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Pathoma > Principles of Neoplasia > Flashcards

Principles of Neoplasia Flashcards

1
Q

Name for Cancers of Epithelium

A 
B = Adenoma, papilloma
M = Adenocarcinoma, papillary carcinoma
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2
Q

Name for Cancers of Mesenchyme

A 
B = Lipoma
M = Liposarcoma
Mesenchyme = connective tissue (fat, bone, blood vessels, cartilage)
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3
Q

Lymphocyte

A

M = Lymphoma/Leukemia

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4
Q

Melanocyte

A 
B = Nevus (mole)
M = Melanoma
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5
Q

Aflatoxins causes

A

Hepatocellular carcinoma. Find this chemical in Aspergillus which can contaminate rice and grains so see commonly in Africa

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6
Q

Alkylating Agents cause

A

Leukemia/lymphoma. Side effect of chemotherapy

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7
Q

Arsenic causes

A

Squamous cell carcinoma of oropharynx and upper esophagus. Also hepatocellular carcinoma. Find in cigarette smoke

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8
Q

Asbestos Causes

A

Primarily lung carcinoma but also mesothelioma.

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9
Q

Cigarette Smoke Causes

A

Carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas. The polycyclic hydrocarbons are the most carcinogenic

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10
Q

Nitrosamines Cause

A

stomach carcinoma. See in smoked foods so common in Japan

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11
Q

Napthylamine Casues

A

Urothelial carcinoma of bladder. Find in cigarette smoke

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12
Q

Vinyl Chloride Casues

A

Angiosarcoma of liver. See in workers that make PVC pipes

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13
Q

Nickel, chromium, beryllium, or silica Casues

A

Lung carcinoma

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14
Q

Epstein Barr Virus Causes (EBV) Causes

A

Nasopharyngeal carcinoma in chinese males or Africans. Usually present with a neck mass
Burkitt lumphoma
CNS lymphoma in AIDS

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15
Q

Herpes Virus (HHV8) Causes

A

Kaposi Sarcoma. Find in Eastern European males, AIDS patients, or organ transplant (immunocompromised)

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16
Q

Hepatitis B (HBV) and C (HCV) causes

A

Hepatocellular Carcinoma

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17
Q

Human T-lymphotropic Virus 1 Causes

A

Adult T-Cell leukemia/lymphoma

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18
Q

HPV Causes

A

Squamous cell carcinoma of vulva, vagina, anus, and cervix. Also get adencarcinoma of cervix

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19
Q

Ionizing Radiation (nuclear accidents and radiotherapy) Causes

A

AML, CML, and papillary carcinoma of the thyroid

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20
Q

Nonionizing (UV sun rays)

A

Basal cell carcinoma, squamous cell carcinoma, and melanoma of the skin

21
Q

Platelet Derived Frowth Factor B Associated w/

A

Astrocytoma (brain cancer). Overexpression so astrocyte is bombarded with PDGFB and grows and divides rapidly.

22
Q

ERBB2 (HER2/neu) Associated w/

A

Subsets of breast carcinomas. Amplification of these growth factor receptors causes the cell to be hyperresponsive to growth factors and grow and divide

23
Q

RET is associated w/

A

Neural Growth factor receptor. A point mutation can cause MEN2A or B and medullary carcinoma of thyroid

24
Q

KIT assoicated w/

A

Stem cell growth factor receptor. Point mutation can cause GI stromal tumor

25
Q

RAS gene family associated w/

A

Signal transducer that is a GTP binding protein. Point mutation results in a prolonged activated state and it sends too much message and get cancers of all kinds

26
Q

ABLassociated with

A

Signal transducer that is a tyrosine kinase.
Get Philladelphia chromosome t(9:22) with BCR leading to overactivation of the tyrosine kinase and lots of cell growth. See in CML and some types of ALL. Philadelphia chromosome is poor prognosis

27
Q

C, N, and L MYC

A

All are nuclear regulators that cause upregulation of genes needed for cell growth.

C- see a t(8:14) involving IgH. IgH is on chromosome 14 and usually on so translocation of c-MYC from 8 to Cr 14, get chronicall on c-MYC and get Burkitt Lymphoma

N - neuroblastoma
L = lung carcinoma

28
Q

CCND1 (Cyclin D1)

A

t(11:14) involving IgH. Overexpression of Cyclin D1 so cell moves from G1 to S phase rapidly. Get Mantle Cell lymphoma

29
Q

CDK4

A

Cell cycle regulator whose amplification leads to melanoma

30
Q

Tumor Suppressor Genes

A

Regulate cell growth and check to make sure cell is ok to move from G1 to S. When working properly they reduce risk of cancer formation.

p53 and Rb are classic examples

Need both copies of gene to be mutated to get cancer (as compared to proto-oncogenes where only need 1 mutation)

31
Q

p53

A

regulates progression from G1 to S. When DNA is damaged it upregulates repair enzymes

If DNA damage is so bad it induces apoptosis by upregulating BAX which dirupts Bcl2 allowing ytochrome C to leak out of mitochondria and apoptose.

Need both genes to be knocked out to get cancer.
Germline mutation results in Li-Fraumeni Syndrome.

32
Q

Rb

A

Rb “holds” E2F transcription factor, which is needed to move to S phase. Rb mutation results in constitutively free E2F, allowing progression through cell cycle.

Sporadic mutation (both hits are somatic) get unilateral retinoblastoma but it is very rare

Germline mutation results familial retinoblastoma and can frequently see it bilaterally. Also more prone to osteosarcoma

33
Q

Bcl2

A

Normally stabilizes mitochondiral membrane and prevents release of cytochrome c and apoptosis.

Overexpressed in follicular lymphoma. Get t(14:18) Bcl2 on 14 and Ig heavy chain on 18. See increased Bcl2 so get a bunch of B cells that would normally undergo apoptosis during somatic hypermutation in the lymph node germinal center are now living and circulate as useless B cells.

34
Q

Telomerase

A

Cancers upregulate telomerase so can live longer

35
Q

FGF and VEGF

A

Tumor cells express these a lot for angiogenesis so they can get nutrients to thrive

36
Q

MHC1

A

Cancers avoid immune surveilance by downregulating MHC1. (Also reason you see cancers in immunocompromised)

37
Q

Tumor Progression

A

1) Downregulation of E-cadherin so dissociate from neighboring cells
2) Cells attach to laminin and destroy basement membrane via colleganse
3) Attach to fibronectin in ECM and spread locally
4) Entry into blood or lymphatics allows them to spread all over

38
Q

Cancers that spread via Lymphatics

A

Carcinomas

39
Q

Cancers that spread hematogenously

A

Sarcomas + the following carcinomas

Renal cell, hepatocellular, follicular, and chorio

40
Q

Clinical Features of Benign Tumors

A

slow growing
well circumscribed
distinct
mobile

41
Q

Clinical features of Malignant Tumors

A

Rapid growing
poorly circumscribed
Infiltrative
Fixed to surrounding tissues and structures

42
Q

Histologic Features of Benign Tumors

A 
Organized growth
Uniform Nuclei
low nuclear:cytoplasmic
minimal mitotic activity
lack invasion
no metastatic potential
43
Q

Hitologic Features of Malignant Tumors

A 
Disorganized growth
Nuclear pleomorphism and hyperchromasia
High nuclear:cytoplasmic
High mitotic activity
Invasion
44
Q

Immunohistochemical Stains indicate tumor of what origin:

Keratin, Vimentin, Desmin, GFAP, Neurofilament

A 
Keratin = Epithelium
Vimentin = Mesenchyme
Desmin = Muscle
GFAP = neuroglia
Neurofilament = neurons
45
Q

Immunohistochemical Stains indicate tumor of what origin:

PSA, Estrogen Receptor, Thyroglobulin, Chromogranin, S-100

A

PSA= Prostatic epithelium
Estrogen Receptor = breast epithelium
Thyroglobulin= thyroid follicular cells
Chromogranin = neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)
S-100 = Melanoma, Schwannoma, and Langerhans Cell Histiocytosis

46
Q

Grading of cancer Low vs High

A 
Low = well differentiated (resembles normal parent tissue)
High = poorly differentiated (does not resemble parent tissue)
47
Q

Serum Tumor Markers

A

Useful for screening, monitoring response to treatment, and monitoring reccurence.
CANNOT be used to diagnose someone with cancer. Only a biopsy can diagnose. If serum levels are high the next step is biopsy not surgery or treatment.

48
Q

Staging of Cancer : TNM

A

T- tumor size and depth of invasion
N = spread to regional lymph NODES
M = Metastasis

Pathoma (25 decks)

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