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50 Cards in this Set
- Front
- Back
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What are the hallmarks of cancer?
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- Evasion of apoptosis
- Growth signal self-sufficiency - Anti-growth signal insensitivity - Sustained angiogenesis - Limitless replicative potential - Tissue invasion - Metastasis |
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What is the organization of normal epithelial cells in relation to the basement membrane?
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Normal cells with basal → apical differentiation
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What is the organization of epithelial cells in relation to the basement membrane undergoing hyperplasia?
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Cells ↑ in number
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What is the organization of epithelial cells in relation to the basement membrane undergoing dysplasia?
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Abnormal proliferation of cells with loss of size, shape, and orientation
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What is dysplasia?
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Abnormal proliferation of cells with loss of size, shape, and orientation
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What is the organization of epithelial cells in relation to the basement membrane undergoing carcinoma in situ?
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- Neoplastic cells have not invaded basement membrane
- High nuclear / cytoplasmic ratio and clumped chromatin - Neoplastic cells encompass entire thickness |
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What is the organization of epithelial cells in relation to the basement membrane undergoing invasive carcinoma?
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- Cells have invaded basement membrane using collagenases and hydrolases (metalloproteinases)
- Can metastasize if they reach a blood or lymphatic vessel |
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What is the mechanism by which cells invade the basement membrane in invasive carcinoma?
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Collagenases and Hydrolases (Metalloproteinases)
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What is necessary for cancerous cells to metastasize?
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If they reach a blood or lymphatic vessel
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What is the organization of epithelial cells in relation to the basement membrane undergoing metastasis?
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Spread to distant organ
- Must survive immune attack - Seed and soil theory of metastasis |
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What is the "seed" in the seed and soil theory of metastasis?
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Tumor embolus
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What is the "soil" in the seed and soil theory of metastasis?
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Target organ: liver, lungs, bone, brain, etc
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What is the multidrug resistance protein 1 (MDR1)?
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P-glycoprotein
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What is P-glycoprotein also known as? What cells express this?
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AKA Multidrug Resistance Protein 1 (MDR1)
- Expressed by some cancer cells (eg, colon, liver) |
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What is the function of P-glycoprotein?
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Pumps out toxins, including chemotherapeutic agents (one mechanism of ↓ responsiveness or resistance to chemotherapy over time)
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What is the term for an ↑ in the number of cells?
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Hyperplasia
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What is the term for an adult cell type being replaced by another? Cause?
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Metaplasia
- Caused by irritation (eg, Barrett esophagus) and/or environmental exposure (eg, smoking-induced tracheal/bronchial squamous metaplasia) |
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What is the term for abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation?
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Dysplasia
- Commonly preneoplastic |
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What is the term for the loss of structural differentiation and function of cells, resembling primitive cells of the same tissue?
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Anaplasia
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What happens in Anaplasia? What is it associated with?
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- Loss of structural differentiation and function of cells, resembling primitive cells of same tissue
- Often equated with undifferentiated malignant neoplasms - May see giant cells with single large nucleus or several nuclei |
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What is the term for a clonal proliferation of cells that is uncontrolled and excessive?
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Neoplasia
- Benign of malignant |
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What is the term for fibrous tissue formation in response to neoplasm?
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Desmoplasia
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What is an example of Desmoplasia?
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Linitis plastica in diffuse stomach cancer
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What determines the tumor grade?
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Determined by degree of cellular differentiation and mitotic activity on histology
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What do the tumor grades mean?
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Graded 1-4:
- 1 = low grade, well differentiated - 4 = high grade, poorly differentiated, anaplastic |
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Which has more prognostic value: tumor grade or stage?
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Tumor stage has more prognostic value
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What determines the tumor stage?
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Stage = Spread
- Degree of localization / spread based on site and size of primary lesion, spread to regional lymph nodes, and presence of metastases - Based on clinical (c) or pathology (p) findings |
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What is the tumor staging system?
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- T = Tumor size
- N = Nodal involvement - M = Metastases TMN each has independent prognostic value |
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What is the difference between carcinoma and sarcoma?
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Both imply malignancy
- Carcinoma: epithelial origin, spreads lymphatically - Sarcoma: mesenchymal origin, spreads hematogenously |
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Which type of malignancy originates from epithelial tissue?
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Carcinoma
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Which type of malignancy originates from mesenchymal tissue?
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Sarcoma
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Which type of malignancy spreads hematogenously?
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- Sarcomas
- Renal cell carcinoma (renal vein invasion), hepatocellular carcinoma (hepatic vein invasion), follicular carcinoma of the thyroid, and choriocarcinoma |
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Which type of malignancy spreads lymphatically?
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Carcinomas (exception: renal cell carcinoma, hepatocellular carcinoma, follicular carcinoma of thyroid, and choriocarcinoma spread hematogenously)
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What are the types of benign epithelial tumors?
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Adenoma and Papilloma
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What are the types of malignant epithelial tumors?
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Adenocarcinoma and Papillary Carcinoma
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What are the types of malignant blood cell tumors?
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Leukemia and Lymphoma
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What are the types of benign blood vessel tumors?
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Hemangioma
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What are the types of malignant blood vessel tumors?
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Angiosarcoma
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What are the types of benign smooth muscle tumors?
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Leiomyoma
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What are the types of malignant smooth muscle tumors?
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Leiomyosarcoma
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What are the types of benign striated muscle tumors?
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Rhabdomyoma
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What are the types of malignant striated muscle tumors?
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Rhabdomyosarcoma
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What are the types of benign connective tissue tumors?
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Fibroma
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What are the types of malignant connective tissue tumors?
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Fibrosarcoma
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What are the types of benign bone tumors?
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Osteoma
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What are the types of malignant bone tumors?
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Osteosarcoma
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What are the types of benign fat tumors?
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Lipoma
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What are the types of malignant fat tumors?
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Liposarcoma
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What are the typical characteristics of benign tumors?
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- Usually well differentiated
- Low mitotic activity - Well demarcated - No metastasis - No necrosis |
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What are the typical characteristics of malignant tumors?
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- May be poorly differentiated
- Erratic growth - Locally invasive / diffuse - May metastasize - ↓ Apoptosis (upregulation of telomerase prevents chromosome shortening and cell death) |
