Polycyclic hydrocarbons

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11
Q

nitrosamines

A

Smoked foods=stomach ca in Japan

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12
Q

Naphthylamine=

A

cigarette smoke=urothelial Ca of bladder

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13
Q

Vinyl chlorida

A

HY Occupation exposure=Angiosarcoma of liver

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14
Q

Nickel, Chromium, Beryllium, Silica

A

Occupational=Lung Ca

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15
Q

list what these oncogenic viruses cause:

EBV

A

burkitt’s

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16
Q

HHV-8

A

Kaposi Sarcoma

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17
Q

HBV/HCV

A

Hapatocellular carcinoma

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18
Q

HTLV-1

A

Adult cell leuk/lymph

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19
Q

High risk HPV (16, 18, 31, 33)

A

Sq cell carcinoma of vulva, vagina, anus , cervix and Adenocarcinoma of Cervix

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20
Q

Radiation can be 1. ionizing and 2. Non Ionizing. What cancers do they cause and why?

A
  1. (Radiotherapy or nuclear accidents)AML, CML, Papillary carcinoma of Thyroid (OH- free radicals
  2. (UVB rays)Basal cell, sq cell carcinoma, melanoma. (forms pyrimidine dimers and
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21
Q

Name the 1 GF oncogen

A

PDGFB=Astrocytoma

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22
Q

Main GF rcp Oncogenes, mechanism and Cancer

A
  1. HER2/Neu= Breast carciniomas
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23
Q

GF rcp RET oncogen=

A

MEN 2a/2b + medullary carcinoma od Thyroid

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24
Q

GF rcp KIT oncogen=

A

GI stromal tumors

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25
Q

Signal transducer RAS gene family oncogen=

A

it’s a GTP binging ptn= MULTIPLE carcinomas, MELANOMA, LYMPHOMA

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26
Q

Signal transducer ABL oncogen=

A

tyrosine kinase=t(9:22) philadelphia=CML

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27
Q

name the 3 Nuclear regulator oncogenes

A

c-MYC, n-Myc, l-MYC

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28
Q

C-myc and their manin mechanism

A

Burkitt’s lymphoma thru t(8;14)
B cells have Ig heavy chain locus on c14, when tslc happens, MYC, from c8 takes place of IgH, and overexplesses!=lymphoma

29
Q

n-myc

A

neuroblastoma

30
Q

L-myc

A

lung ca

31
Q

Cell cycle regulator CCND1 (Cyclin D1) = cancer type and mechanism.

A

Mantle cell lymphoma thru t(11;14)

CD in c8 takes place of IgH in c14=overgrowth!

32
Q

what r the 3 zones in Bcell zone of lymph node periphery

A
  1. follicular
  2. mantle
  3. margin
    each can result in lymphoma
33
Q

vignette: biopsy of lymph node w/ growth of area next to follicles:

A

Mantle cell lymphoma!!!

34
Q

CDK4 (cyclin dependent kinase)

A

Melanoma!

35
Q

What are the main tumor suppressor genes?

A

p53, Rb

36
Q

What’s the apoptosis mechanism for p53? Who does he call in?

A

If DNA can’t be repaired, he secretes/calls in BAX, which destroys Bcl2 (freeing cytochromeC from mitochondria and starting Caspase cascade)

37
Q

What’s the 2 hit hypothesus for the tumor suppressor genes?

A

both copies must be mutated for cancer to arise

38
Q

What results form germline mutation of p53?

A

Li-fraumeni sme

39
Q

What does Rb so to regulate g1___to___S progression?

A

It holds E2F (which is necessary for G1-S transition)… until Rb is phosphorylated by Cyclin D or CDK4. Then it lets EGF go and cell progresses. It’s the filter.

40
Q

What happens to E2F whe Rb is mutated?

A

It’s not held back…romes free in cell, leading to uncontrolled progression thru cell cycle.

41
Q

What are the 2 main regulators of Apoptosis?

A
  1. Bcl2

2. Telomerase

42
Q

What does Bcl2 do and what Ca is favored if it’s mutated?

A
  1. normally stabilized mtc membrane, keeping cytochrome C in, so that apoptosis doesn’t happen.
  2. If it’s OVEREXPRESSED, apoptosis won’t happen at all and Cancer can progress.
43
Q

How does Bcl2 cause follicular cell lymphoma?

A

t(14;18) moves Bcl to IgH locus, and overexpresses in these B cells, it won’t kill the cells that are defective from the Bcell college (those that don’t pass the somatic hypermutation)…so we’ll end up with a follicular cell lymphoma.

44
Q

is Telomerase up or downregulated in cancer cells?

A

up

45
Q

What do tumor cells produce to foster angiogenesis?

A

FGF, VEGF

46
Q

How does a tumor avoid surveillance?

A

down regulating MHC1, so that CD8+ can’t detect their aberrant proteins and kill them.
immunesuppression also favors avoidance

47
Q

Steps of how a tumor invades…

A
  1. down regulation of E-cadherin
  2. attach to Laminin on BM
  3. destroy BM using collagenase 4
  4. come to EC matrix and attach to fibronectin to begin to spread locally
  5. enter into vascular or lymphatic space
48
Q

Lymphatic spread is characteristic of:

A

Carcinomas

49
Q

How do sarcomas spread?

A

hematogenously

50
Q

what ate the exceptions to rule of carcinomas spreading lymphatically?

A
  1. Renal cell
  2. Hepatocellular carcinoma
  3. follicular carcinoma of Thyroid
  4. Choriocarcinoma
51
Q

Which tumor seeds in body cavities and what does it cause?

A

Ovarian cancer=omental caking

52
Q

Hystologic differences between benign and malignant

A

Malignant: disorganised, high nucleus-cytoplasm ratio, nucleus pleomorphism, high mitotic activity, invasion.

53
Q

What is immunhystochemistry?

A

it’s a dx technique used to classify malignant tumors with difficult histology

54
Q

List the intermediate filament for

1. Epithelium

A

1.Keratin

55
Q

List the intermediate filament for Mesenchyme

A

vimentin

56
Q

List the intermediate filament for Muscle

A

Desmin

57
Q

List the intermediate filament for Neuroglia

A

GFAP

58
Q

List the intermediate filament for Neurons

A

Neurofilament

59
Q

List the IH test for Prostatic epithelium

A

PSA

60
Q

List the IH test for Breast epithelium

A

ER

61
Q

List the IH test for Thyroid follicular cells

A

Thyroglobulin

62
Q

List the IH test for Neuroendocrine cells

A

Chromogranin

63
Q

What is the best and worst Neuroendocrine cancer?

A

Best differentiated=Carcinoid tumors

Poorest diff=Small cell carcinoma of Lung

64
Q

List the IH test for Melanoma

A

S-100

65
Q

What do we use serum markers for?

A

screening, monitoring ttm, monitoring recurrence

66
Q

WHat does grading identify

A

cell microscopic differentiation

67
Q

What does staging identify?

A

SIZE and SPREAD.

68
Q

when can we stage?

A

after final resection

69
Q

How do we stage?

A

T=tumor SIZE(breast)/DEPTH (bowels)
N=spread to regional lymph nodes (2nd +IMP)
M= Metastasis (ULTMATE PX factor)

Pathology (5 decks)

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