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Heme / Onc > SM_261b: Introduction to Neoplasia > Flashcards

SM_261b: Introduction to Neoplasia Flashcards

1
Q

Hyperplastic polyps are ___

A

Hyperplastic polyps are benign lesions that arise throughout colon but especially common distally

  • Not believed to harbor risk of malignant transformation
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2
Q

Tubular adenoma is ___

A

Tubular adenoma is dysplastic proliferation of colonic epithelium

  • Can be pedunculated or sessile with variety of architectural patterns
  • By definition contain low-grade dysplasia at baseline
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3
Q

This is ___

A

Normal colonic mucosa

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4
Q

This is a ___

A

Hyperplastic polyp

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5
Q

This is a ___

A

Tubular adenoma

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6
Q

This is ___

A

Tubular adenoma -> carcinoma

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7
Q

Describe progression from dysplasia to carcinoma in colon

A

Dysplasia to carcinoma in colon

  1. Normal colon
  2. Hyperproliferative epithelium: methylation abnormalities, APC / hMSH2 / hMLH1 inactivation
  3. Adenoma: K-ras mutation, DCC deletion, p53 deletion
  4. Carcinoma: further accumulation of genetic abnormalities
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8
Q

This is ___

A

Colorectal carcinoma

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9
Q

Describe treatment and staging for colorectal carcinoma

A

Colorectal carcinoma

  • Surgical resection
  • Histologic considerations: depth of invasion, lymphovascular invasion, margin status, lymph node metastases
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10
Q

Describe TNM staging for colorectal carcinoma

A

TNM staging for colorectal carcinoma

  • Tumor
    • T1: submucosal invasion
    • T2: muscularis propria invasion
    • T3: pericolonic tissue invasion
    • T4: invasion into or beyond visceral peritoneum
  • Nodes
    • N1: mets in 1-3 regional nodes
    • N2: mets in 4 or more regional nodes
  • Metastases
    • M1: distant metastases
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11
Q

____, ____, and ____ are ancillary studies for colorectal carcinoma

A

BRAF V600E mutation testing, microsatellite instability, and KRAS mutation testing are ancillary studies for colorectal carcinoma

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12
Q

Presence of ____ predicts negative outcome in anti-EGFR monoclonal antibody treatment of colorectal carcinoma

A

Presence of BRAF V600E mutation predicts negative outcome in anti-EGFR monoclonal antibody treatment of colorectal carcinoma

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13
Q

Microsatellite instability is caused by ____ and occurs in ____

A

Microsatellite instability is caused by mutations in DNA mismatch repair genes (MLH1, MSH2, MSH6) and occurs in Lynch syndrome

  • Prognostic indicator for fluorouracil-based adjuvant chemotherapy in colon cancer
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14
Q

____ predicts negative outcome in anti-EGFR monoclonal antibody treatment for colorectal carcinoma

A

KRAS mutation predicts negative outcome in anti-EGFR monoclonal antibody treatment for colorectal carcinoma

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15
Q

Screening for prostate cancer involves ___ and ___

A

Screening for prostate cancer involves digital rectal exam and serum PSA levels

  • Confirmation is done with prostate needle biopsy
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16
Q

This is ___

A

Normal prostate epithelium

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18
Q

This is ___

A

High grade prostatic intraepithelial neoplasia

19
Q

This is ___

A

Prostatic carcinoma

20
Q

Describe Gleason grading

A

Gleason grading

  1. Small uniform glands
  2. More stroma between glands
  3. Distinctly infiltrative margins
  4. Irregular masses of neoplastic glands
  5. Only occasional gland formation
21
Q

This is ___ prostate carcinoma

A

Gleason Grade 3 prostate carcinoma

22
Q

This is ___ prostate carcinoma

A

Gleason Grade 4 prostate carcinoma

23
Q

This is ___ prostate carcinoma

A

Gleason Grade 5 prostate carcinoma

24
Q

Describe treatment and staging of prostate carcinoma

A

Prostate carcinoma

  • Surgical resection
  • Histologic considerations
    • Unilateral vs bilateral disease
    • Lymphovascular and perineural invasion
    • Extraprostatic extension
    • Margin status
    • Seminal vesicle invasion
    • Lymph node metastases
    • Volume of tumor involved
25
Q

Describe TNM staging of prostate carcinoma

A

TNM staging of prostate carcinoma

  • Tumor
    • T1: tumor that is not yet clinically detectable
    • T2: palpable tumor confined to gland
    • T3: tumor that has grown beyond prostatic capsule
    • T4: tumor that has grown directly into adjacent tissues
  • Lymph nodes
    • N1: tumor has spread to nearby lymph nodes
  • Metastases
    • M1: tumor has spread to distant lymph nodes or beyond
26
Q

This is ___ of prostate carcinoma

A

Perineural invasion of prostate carcinoma

27
Q

This is ___ of prostate carcinoma

A

Seminal vesicle invasion of prostate carcinoma

28
Q

Prostate cancer is treated with ___

A

Prostate cancer is treated with surgical resection and adjuvant therapy

29
Q

This is ___

A

Normal breast epithelium

30
Q

Pre-neoplastic diseases of breast are ____, ____, and ____

A

Pre-neoplastic diseases of breast are atypical ductal hyperplasia, ductal carcinoma in situ, and lobular carcinoma in situ

31
Q

This is ___

A

Atypical ductal hyperplasia

32
Q

This is ___

A

Lobular carcinoma in situ

33
Q

This is ___

A

Ductal carcinoma in situ

34
Q

Invasive ductal carcinoma is treated with ___

A

Invasive ductal carcinoma is treated with excision with needle localization

35
Q

Negative margins are when ___

A

Negative margins are when cancer cells do not touch the edge of the resection

36
Q

Positive margins are when ___

A

Positive margins are when cancer cells touch the edge of resection

37
Q

Describe invasive ductal carcinoma

A

Invasive ductal carcinoma

  • Most common subtype of breast cancer
  • Hard consistency and stellate appearance
  • Histology: cords or solid nests of malignant cells invading into stroma
  • Association with in situ carcinomas
38
Q

Describe histologic grading of breast carcinoma

A

Histologic grading of breast carcinoma: modified Bloom-Richardson grading system

  • Combines three components: architecture (tubule formation), mitotic rate, and nuclear grade
  • Grades
    • I: low grade, well differentiated
    • II: intermediate grade, moderately differentiated
    • III: high grade, poorly differentiated
39
Q

Describe invasive lobular carcinoma

A

Invasive lobular carcinoma

  • Bilaterality and multicentricity
  • Histology: lack of cohesion, strands of infiltrating small tumor cells in form of a single file
  • E-cadherin is absent
  • Unusual metastatic sites: serosal surfaces, bone marrow, meninges
40
Q

Describe treatment and staging of breast carcinoma

A

Breast carcinoma

  • Surgical resection
  • Histologic considerations
    • Tumor size
    • Multifocality
    • Lymphovascular invasion
    • Margin status
    • Lymph node metastases
41
Q

Describe TNM staging of breast cancer

A

TNM staging of breast cancer

  • Tumor
    • T1: tumor ≤ 20 mm in greatest dimension
    • T2: tumor between 2-5 cm in greatest dimension
    • T3: tumor > 5 cm in greatest dimension
    • T4: tumor of any site attached to chest well or skin
  • Nodes
    • N1: metastases in 1-3 lymph nodes
    • N2: metastases in 4-9 lymph nodes
    • N3: metastases in > 10 lymph nodes
  • Metastases
42
Q

____ and ____ are ancillary studies for breast carcinoma

A

Hormone receptor status and OncotypeDx are ancillary studies for breast carcinoma

  • Hormone receptor status: ER/PR/Her-2 immunohistochemistry, Her-2 amplification via FISH
  • OncotypeDx: analyzes expression of 21 genes using RT-PCR, provides individual estimate of 10-year risk of local recurrence, used in women with ductal carcinoma in situ treated with local excision ± tamoxifen

Heme / Onc (41 decks)

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