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Block 4 Found Sci > VII- Neoplasia > Flashcards

VII- Neoplasia Flashcards

1
Q

definition of neoplasm

A

clonal proliferation of cells that is uncontrolled and excessive
-irreversible change in cell type (metaplasia) and structure (dysplasia)
-benign or malignant

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2
Q

two components of neoplasm

A
  1. parenchyma - the monoclonal neplatic cells themselves, decides biological behavior of tumor
  2. stroma - CT/blood vessels/macrophages/lymphocytes that determine growth, spread, and mass consistency
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3
Q

hard mass = what stroma

A

abundant collagenous stroma

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4
Q

soft mass = what stroma

A

scant stroma
-tumor soft and fleshy

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5
Q

if benign @ epithelial tissue

A

ademoma
papilloma - finger like projections

if cavity or cyst then cystadenoma

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6
Q

features of benign tumors

A
  1. slow growth
  2. capsule present
  3. non invasive, non metastatic
  4. well differentiated
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7
Q

tumor-like conditions

A
  1. choristoma
  2. hamartoma
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8
Q

monoclonality of tumors

A

ALL TUMORS ARE MONOCLONAL so og from single precursor cell
-both benign and malignant

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9
Q

rubbery mass = what stroma

A

b/t soft and hard stroma status

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10
Q

if malignant @ epithelial tissue

A

carcinoma

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11
Q

if benign @ mesenchymal tissue

A

add -oma suffix

EXCEPTIONS: melanoma, lymphoma, seminoma, hepatoma, astrocytoma

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12
Q

if malignant @mesenchymal tissue

A

add -sarcoma suffix

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13
Q

polyp definition

A

club shaped growth projecting from mucosal surface into lumen of hollow viscus/organ
-bengin epithelial or hyperplasia

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14
Q

hematopoietic cell tumors

A

leukemia
-malignant from bone marrow stem cells
-CLL common for adults and ALL for peds

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15
Q

teratoma definition

A

tumor of 1+ parenchymal cell type so from more than one germ layer
-BUT all cells arise from single clone that can produce multi cell types

i.e. totipotent cells in gonads

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16
Q

non neoplastic lesions with -oma

A

granuloma
hematoma
choristoma

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17
Q

features of malignant tumors

A
  1. rapid growth
  2. no capsule
  3. invasive and metastatic potential
  4. range from well differentiated to poorly
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18
Q

features of sarcomas

A
  1. mesenchymal origin
  2. less common incidence vs carcinoma
  3. hematogenous initial spread
  4. poor prognosis
  5. early presentation

i.e. leiomyosarcoma (smooth m) or rhabdomyoSA (striated m)

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19
Q

features of carcinomas

A
  1. epithelial cell orgin
  2. more common than sarcomas
  3. lymphatic spread initially
  4. better prognosis
  5. late presentation

i.e. squamous cell CA, adenocarcinoma

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20
Q

carcinomas that spread hematogenously

exceptions to normal

A
  1. follicular CA of thyroid
  2. choriocarcinoma
  3. renal cell CA - invades renal vein
  4. hepatocellular CA invades hepatic vein

Four Carcinomas Route Hematogenously

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21
Q

choristoma

A

ectopic rest of normal tissue OR normal tissue in foreign location

ex. pancreatic tissue in mucosa of stomach

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22
Q

hamartoma def

A

disorganized benign mass of indigenous cells to invovled site
-developmental malformation

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23
Q

peutz-jeghers syndrome

A

hereditary intestinal polyposis syndrome aka autosomal dom
-polyps in GI tract and hyperpigmented macules @ lips and oral mucosa

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24
Q

determining B cell clonality

A

by Ig light chain phenotype

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25
determining clonality of other cells
1. glucose 6 phosphate dehydrogenase isoforms 2. androgen receptor isoforms
26
pro-angiogenic factors
1. VEGF 2. bFGF 3. HIF -all are direct, indirect are Ras and myc by promoting
27
anti-angiogenic factors
1. thrombospondin-1 2. angiostatin 3. endostatin 4. tumstatin
28
rate of growth malignant
-rapid growth cancers highly susceptible to chemo
29
differentiation benign
-well differentiated bc only 1-10% are in cell cycle -usually resemble normal mature cells/tissue
30
differentiation malignant
20-80% are in cell cycle so the rest of cells can differentiate varying -may not resemble normal tissues anaplasia (no resemblence to normal tissue) hallmark of high grade malignant tumor
31
indicators of tumor cell growth
1. Ki-67 2. PCNA
32
significance of mitotic figures
the more abnormal the mitotic figures (not metaphase, anaphase, prophase) the more likely malignancy
33
desmoplasia examples
1. diffuse stomach cancer linitis plastica 2. breast cancer 3. prostate cancer 4. cholangiocarcinoma
34
desmoplasia definitions
hyperplasia of activated fibroblasts + production of abundant collagen in stroma
35
recognizing cellular atypia
1. cellular pleomorphism - vary in size and shape 2. nuclear changes/pleomorphism 3. inc ratio of nucleus:cytoplasm (1:1 instead of normal 1:5)
36
atypia definition
structural abnormality in a cell -only in premalignant conditions and malignant tumors
37
cellular polarity
spatial diffs in shape, structure, function of cells -if lost then can't tell up from down of cell
38
P53 normally
1. inhibits VEGF 2. promotes thrombospondin-1
39
recognizing cellular atypia
1. cellular pleomorphism - vary in size and shape 2. nuclear changes/pleomorphism 3. inc ratio of nucleus:cytoplasm (1:1 instead of normal 1:5)
40
role of invasion benign
tumors cells stay attached by adhesion molecules like E. cadherin
41
steps of invasion
1. detachment of tumor cells from each other bc no E-cadherin 2. attachment to matrix by laminin 3. degradation of ECM by tumor cells, fibroblasts, inflamm cells, collagenase/MMP for type IV BM collagen 4. migration of tumor cells by binding fibronectin and secreting motility factor
42
metastatic cascade
1. invasion of BM 2. movement thru ECM 3. vascular dissemination 4. homing
43
role of metastasis malignant
unequivocally marks a tumor malignant -CD44 !!! favors metastasis
44
tumor grading mechanisms
1. conventional - degree of differentiation with H and E stain, mitotic index 2. uptake of BrdU - higher uptake higher grade tumor
45
TNM tumor staging
T = size of primary tumor N = nodal involvement M = distant metaastases
46
cancer incidence
#2 cause of death (heart dz is 1) 1. prostate or breast 2. lung 3. colon
47
primary tumors that metastasis to brain
LUBMECK -lung > breast > melanoma/colon/kidney
48
primary tumors that metastasis to liver
1. colon 2. stomach 3. pancreas
49
primary tumors that metastasis to bone
1. prostate (blastic) and breast (mixed) 2. lung, thyroid, kidney (all lytic)
50
4 grades
1. well differentiated 2. moderately 3. poorly 4. nearly aplastic
51
cervical dysplasia grading
1. mild - confined to basal 1/3 of epi 2. moderate- confined to basal 2/3 of epi 3. severe - more than 2/3 but less than 3/3 4. carcinoma in situ - full thickness dysplasia
52
4 common acquired pre-cancerous conditions
1. oral leukoplakia 2. barret esophagus 3. chornic ulcerative colitis 4. hep B and C
53
gene translocation CML
abl from 9 > bcr on 22 bcr-abl hybrid inc tyrosine kinase activity -philadelphia chromosome
54
gene translocation Burkitt lymphoma
c-myc from 8 > Ig heavy chain on 14 -inc myc protein
55
gene translocation follicular B cell lymphoma
14 > 18 BCL-2 genes prevent mitochondrial leakage of cytochrome c (so no apoptosis)
56
BRAF oncogene
inc serine/threonine kinase -non hodgkin lymphoma, melanoma
57
oral leukoplakia
starts as hyperlasia/hyperkeratosis leads to mild-severe dysplasia ends with squamous cell carcinoma
58
Barretts esophagus progression
glandular metaplasia in lower esophagus > dysplasia > adeoCA of esophagus
59
chronic ulcerative colitis progression
to dysplasia then adenoCa of colon
60
hepatitis infection progression
1. B or C 2. macronodular cirrhosis 3. hepatocellular carcinoma
61
HER2 oncogene
inc receptor tyrosine kinase -breast and gastric carcinoma
62
MYC- L1 oncogene
inc transcription -lung tumors
63
N-MYC oncogene
inc transcription -neuroblatomas
64
RET oncogene
inc receptor tyrosine kinase -medullary thyroid cancer
65
APC
colorectal cancer -normally downregs B-catenin to prevent accumulation -pathologic by WNT signalling
66
p53
most human cancers -activates p21 to block G1 to S phase so apoptosis by BAX -also inhibited by E6 and E7 from HPV
67
VHL
von hippel lindau dz aka renal carcinomas + hemangioblastomas (benign), renal cysts -normally tumor suppressor gene that inhibits HIF-1a
68
RB
retinoblastomas, osteosarcoma, soft tissue sarcoma -blocks G1 to S phase -both alleles inactivated for cancer
69
telomerase role in cancer
telomere shortening and loss of function can activate p53 -expression can be inc by E6
70
psammoma body
1. papillary thyroid carcinoma 2. papillary renal cell carcinoma 3. serous papillary cystadenocarcinoma ovary 4. meningioma 5. malignant mesothlioma concentric spherules with calcification
71
two steps of chemical carcinogenesis
1. initiation by chemicals, perm DNA damage irreversible 2. promotion - induces tumors but not affect DNA itself chems can be direct without transformation or indirection need metabolism
72
UVB and skin cancer
UVB causes DNA damage from pyrimidine dimers -if defective repair enzymes then esp susceptible
73
viral carcinogens
1. HBV encodes HBx that activates growth promoting genes and inhibits p53, also chronic liver injury regen hyperplasia 2. HCV gives chronic liver cell injury and regen 3. EBV = burkitts, hodgkin, nasopharyngeal 4. HPV 16, 18, 31 5. HTLV1 via tax gene 6. HIV 7. HHV-8 kaposi sarcoma
74
bacterial carcinogens
H pylori via CagA cytotoxin -gastric lymphoma MALT, gastric carcinoma
75
key paraneoplastic syndromes
1. cushing syndrome - ACTH, small cell lung carcinoma 2. SIADH - ADH, small cell lun carcinoma 3. polycythemia- EPO, renal cell carcinoma, hepatocellular carcinoma, leiomyoma 4. hypercalcemia - PTHrP, squamous cell carcinoma lung/head/neck
76
IHC markers
1. thyroglobulin = thyroid cancer 2. CD10/CALLA = acute lymphobalstic leukemia 3. placental alkaline phosphatase = seminoma 4. vWF, CD31 = vascular neoplasms
77
epithelial cell markers
cytokeratin or keratin or epithelial membrane antigen (EMA)
78
hormonal carcinogens
estogren contraceptive hormones anabolic steroids
79
mesenchymal origin markers
vimentin or desmin or muscle specific actin
80
neuronal tumor origin markers
neuron specific enolase NSE chromogranin synaptophysin NSE also stains for small cell carcinoma lung and carcinoids

Block 4 Found Sci (67 decks)

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