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neuro > Pathoma: Principles of Neoplasia > Flashcards

Pathoma: Principles of Neoplasia Flashcards

1
Q

definition of neoplasia

A

new tissue growth that is unregulated, irreversible, and monoclonal

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2
Q

definition of monoclonal

A

the neoplastic cells are derived from a single mother cell

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3
Q

How is clonality of B lymphocytes determine

A

Ig light chain phenotype
Immunoglobulin composed of heavy and light chains that is either kappa or lambda
normal kappa to lambda is 3:1
monoclonal is 6:1 or inverted 1:3

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4
Q

benign neoplastic tumors

A

remain localized and do not metastasize

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5
Q

malignant neoplastic tumors

A

invade locally and have the potential to metastasize

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6
Q

Epithelium tumors nomenclature - benign and malignant

A

Benign: adenoma, papilloma
Malignant: adenocarcinoma, Papillary carcinoma

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7
Q

Mesenchyme tumors nomenclature - benign and malignant

A

Benign: lipoma
Malignant: liposarcoma

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8
Q

lymphocyte tumors nomenclature - benign and malignant

A

Benign: does not exist
Malignant: lymphoma, leukemia

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9
Q

Melanocyte tumors nomenclature - benign and malignant

A

Benign: Nevus
Malignant: Melanoma

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10
Q

most common cancers by incidence in adults

A

1) breast/prostate
2) lung
3) colorectal

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11
Q

most common cause of cancer mortality

A

1) lung
2) breast/prostate
3) colorectal

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12
Q

definition of carcinogens

A

agents that damage DNA, increasing the risk for cancer

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13
Q

What is the associated cancer with this carcinogenic chemical:
Aflatoxins

A

Hepatocellular carcinoma

Derived from aspergillus, which can contaminate stored rice and grains

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14
Q

What is the associated cancer with this carcinogenic chemical:
Alkylating agents

A

leukemia/lymphoma

side effect of chemo

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15
Q

What is the associated cancer with this carcinogenic chemical:
alcohol

A

squamous cell carcinoma of oropharynx and upper esophagus,

hepatocellular carcinoma

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16
Q

What is the associated cancer with this carcinogenic chemical:
arsenic

A

squamous cell carcinoma of skin, lung cancer, and angiosarcoma of liver

arsenic is present in cigarette smoke

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17
Q

What is the associated cancer with this carcinogenic chemical:
nitrosamines

A

stomach carcinoma

found in smoked foods
responsible for high rate of stomach carcinoma in Japan

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18
Q

What is the associated cancer with this carcinogenic chemical:
naphthylamine

A

urothelial carcinoma of bladder

derived from cigarette smoke

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19
Q

What is the associated cancer with this carcinogenic chemical:
vinyl chloride

A

angiosarcoma of liver

occupational exposure
used to make PVC

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20
Q

What is the associated cancer with this carcinogenic chemical:
nickel, chromium, beryllium, or silica

A

lung carcinoma

occupational carcinoma

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21
Q

What is the associated cancer with this carcinogenic chemical:
asbestos

A

lung carcinoma and mesothelioma

exposure to asbestos is more likely to lead to lung cancer than mesothelioma

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22
Q

What is the associated cancer with this carcinogenic chemical:
cigaretter smoke

A

carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas

most common carcinogen worldwide, polycyclic hydrocarbons are particularly carcinogenic

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23
Q

What is the associated cancer with this carcinogenic oncogenic virus:
EBV

A

nasopharyngeal carcinoma, burkitt lymphoma, and CNS lymphoma in AIDS

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24
Q

What is the associated cancer with this carcinogenic oncogenic virus:
HHV-8

A

Kaposi Sarcoma

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25
Q

What is the associated cancer with this carcinogenic oncogenic virus:
HBV and HCV

A

Hepatocellular carcinoma

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26
Q

What is the associated cancer with this carcinogenic oncogenic virus:
HTLV-1

A

Adult T-cell leukemia/lymphoma

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27
Q

What is the associated cancer with this carcinogenic oncogenic virus:
High-risk HPV (16,18,31,33)

A

squamous cell carcinoma of vulva, vagina, anus, and cervix, adenocarcinoma of cervix

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28
Q

What is the associated cancer with radiation:

ionizing (nuclear reactor accidents and radiotherapy)

A

AML, CML, and papillary carcinoma of the thyroid

generates hydroxyl free radicals

29
Q

What is the associated cancer with radiation:

nonionizing (UVB sunlight is most common source)

A

basal cell carcinoma, squamous cell carcinoma, and melanoma of skin

results in formation of pyrimidine dimers in DNA, which are normally excised by restriction endonuclease

30
Q

Function
Mechanism
associated tumor of:
PDGFB

A

platelet-derived growth factor
overexpression, autocrine loop
astrocytoma

31
Q

Function
Mechanism
associated tumor of:
ERBB2 (HER2/neu)

A

Epidermal growth factor receptor
amplification
subset of breast carcinomas

32
Q

Function
Mechanism
associated tumor of:
RET

A

neural growth factor receptor
point mutation
MEN2A, MEN 2B and sporadic medullary carcinoma of thyroid

33
Q

Function
Mechanism
associated tumor of:
KIT

A

stem cell growth factor receptor
point mutation
gastrointestinal stromal tumor

34
Q

Function
Mechanism
associated tumor of:
RAS gene family

A

GTP-binding protein
point mutation
carcinomas, melanoma, and lymphoma

35
Q

Function
Mechanism
associated tumor of:
ABL

A

tyrosine kinase
t(9:22) with BCR
CML and some types of ALL

36
Q

Function
Mechanism
associated tumor of:
c-Myc

A

transcription factor
t(8:14) involving IgH
burkitt lymphoma

37
Q

Function
Mechanism
associated tumor of:
N-Myc

A

transcription factor
amplification
neuroblastoma

38
Q

Function
Mechanism
associated tumor of:
L-myc

A

transcription factor
amplification
lung carcinoma (small cell)

39
Q

Function
Mechanism
associated tumor of:
CCND1 (cyclin D1)

A

cyclin
t(11:14) involving IgH
mantle cell lymphoma

40
Q

Function
Mechanism
associated tumor of:
CDK 4

A

cyclin dependent kinase
amplification
melanoma

41
Q

p53

A

tumor suppressor

regulates progression of the cell cycle from G1 to S phase
slows cell cycle when damage is present
if repair is not possible, upregulates BAX -> disrupts Bcl2 -> induces apoptosis

42
Q

Knudson two hit hypothesis

A

both copies of p53 gene must be knocked out for tumor formation

43
Q

Rb

A

tumor suppressor

hold E2F transcription factor which is necessary for transition to S phase from G1

44
Q

sporadic Rb mutation

A

both hits are somatic

characterized by unilateral retinoblastoma

45
Q

germline Rb mutation

A

familial retinoblastoma - 2nd hit is somatic

bilateral retinoblastoma and osteosarcoma

46
Q

Bcl2

A

prevents apoptosis in normal cells
stabilizes mitochondrial membrane, blocking release of cytochrome c
over expressed in follicular lymphoma

47
Q

telomerase is necessary for

A

cell immortality

cancers often have upregulated telomerase, which preserves telomeres

48
Q

angiogenesis

A

necessary for tumor survival and growth

FGF and VEGF often produced by tumor cells

49
Q

how do tumor cells evade immune surveillance

A

downregulating expression of MHC I

normally, the abnormal proteins would be displayed by MHC I and destroyed by CD8+

50
Q

lymphatic spread is characteristic of

A

carcinomas

51
Q

hematogenous spread is characteristic of

A

sarcomas and some carcinomas

52
Q

seeding of body cavities is characteristic of

A

ovarian carcinoma

which often involves the peritoneum

53
Q

Benign tumors histologic features

A 
organized growth 
uniform nuclei
low nuclear to cytoplasmic ratio
minmal mitotic activity
lack of invasion
no met potential
54
Q

malignant tumor histology

A 
disorganized growth
nuclear pleomorphism and hyperchromasia
high nuclear cytoplasmic ratio
high mitotic activity with atypical mitosis
invasion
55
Q

well differentiated

A

low grade

resembles normal parent tissue

56
Q

poorly differentiated

A

high grade

does not resemble parent tissue

57
Q

grading

A

determines prognosis

58
Q

staging

A

more important than grade

assessment of size and spread of cancer

59
Q

TNM staging of a tumor

A

T - tumor - size and/or depth of invasion
N - spread to regional lymph nodes, 2nd most important prognostic factor
M - metastasis - single most important prognostic factor

60
Q

Immunohistochemical stain assoc. with which tissue:

keratin

A

epithelium

61
Q

Immunohistochemical stain assoc. with which tissue:

vimentin

A

mesenchyme

62
Q

Immunohistochemical stain assoc. with which tissue:

desmin

A

muscle

63
Q

Immunohistochemical stain assoc. with which tissue:

GFAP

A

neuroglia

astrocytes

64
Q

Immunohistochemical stain assoc. with which tissue:

neurofilament

A

neurons

65
Q

Immunohistochemical stain assoc. with which tissue:

PSA

A

prostatic epithelium

66
Q

Immunohistochemical stain assoc. with which tissue:

ER

A

breast epithelium

67
Q

Immunohistochemical stain assoc. with which tissue:

thyroglobulin

A

thyroid follicular cells

68
Q

Immunohistochemical stain assoc. with which tissue:

chromogranin

A 
neuroendocrine cells
(small cell carcinoma of lung and carcinoid tumors)
69
Q

Immunohistochemical stain assoc. with which tissue:

S-100

A

melanoma, Schwannoma, and Langerhans cell histiocytosis

neuro (18 decks)

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