Test 2 - pathology

Question 1

Define grade and what it means to be low, intermediate, and high grade.

Answer 1

grade tells you how much the cancer looks like the original cell; differentiation

Low = resembles normal tissue (well differentiated)

intermediate = somewhat resembles normal tissue

High = does not resemble the normal tissue (poorly differentiated)

Question 2

Is an in-situ carcinoma cancer?

Answer 2

No! To be cancer, it must invade the basement membrane

Question 3

What is TNM staging?

Answer 3

Tumor, Node (lymph), Metastasis

Question 4

What is an in-situ neoplasia?

Answer 4

Clonal overgowth of cells which have the potential to invade but have not yet done so

Question 5

What is a carcinoma?

Answer 5

malignant neoplasm derived from epithelial cells

Question 6

What should trigger you to think someone has a familial cancer syndrome?

Answer 6

Young age

rare/uncommon cancer

more than one type of cancer in one person

family history of rare/uncommon cancers

Question 7

In Von Hippel Lindau disease, what chromosome is mutated? What does the vHL gene regulate?

Answer 7

chromosome 3

Hypoxia Inducible Factor

Question 8

In Von Hippel Lindau disease, what do patients develop? Where?

Answer 8

Hemangioblastomas

Medulla, retina, and cerebellum

Question 9

In Von Hippel Lindau disease, what are patients at increased risk for?

Answer 9

cysts in the pancreas, liver, and kidneys

bilateral renal carcinoma

pheochromocytoma

Question 10

What is the major issue with retinoblastoma?

Answer 10

mutation in Rb allows for cell cycle to progress forward

Question 11

How can retinoblastima be diagnosed with physical examination?

Answer 11

leukocoria

Question 12

What is the major issue with lynch syndrome?

Answer 12

defective DNA mismatch repair gene

Question 13

How is lynch syndrome inherited?

Answer 13

autosomal dominant

Question 14

What are patients with lynch syndrome at high risk for developing (types of cancer)?

Answer 14

colon cancer

skin cancer

ovarian cancer

Question 15

What is the major issue with Li Fraumeni?

Answer 15

Mutation in P53

Question 16

How is Li Fraumeni inherited?

Answer 16

autosomal dominant

Question 17

What types of cancer are patients with Li Fraumini at risk for?

Answer 17

Breast

Brain

Sarcomas

Leukemias

Adrenalcortical carcinoma

Question 18

What type of cells make embryonic tumors?

Answer 18

blast cells

Question 19

What do blastomas have a tendancy to do depending on its environment?

Answer 19

Blastomas like try and differentiate towards the surrounding cell types (they like to try and look like its surrounding tissue)

Question 20

What is a neuroblastoma? What gene is typically mutated?

Answer 20

embryonic cancer of the adrenal glands

N-myc is typically mutated

Question 21

Can you tell what type of cancer this is just by looking at it?

Answer 21

No! Although this is a neuroblastoma, all blastomas look the same under the microscope

Question 22

What are the 3 main good prognostic features in neuroblastoma?

Answer 22

age < 1 year old

N-myc is not expressed/amplified

clinical stage 1, 2, 4s

Question 23

What embryonic malignancy is this?

(normal image is on the right)

Answer 23

Wilm’s/nephroblastoma

Question 24

This slide is triphasic. What is the embryonic maligancy?

Answer 24

Wilm’s tumor/nephroblastoma

The blast cells in the middle are trying to look like their surrounding

Question 25

Is Wilm’s tumor associate with congenital malformations?

Answer 25

Yes

Question 26

What is WAGR syndrome?

Answer 26

WAGR syndrome is a congenital malformation:

Wilm’s

Aniridia

Genital anomalies

Retardation

Question 27

What is medulloblastoma?

Answer 27

embryonic malignancy that typically arises in the cerebellum

Question 28

How does medulloblastoma spread?

Answer 28

Through the CSF

Question 29

What is the term for this clinical finding? What embryonic malignancy causes this?

Answer 29

sunburst pattern

osteosarcoma

Question 30

What is this cancer?

Answer 30

osteosarcoma

malignant osteoblasts lay down malignant osteoid

Question 31

Where in the bone does osteosarcoma tyically present (epiphysis/metaphysis/diaphysis)

Answer 31

metaphysis

Question 32

Are sunburst patterns seen here?

Answer 32

no

Question 33

What is Ewing’s sarcoma mutation?

Answer 33

t(11;22) in primitive neural cells

Question 34

What CD marker do Ewing’s sarcoma cells express?

Answer 34

CD99

Question 35

Where do Ewing’s sarcoma tumors typically present? (epiphysis/metaphysis/diaphysis)

Answer 35

diaphysis