Pathoma Chapter 3C

Question 2

Malignant tumors are classically

Answer 2

poorly differentiated (anaplastic)

Question 3

Characteristics of malignant tumors include

Answer 3

1. Disorganized growth (loss of polarity) 2. Nuclear pleomorphism and hyperchromasia 3. High nuclear to cytoplasmic ratio 4. High mitotic activity with atypical mitosis 5. Invasion (through basement membrane or into local tissue)

Question 4

What is the hallmark of malignancy?

Answer 4

Metastatic potential - benign tumors never metastasize

Question 5

What is the target cell type for the immunohistochemical stain of Keratin?

Answer 5

Epithelium

Question 6

What is the target cell type for the immunohistochemical stain of Vimentin

Answer 6

Mesenchyme

Question 7

What is the target cell type for the immunohistochemical stain of desmin

Answer 7

Muscle

Question 8

What is the target cell type for the immunohistochemical stain of Neurofilament

Answer 8

Neurons

Question 9

What is the target cell type for the immunohistochemical stain of PSA

Answer 9

Prostatic epil helium

Question 10

What is the target cell type for the immunohistochemical stain of ER

Answer 10

Breast epithelium

Question 11

What is the target cell type for the immunohistochemical stain of Thyroglobulin

Answer 11

thyroid follicular cells

Question 12

What is the target cell type for the immunohistochemical stain of chromogranin?

Answer 12

neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)

Question 13

What is the target cell type for the immunohistochemical stain of S-100?

Answer 13

Melanoma

Question 14

What is used to characterize tumors that are difficult to classify on histology?

Answer 14

Immunohistochemistry

Question 15

What are serum tumor markers?

Answer 15

Proteins released by tumor into serum (e.g PSA)

Question 16

Serum tumor markers are useful for what?

Answer 16

screening, monitoring response to treatment, and monitoring recurrence

Question 17

Elevated levels of serum tissue markers require what?

Answer 17

it requires tissue biopsy for diagnosis of carcinoma (e.g., biopsy of prostate with elevated PSA),

Question 18

What is involved in the grading of cancer?

Answer 18

Microscopic assessment of differentiation (how much a cancer resembles the tissue in which it grows); takes into account architectural and nuclear features

Question 19

What is low grade?

Answer 19

Well differentiated?resembles normal parent tissue

Question 20

What is high grade?

Answer 20

poorly differentiated?does not resemble parent tissue

Question 21

Cancer grading is important for what?

Answer 21

determining prognosis; well-differentiated cancers have better prognosis than poorly-differentiated cancers.

Question 22

What is staging of cancer?

Answer 22

its an assessment of size and spread of a cancer,

Question 23

How does the staging of cancer compare to the grading of cancer?

Answer 23

Key prognostic factor; more important than grading

Question 24

When is the staging of cancer determined?

Answer 24

after final surgical resection of the tumor

Question 25

What is the TNM staging system?

Answer 25

T?tumor (size and/or depth of invasion), N?spread to regional lymph nodes; second most important prognostic factor, M?metastasis; single most important prognostic factor

Question 26

In the TNM staging system what is the most important prognostic factor?

Answer 26

Metastasis