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135 Cards in this Set

  • Front
  • Back
Main difference between benign and malignant
malignant can metastasize
what is the most common benign tumor of women, and in which organ of a female?
leiomyomas (fibroid, tumor of smooth muscle) and located in the uterus
most common benign tumor of a male?
lipoma
benign tumor of glands
adenoma
Benign tumors are of what tissue origin?
epithelial or CT origin
this class of tumor is derived from ectoderm, endoderm and mesoderm?
teratoma
This class of cancer derives from squamous, glandular or transitional epithelium?
Carcinoma
This class of cancer is derived from connective tissue (mesenchymal tissue)?
sarcoma - e.g. osteogenic sarcoma (cod-mans triangle and sunburst
This structure is a non-neoplastic overgrowth of tissue.
Hamartoma
benign tumor of glands is called?
adenoma
If this tumor was making cortisol what it cause?
Cushing syndrome and cause atrophy of the zona fasciculata (cortisol) and reticularis (sex hormones) because it would suppress ACTH
IF a tumor of the adrenals releases mineralcorticoids what will it do the adrenal gland?
conns syndrome-causes atrophy of zona glomerulosa
most common precursor lesion of colon cancer?
Tubular adenoma
Benign and maligant version of the skin cancer
Nevus and melanoma (of neural crest origin)
Little girl presents w/ mass of the vagina and they took a biopsy, it was vimetin and kertain negative and desmin positive, DX
briano rhabomyosarcoma (striated muslce cancer) - most common sarcoma of little children, presents in the penis of boys
This is a cancer of smooth muscle what is it called?
Leiomyosarcoma
Cancer of fat?
liposarcoma (malignant of mesechymal tissue)
VHY***
Most common cancer of the parotid gland?
Mixed tumors - neoplastic cells have two different morphologic patterns but dervie from the same germ cell layer***
6 yr old girl of right lower quadrant pain, X-ray shows calcifications of the pelvic area,DX?
teretoma - also called germ cell tumors
ON EVERY BOARDS
picture of hypersegmented neutrophils, DX

other is a picture of auer rod in a myeloblast?
B12 and folate deficeincy

M3 - for leukemia
malignancy of stem cells of the bone marrow and can metastasize out of it, hepatosplenomegaly and lymph nodes an
Leukemia
These malignancy arise in the lymph nodes and metastasize out of it, they may go to the bone?
Lymphoma
what is the most common site of a lymphoma not developing in a lymph node (extranodal lympoma) what can produce them?
Stomach

H. PYlORI can produce them
what is the 2nd most common place that lymphoma can arise if not from a typical lymph node?
pyers patches in the terminal ileum
Most common of the lymphoma, what is the translocation
follicualr cell lympohoma
14;18 transolocation causes the B cells to inactivate the apoptotic gene
THIS IS ON EVERY EXAM
PICTURE that looks like a cluster of grapes. A patient history like this...preeclampsia (HTN, protein uria), snow storm effect on ultrasound, DX
hydatidform mole (benign tumor of chorionic villi)

complete mole (most likley to become choriocarcinoma)
what are the layers that oxygen diffuses through in the chorionic villi to get to the fetal circulation?
synscotrophoblast

cytotrophoblst...then wortens jelli in the chorionic villus then little vessel in the middle of the vessel theat becomes the umbilical vein

meschymal tisssue

vascular endothelium
which of layers of the placenta makes hormones, what are the important ones?
SYNCIOTROPHOBLAST

beta-hCG, Human placental lactogen (growth hormone of pregnancy)
Choriocarcinoma, are mestastatic cancers of what tissue, where do they metastisize to and what is the best treatment?
Synscotrophblast and cytotrophoblast

LUNG

RESPOND VERY WELL TO CHEMO W/ almost 100% remission.
hyperplatic polyps and peutz-Heghers polyp are considered what type of tissue growth
hamartomas
CHoristoma (heterotopic rest) is a, meckels diverticulum is a common example
non-neoplstic normal tissue in a foreign location
Signs of malignancy
atypical mitotic spindles and anueploid (abnormal number of chromosomes)

longer cell cycle than what they came from.
how many doulbling times does it take to detect a tumor clinically
30X
malignant celles characteristics
lack adhesion, simple anerobic metabolism, lots of enzymes (proteazes and collagenase to break through tissue)
Three modes of metastasis?
hematogenous

seeding

lymphatics
cacinomas first metastasize by what route?
lymphatics frist

can also go by hematogenous spread
sarcomas spread by what route
Hematogenous - thats why lung and bone so common.
what is seeding?

what type of cancer frequently spreads by this route?
when malignant cells exfoliate from a sruface and immplant and invade tissue in a body cavity

cancers that are in cavities (like ovarian cancers (cyst/serousadenocarcinoma), most are surface derived, so its easy for them to send out malignant seeds like to the omentum)
VHY***
what you feel on a Rectal in a women is analagous to what structure in men? why is this an important area in women?
most dependent part of a women, were endometrial implants, blood pools and seeding goes from cancer
Most common priamry maligancy of the brain, how does it spread?
Glioblastoma multiforme commonly seeds the cerrebrospinal fluid...causing spread to the brain in
when asking about cancer to an organ think is primary or metastasize most common to this area: lung, kidney, bone, batson system
LUNG MC- mets from the breast

kidney - MC is a primary renal cell carcinoma

Bone - MC is mets from the breast to the vertebral column
What is responsible for transporting malignancies to the vertebral column?
Batson system (venous network)
1st and 2nd most common bones to be effectd by malignancy?
vertebral column

2nd - head of the femur
most common organ to lymphasize too?
lymph node
what is the most common cancer to metasatize to the liver?
lung

2nd most common is colon
where does testicular cancer metastasize to?
para-aortic lymph nodes-because they originate to there during development
left supraclavicular node (virchow), most common primary caner?
mets from the stomach (weight loss and epigstric distress)
what cancer causes lytic bone lesions? why, what blood chemistry will be elevated?
Multiple myeloma

all malignant plasma cells have IL-1, (osteoclast activating factor), Calcium from breaking down bone
what cancer causes bastic change to bone,what enzyme will be elevated?
prostate cancer - alkaline phosphatase
80 yr old man w/ lower lumbar pain and point tenderness, what is your frist step in managment?
DRE - its the cheapest and the easiest
what do you do to look for mets in spine?
radionucleotide bone scan
most common cancer of brain?
mets from the lung
most common cancer of the lung?
mets from the breast is most common
steps of oncogenesis
1. Mutation
2. Make multiple copies, dividing
3. Progression/subspecialiation (different cancer cells have different functions all the purpose to kill you: invasion, spread, resistance...)
what are the two big sets of genes involved in cancer?
1. Proto-oncogenes - involved in normal growth receptors, those that send messanges and repair

2. Suppressor genes (anti-oncogenes)-protect from unregulated cell grwoth

3. Anti-apoptosis genes (BCL2)

4.Apoptosis (BAX gene)
In which way are RAS and TP53 mutated?
point mutations
what are the differnt types of mutations
translocation
amplification
point mutations
**ON EVER BOARD**
acute progranulocytic lukemia occured as a result of what type of mutation in its genes.

What is the treatment for this cancer?
t(15;17)

retinoic acid - causes the blasts to mature
B cell lymphoma involves what type of mutation
t(14;18)
the cancer chronic myelogenous leukemia, involves what type of proto-oncogene and mutation?
ABL proto-oncogene w/ a mutation being a traslocation of 9;22 the chromosome is 22 the philadelphia chromosome
what is the oncogenesis of brukitts lymphoma?
8; 14 translocation of the proto-oncogene MYC

Has a strong correlation w/ Epstein Barr-virus - it hooks into CD21 receptor and causes bell cells to become plasma cells (multiple division result in a mutation)
what is the important anti-oncogenes (suppresor genes) that when mutated causes leukemia, lung, colon and pancreatic cancer?
RAS - when it has a point mutation it no longer protects against un-regulated growth
what is the antioncogene associated w/ familial polyposis (colorectal cancer)?
APC
what is the anti-oncogene associated w/ breast, ovary, and prostate cancers?
BRCA1/BRCA2 (two is only associated w/ breast cancer)
what is the anti-oncogene associated w/ wilms tumor
WT1
what is the role of TP53
it inhibits G1 to S phase so that DNA can be repaired

if the DNA is damaged to bad then it activates BAX an apoptotic gene
Lung, colon, breast carcinomas, Li-Fraumeni syndrome (breast, brain, leukemias and sarcomas) are associated w/ this anti-oncogene?
TP53
Treating H. pylori reduces the risk of developing what two types of cancer?
adenocarcinoma and lymphoma
what is the most common type of mutation in cancer?
point mutation
what are teh carcinogenic agents and which is the most common?
Chemical carcinogens (MC)

Microbes (viruses)

Radiation
what is the most important way to decrease your risk of cancer
stop smoking
Cancers caused by smoking
mouth, larynx, lungs, pancreas, bladder, colon, leukemias, and cervical...
most common casuse of transitional cell carcinoma of the bladder?
smoking
patient working in the dye industry develops transitional cell carcinoma of the bladder what is the cause?
Aniline dye
VHY***
Patient is being treated for wegeners granulomatosis and they develop hematuria, on cytology you see abnormal cells what is the cause?
cyclophosphamide - the drug that is being used to treat the wegeners

use mesna to prevent hemorrhagic cystitis
what are the lung cancer that are most most often associated w/ smoking and the mains stem bronchus?
small cell and SCC
non pruritic raised lesions what is cancer and the virus associated w/ this?
kaposis sarcoma - herpes 8
epstein barr virus is associated w/ what cancer in the chineese population?
nasopharangeal carcinoma
common cancer of southeast asia?
hepatocellular carcinoma - aflatoxin B and cirrhosis are the cause
The primary increase in primary CNS lymphoma is attributable to?
HIV
Human papilloma virus causes what 4 cancers
Cervical, vaginal, vulvar and anal SCC of homosexulas...16 and 17 knock of TP53 (E6) and retinoblastoma (E7)
most common cancer associated w/ radiation (ionizing radiation)
leukemia-chronic myelogenous leukemia (MC)
t(9;22) ABL
patient had prior radiation, and presents w/ non-tender nodule in the neck is what DX?
Papillary thryoid cancer
which medical profession is most likley to get acute leukemia
radioligist
what is the most common caner associated w/ UV light?
basal cell carcinoma from non-ionizing UVB radiation
what heavy metal is associated w/ arsenic?
skin cancer
retinoblastoma cancer is found on what chromosome?
chromosome 13 - RAS
most common cause of white eye reflex?
congenital cataracts
This patient is pre-disposed to all types of skin cancer when they go out in the sun, DX? what is the problem they have?
xeroderma pigmentosa- defect in repair enzymes
wiscott aldrich, ataxia telangiectasias, and fanconis syndrome all have what as there underlying problem?
defects in repairing DNA
cancers of the upper lip vs the lower lip are usually? (GENERAL RULE)
upper - basal cell carcinoma

lower - SCC
what is the only bacteria that can cause cancer? what are the two cancers it can cause
H. Pylori

adenocarcinoma and low grade malignant lymphoma
what is the most common cause of death in cancer?
Gram-negative sepsis
what is the most common paraneoplastic syndrome (distant effects of a cancer that are unreleated to metastsis)?
HYpercalcemia
VHY***
what is the most effective host defense against cancer?
Cytotoxic CD8 T cells
what does grade mean?
degree of differentiation (what it looks like)
Staging system TNM system (goes from least to most important)
T-size (how big it is)>2cm has a chance for metastazing

N-nodes

M-metastasize (most important)
What is the more important in prognosis, the grade or the stage?
STAGE
patient had prostate cancer which has the worse prognosis, someone w/ mets to the lymph nodes, cancer spread to the seminal vesicles or someone w/ spread to the bone?
BONE - remeber M is the worst of all
what is the cause of cachexia?
tumor necrosis factor alpha, it is irrevesible and TP
most common anemia in cancer
anemia of chronic disease
VHY***
patient has painless jaundice, left supraclavicular node, light colored stools and peculiar lesions in the vein that jump from one part of the body to another, DX? (trouseas sign)
superficial migratory thrombophlebitis of patient w/ pancreatic cancer of the head of the pancreas.

NOTE: most disseminanted cancers produce a hypercoagulable state
most common cuase of a fever in cancer patient?
gram negative infection, most common cause of death in cancer patients
Patient has mets to the bone causing lysis of bone and hypercalcemia. Another patient has lung cancer or renal cell cancer that produces Parathyroid like hormone and causes hypercalcemia which scernaria is a paraneoplastic syndrome?
PTH-like hormone

The idea is to recognize theses so that you can prevent spread
Acanthosis nigracans and
seborrheic keratosis (leser-Trelat sign) that pops up over night is a sign for what?
paraneoplastic marker for underlying gastric adenocarcinoma
Hypertrophic osteoarthropathy (clubbing) is associated w/ what cancer?
Bronchogenic carcinoma

results from periosteal reasction of distal phalynx
dermatomyositis high serum CK
luekemias,
Nonbacterial thrombotic endocarditis (sterile vegitations on the mitral valve) is associated w/ what cancer?
Mucus-secreting pancreastic and coloretal cancers

They can embolize

Tell the difference from rheumatic fever based on history
patient has myasthenia gravis-like symptoms (muscle weakness), what cancer is this associated w/?
Small cell carcinoma of the lung (Eaton lambert syndrome)
What is the associated cancer w/ the follwoing findings:
Ectopic ACTH/cushing syndrome or ADH (hyponatremia)
small cell carcinoma of the lung

neural crest origin, see neural secretory granules on EM.
What is the associated cancer w/ the follwoing findings:
PTH-related protein/hypercalcemia or erythropoeitin
Renal adenocarcinoma
What is the associated cancer w/ the follwoing findings:
erythopoeitin or insulin-like factor (hypoglycemia)?
Hepatocellular carcinoma
What is the associated cancer w/ the follwoing findings:
Hypocalcemia or cushings, rare tumor where the tumor marker can be converted to amyloid?
medullary carcinoma of the thyroid

calcitonin can be converted to amyloid
What two tumor markers do you always get when a male has a testicular cancer?
alpha feta protein (AFP) - yolk sac tumor/endodermal sinus tumor

hCG
AFP is also elevated in what other syndromes
hepatocellular and open nueral tube defects

AFP is decreased in down syndrome
when do you see bence Jones proteins? what is it?
Multiple myeloma or Waldenstroms macroglubulinemia

Represents light chains in the urine
PSA is elevated in what cancer
not specific for prostate cancer (because also elevated in hyperplasia) but it is sensetive
CA 125 is elevated in what cancer?
surface derived ovarian cancer
CA 15-3 is elevated in what cancer?
Breast cancer
CEA (carcinoma embryonal antigen) is elevated in what cancer
colon cancer
CEA can be the antigen part of immune complex that deposits in the kideny, what does it cause?
diffuse membranous glomerulonephritis (nephrotic syndrome)
women who you think has a mole or trophoblastic tumor what lab would you check for?
beta-hcG
most common primary tumor of the brain in kids?
cerebellar cystic astrocytoma
most common primary cancer of the brain?
medulloblastoma - arises from the cerebellum
Most common childhood cancer
leukemia - ALL
Incidenc of women cancer?
1. breast
2. lung
3. colon
Incidence of men cancer?
1.prostate
2.lung
3.colon
Most common cancer killer in adults
Lung
Most common cancer killer of women
1. lung
2. breast
3. colon
Most common cancer killer of men
1. lung
2. prostate
3. colon
2nd most common cancer overall and cancer killer in men and women when you add them together?
colon
most common cause of positive guiac stool after 50?
colon cancer
most common gyn cancer
1. endometrial
2. ovarian
3. cervix (least common because of pap smear)
most common cancer killers of women
ovarian
cervix
endometrial
VHY****
only tumor vaccine?
hepatitis B - commonly transmitted by accidental needle stick

protected from Hep D because needs B to infect you

hepatocellular carcinoma dosne't develop because of this vaccine because you don't get Hep B.