Session 8 - Neoplasia

Question 1

What is an example given in lecture that leads to the impairment of cell adhesion?

Answer 1

E cadherin inhibition

Question 2

What is a method by which the tumor uses to degrade the basement membrane?

Answer 2

Proteases

Question 3

What is another name for the basement membrane?

Answer 3

Basal lamina

Question 4

What are the three stages of invasion?

Answer 4

Transformed cells detach from mass
Intravasation
Extravasation

Question 5

What is intravasation?

Answer 5

Extension of mass through endothelium
Interaction with lymphoid cells
Coating with platelets

Question 6

What does intravasation form?

Answer 6

Tumor emboli

Question 7

What is extravasation?

Answer 7

extension back through endothelium
Formation of metastatic deposit
Angiogenesis

Question 8

What are three common methods of metastatic routes

Answer 8

Lymphatic + Hematogenous + Exfoliation/implantation

Question 9

What tumor type prefers metastasis via lymphatics?

Answer 9

Carcinomas

Question 10

Why are the lymphatics an easy target for metastasis?

Answer 10

Very little basement membrane, easy to get through

Question 11

What type of tumor prefers Hematogenous method of metastasis?

Answer 11

Sarcomas

Question 12

What is the first capillary bed for the vena cava?

Answer 12

Lung

Question 13

What types of cancers tend to spread via the vena cava?

Answer 13

Mammary + Skin + Soft tissue + Bone + Thyroid

Question 14

What is the first capillary bed for the portal vein?

Answer 14

Liver

Question 15

What tumors tend to pass through the portal vein?

Answer 15

GI + Pancreatic

Question 16

What lymphatic vessel dumps into the left side of the neck?

Answer 16

Thoracic duct

Question 17

What lymphatic vessel dumps into the right side of the neck?

Answer 17

Lymphatic trunk

Question 18

What tumors tend to spread via exfoliation + implantation?

Answer 18

Mesothelioma + Some reproductive carciomas

Question 19

What are two primary effects of tumors that are used to gauge morbidity?

Answer 19

Loss of function + Pain/Discomfort

Question 20

What is paraneoplastic syndrome?

Answer 20

Symptom complexes that cannot be directly linked to local or distant tumors

Question 21

What causes hypercalcemia with some masses?

Answer 21

Increased calcium reabsorption + decreased phosphate reabsorption
Release from bones via osteoclasts
(both of the above stimulated by PTHrP)
Increased absorption in the intestines

Question 22

What are the common clincal presentations of anorexia/cachexia?

Answer 22

Anemia + Weakness + Fatigue + Weight loss + Weak immunity

Question 23

What are common mechanisms for anorexia/cachexia?

Answer 23

Reduced caloric intake
Metabolic alterations
Increased catabolism
Cytokine release

Question 24

What cytokine encourages lipid breakdown?

Answer 24

TNF-alpha

Question 25

What is important clinically about paraneoplastic syndrome?

Answer 25

Major contributor to clinical signs seen with cancer Can serve as diagnostic aids Markers for response to treatment

Question 26

What is the best predictor of tumor behavior?

Answer 26

Cell morphology

Question 27

What characteristics are used for classifying tumors?

Answer 27

``` Tissue of origin Low to high based of level of differentiation (high being poor) Invasiveness Mitotic index Necrosis ```

Question 28

What is the mitotic index?

Answer 28

Number of mitoses in 10 fields at 40x magnification

Question 29

What do grading schemes of tumors relate together?

Answer 29

Tumor features Disease free intervals Rate of recurrence Survival data

Question 30

What are the stages of the TMN classification scheme?

Answer 30

Local + Regional + Metastatic

Question 31

What is are the components of the TMN classification scheme?

Answer 31

Size of primary tumor Spread to lymph nodes Presence or absence of distant metastasis

Question 32

What can go wrong with incomplete excision of a tumor?

Answer 32

Can lead to regrowth w/ greater malignancy

Question 33

What is involved in the invasion process of tumor growth?

Answer 33

Impairment of cell adhesion Basement membrane degradation Extension to permissive tissues