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DT3- EXAM 1 > Tumors of CV System- Melissa (3) > Flashcards

Tumors of CV System- Melissa (3) Flashcards

1
Q

What is a hemangioma?

Where do they occur (2)

A
  • Benign tumor of blood vessels that resemble capillaries

- Occur in skin, subQ tissues, mucous membranes, and internal organs (liver, spleen, kidney)

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2
Q

Describe the gross morphology of a hemangioma:

A
  • Vary in size, elevation, and color (blue-red)

- Blood filled, thin walled capillaries (blanching)

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3
Q

What is a strawberry hemangioma?

By when do they regress?

A
  • Hemangioma found on skin of newborns

- Common; regress by 7yoa

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4
Q

What is a glomus tumor?
What do they look like?
From what type of cells do they originate?
Where are they found?

A
  • PAINFUL, benign vascular tumor
  • Small, elevated, red-blue color, firm nodules
  • Originates in smooth muscle of glomus body
  • Commonly found on tips of fingers and toes
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5
Q

What are glomus bodies?

A

AV shunts in skin/ soft tissue at tips of fingers and toes; function to conserve heat/ shunt blood proximally when body is cold

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6
Q

Components of glomus tumor (2)

A
  • Branching vascular channels

- Aggregates of glomus cells

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7
Q

List the 4 vascular ectasias.

Are these benign or malignant tumors?

A

Benign:

  1. Nevus Flammus
  2. Port Wine Stain
  3. Spider Telangiectasia
  4. Osler Weber Rendu Disease
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8
Q

What is a nevus flames?
Where do they most commonly occur?
What is their prognosis?

A

Light pink-purple “Birth mark”

  • occurs on head and neck
  • most fade or regress
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9
Q

What is a port wine stain and with what disease are they associated?

A
  • special type of nevus flames that may thicken and not fade
  • associated with Sturge Weber Syndrome
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10
Q

What are the three findings associated with Sturge Weber Syndrome?

A

Port wine stain in distribution of CN V
Leptomeninges- venous angiomas
CNS- Mental retardation, seizures, hemiplegia, radiopacities in skull

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11
Q

Spider telangectasias:

  • Describe the lesion
  • Where are they commonly found?
  • In what type of patients do these most often occur (2)?
A
  • Benign, radial, pulsatile vascular lesion w/ blanching central core
  • Head and neck
  • Associated with ^ Estrogen:
    1. Preggos
    2. Liver failure!
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12
Q

What is Osler-Weber-Rendu Disease?
What is its inheritance pattern?

Symptoms:

A

“Hereditary Hemorrhagic Telangiectasia”

  • AD inheritance
  • Dilated capillaries, vv’s in mucous membranes - Lesions are benign, present at birth, and distributed across body in well defined regions

*bleeding everywhere: nose, GI, urine, everywhere!!!

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13
Q

Bacillary Angiomatosis:

What what are these lesions like and what organism causes them?

A
  • Vascular proliferation in immunosuppressed

- Associated with Bartonella infections

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14
Q

4 forms of Kaposi Sarcoma:

A
  1. Chronic (older european men)
  2. Lymphadenopathic (endemic-african children)
  3. Transplant-associated
  4. AIDS-Assocated
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15
Q

Describe AIDS Assocated Kaposi Sarcoma:
How common is it?
What is the prognosis?

A
  • # 1 AIDS associated malignancy
  • AIDS defining illness
  • HAART decreased incidence to under 1%
  • Involves lymph nodes, viscera, disseminates widely, but NOT FATAL
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16
Q

Which virus causes AIDS related Kaposi Sarcoma? How does this work?

A
  • KS associated herpesvirus: HHV8

- Tumor progression requires cofactor provided by HIV

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17
Q

Three stages of Kaposi Sarcoma Development: how aggressive are these tumors?

A
  1. Patch
  2. Plaque
  3. Nodule
    * Intermediate grade malignancy*
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18
Q

Characteristics of Kaposi’s sarcoma patch phase (2):

A
  • flat, red-purple macules on lower extremities

- Lool like granulation tissue

19
Q

Characteristics of Kaposi’s sarcoma plaque phase (2):

A
  • Dilated vascular channels

- Plump spindle cells

20
Q

Characteristics of Kaposi nodule phase (6)

A

1-2.sheets* of plump spindle cells; scattered small vessels
3-4. slits w/ red cells + hyaline droplets; mitotic figures
5. pink cytoplasmic globules
6. lymph node + viscera involved

21
Q

Describe the clinical course of Kaposi Sarcoma: Is it acute or indolent?
Which forms are more aggressive?
How doe we treat AIDS associated?

A
  • Typically indolent, but presentation and course vary widely
  • Lymphadenopathic + transplant associated= most aggressive
  • AIDS associated clears up with HAART
22
Q

Describe the gross morphology of angiosarcoma; are these tumors benign or malignant?

A
  • Small, clear, red nodules–> Large, fleshy, gray-white mass
  • necrosis + hemorrhage are common
  • OVERTLY MALIGNANT*
23
Q

What are the three causes of HEPATIC angiosarcoma? How quickly do they cause cancer?

A
  1. arsenic
  2. thorotrast (former Xray dye)
  3. polyvinyl chloride
    * long latency period for all toxins*
24
Q

List two causes of general angiosarcoma:

What is the prognosis for this disease?

A
  1. lymphedema (breast cancer surgery, etc)
  2. radiation therapy
    5 year survival = 30%
25
Q

Describe the microscopic morphology of angiosarcoma

A
  • multiple degrees of differentiation
26
Q

What is an angioplasty and why is it done?

What are two associated risks with this procedure?

A

Balloon dilation of artery to stretch media and fracture plaques

Complications:
1. Localized hemorrhagic dissection–> abrupt closure/ thrombosis and reclosure

  1. Intimal thickening–> proliferative re-stenosis (Occurs in up to 50% of patients w/in 4-6mos)
27
Q

Endovascular stents:
What are they and what is their purpose?
What are some immediate and late complications associated with this procedure?

A

Expandable mesh tubes used to preserve lumens potency

  • Can cause ACUTE thrombosis: put patient on anticoagulant
  • Can cause LATE intimal thickening + proliferative restenosis: coat in anti proliferative drugs
28
Q

Which arteries fair better with synthetic grafts?

Do grafts work well for arteries, veins, or both?

A
  • Larger arteries; small diameter grafts often fail due to thrombosis and intimal thickening
  • Work well for ARTERIES and not veins; they do not collapse well enough to replace veins
29
Q

Which vessels are implemented for autologous grafts (2)?

For what procedure are these used?

A

1: Internal mammary artery

(patency 90% @ 10 yrs)
2. Reversed Saphenous vein
(patency 50% @ 10 yrs)

Used for CABG

30
Q

What are three complications associated with using the Reversed Saphenous vein as an autologous graft?

A
  • more early thrombosis
  • more late intimal thickening
  • athroscleorosis w/ rupture, thrombi, aneurysm after 2-3 years
31
Q

What is the #1 primary cardiac tumor in adults?
Are they benign or malignant?
Where do they typically occur?
What causes them?

A
  • Myxoma (benign)
  • Most commonly single tumor in Left Atrium
  • 10% hereditary
32
Q

Describe gross morphology of a cardiac myxoma; what are 3 associated complications?

A

Single tumor that ranges in size
Pedunculated tumors may:
1. Obstruction of AV valve (“Ball valve”)
2. Cause “wrecking ball” effects on AV leaflets
3. All tumors can embolize or cause flu like syndrome

33
Q

Describe the microscopic morphology of a cardiac myxoma: (3)

A
  • stellate or globular myxoma
  • covered with endothelium
  • contains structures resembling poorly formed glands or vessels
34
Q

How are cardiac myxomas diagnosed? Treated?

A
  • Dx with echo

- Surgery is curative

35
Q 
#1 cardiac tumor in kiddos/ infants? 
Benign or malignant? 
What do we look for morphologically with these (2)?
A

Rhabdomyoma (benign)

  • Spider cells (large, polygonal, ^ glycogen)
  • Resemble a hamartoma more than neoplasm
36
Q

What are two ways a malignancy can directly invade the heart?

A

hemorrhagic pericardial effusion; myocardial mets

37
Q

Describe superior vena cava syndrome:

What type of tumors typically cause this?

A

Tumor invades/ compresses SVC–> obstruction of venous return from head and upper extremities
- Common associated with lymphomas of the mediastinal area

38
Q

Describe Inferior vena cava syndrome:

What type of tumors typically cause this?

A

Renal cell carcinoma grows in renal vein–> infiltrates and obstructs IVC–> Stops venous return from lower extremity

39
Q

4 negative effects of radiation to treat cardiac/ non cardiac chest neoplasms:

A
  1. Serous/serofibrinous pericarditis +/- pericardial effusion
  2. Fibrosis of basically any heart tissue
  3. ^ CAD
  4. Restrictive cardiopathy (probably due to pericarditis)
40
Q

What are the indications for cardiac transplantation?

A

severe intractable heart failure, typically due to dilated cardiomyopathy or IHD

41
Q

3 factors lending to success of cardiac transplants:

A
  1. careful selection of candidates
  2. better maintenance (immunosuppressive drugs)
  3. sequential endomyocardial biopsies–> early histopathic dx of rejection
42
Q

What are 4 major complications associated with cardiac transplants?

A
  1. Allograft rejection
    (^ lymphocytes, myocyte damage on biopsy)
  2. Graft CAD: late, progressive, diffuse–>silent MI, CHF, sudden cardiac death
  3. Infection
  4. Malignancy (lymphoma asstd. EBV)

*Grafts typically don’t last more than 15 years

43
Q

Why do cardiac allografts typically only last 10-15 years?

A

CAD

44
Q

Which tumor has spider cells and what do they look like?

A

Rhabdomyoma– they are large, polygonal, and have lots of glycogen

DT3- EXAM 1 (26 decks)

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