Fa Pathology: Neoplasia

Front 1

What neoplasm is associated with the following disease conditions...

1. Down Syndrome?
2. Xeroderma Pigmentosum?
3. Cirrhosis (alcoholic, hep B or C)?
4. Immunodeficiency states?
5. AIDS?

Back 1

1. Acute Lymphoblastic Leukemia (We ALL fall DOWN)
Acute myeloid leukemia

2. Melanoma and basal squamous cell carcinomas of the skin

3. hepatocellular carcinoma

4. malignant lymphomas

5. Aggressive malignant lymphomas (Non Hodgekins) and Kaposis Sarcoma

Front 2

What neoplasm is associated with the following disease conditions...

1. Chronic atrophic gastritis, pernicious anemia, post surgical gastric remnants?
2. Tuberous sclerosis (facial angiofibroma, seizures, mental retardation)?
3. Actinic Keratosis?
4. Barrett's Esophagus (chronic Gi reflux)?
5. Plummer -Vinson Syndrome (strophic glossitis, esophageal webs, anemia- all due to iron deficiency)?

Back 2

1. Gastric adenocarcinoma

2. astrocytoma and cardiac rhabdomyoma

3. squamous cell carcinoma of the skin

4. esophageal adenocarcinoma

5. squamous cell carcinoma of esophagus

Front 3

What neoplasm is associated with the following disease conditions...

1. ulcerative colitis?
2. Paget's disease of Bone?
3. Autoimune diseases (Hashimotos, thyroiditis, MG)?
4. Ancothosis nigricans (hyperpigmentation and epidermal thickening)?
5. Dysplastic nevus?

Back 3

1. colonic adenocarcinomas

2. 2ndary osteosarcoma and fibrosarcoma

3. benign and malignant thymomas

4. visceral malignancies (stomach,lung, breast, uterus)

5. malignant melanoma

Front 4

What tumors are associated with the activation of the following Oncogenes...?

1. c-myc

2. L-myc

3. N-myc

Back 4

1. Burkitt's Lymphoma

2. Lung tumor

3. neuroblastoma

Front 5

What tumors are associated with the activation of the following Oncogenes...?

1. bcl-2

2. erb-B2

3. ras

4. ret

Back 5

1. follicular and undifferentiated lymphomas (inhibit apoptosis)

2. breast, ovarian and gastric carcinomas

3. colon carcinomas

4. Multiple Endocrine neoplasia (MEN) type I and II

Front 6

What tumors are associated with inactivation of the following Tumor suppressor genes...? Name the chromosomal location of each.

1. Rb
2. BRCA1 and 2
3. p53
4. APC
5. WT1

Back 6

1. 13q; Retinoblastoma, osteosarcoma

2. 17q, 13q; Breast and Ovarian cancer

3. 17p; Most human cancers, Li-Fraumeni Syndrome

4. 5q; colorectal cancer

5. 11q; Wilms Tumor

Front 7

What tumors are associated with inactivation of the following Tumor suppressor genes...? Name the chromosomal location of each.

1. NF1
2. NF2
3. DPC
4. DCC

Back 7

1. 17q; Neurofibromatosis type 1

2. 22q; Neurofibromatosis type 2

3. 18q; Pancreatic cancer

4. 18q; colon cancer

Front 8

What cancers are assocaited with the following Oncogenic viruses...?

1. HTLV-1
2. HBV, HCV
3. EBV
4. HPV
5. HHV-8

Back 8

1. adult T-cell leukemia

2. Hepatocellular carcninoma

3. Burkitt's Lymphoma; nasopharyngeal carcinoma

4. cervical carcinoma (16,18); penile/anal carcinoma

5. Kaposis's sarcoma, body cavity fluid B-cell lymphoma

Front 9

What organs do the following chemical carcinogens usually affect and how...?

1. Aflatoxins
2. vinyl chlorides (plastics industry)
3. Nitrosamines
4. Asbestos
5. Arsenic
6. CCl4
7. Naphthalene(aniline)dyes

Back 9

1. liver- hepatocellular carcinoma
2. liver - angiosarcoma
3. esophagus, stomach
4. lung - mesothelioma and bronchgenic carcinoma
5. skin - squamous cell carcinoma
6. liver - centrilobular necrosis, fatty change
7. bladder - transtional cell carcinoma

Front 10

Describe Squamous Cell Carcinoma

Back 10

very common; commonly appears on hands and face

locally invasive but rarely metastisizes

associated with excessive exposure to sunlight and arsenic

histopathology --> keratin pearls

Actinic keratosis is a precursos to squamous cell carcinoma

Front 11

Describe Basal Cell carcinoma

Back 11

most common in sun exposed areas of the body

locally invasive but almost never metastisizes

gross pathology --> pearly papules

basal cell tumors have "palisading" nuclei

Front 12

Describe Melanoma

Back 12

common tumor w/ significant risk of metastasis

assoc. with sunlight exposure; fair skinned individuals are at increased risk

depth of tumor correlates with risk of metastasis

dysplastic nevus is a precursor to melanoma

Front 13

Describe Ewing's Sarcoma

Back 13

anaplastic small blue cell malignant tumor

most common in boys <15 years

extremely aggressive w/ early metastasis, but responsive to chemo

Characteristic onion skinning appearance in bone ("going out for eWINGS and ONION rings")

commonly appears in the diaphysis of long bones, pelvis, scapula, and ribs

due to 11,22 translocation

Front 14

Describe Osteosarcoma (osteogenic carcinoma)

Back 14

Most common primary malignant tumor of bone

peak incidence in males 10-20 yrs

Predisposing factors include Paget's disease of Bone, bone infarcts, radiation, and familial retinoblastoma

Commonly found in the metaphysis of long bones

Codman's triangle (from elevation of periostium) seen in X-ray

Front 15

Describe the paraneoplastic affects of the following tumors...?

1. Small cell lung carcinoma

2. Small cell lung carcinoma and intracranial neoplasms

3. Small cell lung carcinoma, renal cell carcinoma, breast carcinoma, multiple myeloma, and bone metastasis

Back 15

1. Cushing's Syndrome due to ACTH or ACTH-like peptide

2. SIADH due to ADH or ANP

3. Hypercalcemia due to PTH related peptide, TGF-B, TNF-a, IL-1

Front 16

Describe the paraneoplastic affects of the following tumors...?

1. Renal Cell carcinoma

2. Thymoma, bronchogenic carcinoma

3. leukemias and lymphomas

Back 16

1. polycythemia caused by erythropoietin

2. Lambert-Eaton Syndrome (muscle weakness) caused by antibodies against presynaptic Ca++ channels at neuromuscular junction

3. Gout, urate neuropathy due to Hyperuricemia due to excess nucleic acid turnover

Front 17

What tumors metastasize to BRAIN?

Back 17

Over 50% of brain tumors are due to metastasis

Lung
Breast
Skin (melanoma)
Kidney (renal cell carcinoma)
GI

"Lots of Bad Stuff Kills Glia"

Front 18

What tumors metastasize to LIVER?

Back 18

lung and liver are most common sites of metastasis after the lymph nodes

Colon
Stomach
Pancreas
Breast
Lung

"Cancers Sometimes Penetrate Benign Liver"

Front 19

What tumors metastasize to BONE?

Back 19

Metastasis from breast and prostate are most common; Metastatic bone tumors are much more common that primary bone tumors

Breast
Lung
Thyroid, Testes
Kidney
Prostate

"BLT with a Kosher Pickle"

Front 20

How are the following markers used in the diagnoses of tumors...?

1. PSA (prostatic acid phosphatase)

2. CEA

3. S-100

4. Alkaline Phosphatase

Back 20

1. prostate specific antigen. Used in screening for Prostatic Carcinoma

1.Carcinoembryonic Antigen. very nonspecific but produced in about 70% of colorectal and pancreatic cancers; also produced by gastric and breast carcinomas

3. marker of melanoma, neural tumors, astrocytomas

4. marker for metastasis to bone, obstructive bilary disease, Paget's disease of Bone

Front 21

How are the following markers used in the diagnoses of tumors...?

1. a-fetoprotein
2. B-hCG
3. CA-125
4. Bombesin
5. TRAP

Back 21

1. normally made by the fetus; marker of hepatocellular carcinomas and nonseminomatous germ cell tumors of testis

2. Hydatidiform moles, Choriocarcinomas, and gestational trophoblastic tumors

3. ovarian, malignant epithelial tumors

4. neuroblastoma, lung and gastric cancer

5. tartrate-resistant acid phosphatase; hairy cell leukemia (B Cell neoplasm)