Hallmarks Of Cancer Pt. 2

Front 1

What is the organ?
Describe what you see.

Back 1

Lung
Subpleural, variegated tan, white, and black mass, with partially rounded margins, invading the visceral pleaura creating a bulge

Front 2

Organ?
Describe what you see.
Diagnosis?
What is the other process going on?

Back 2

Lung
Irregularly shaped glandular structures lines by cells with large hyper chromatic nuclei and separated by BROAD BANDS of FIBROUS TISSUE
Lung primary adenocarcinoma
Desmoplasia

Front 3

Describe the transformations you see.
What is the other name for pulmonary adenocarcinoma in situ?

Back 3

Bronchioalveoloar carcinoma (BAC)

Front 4

Describe what you see.

Back 4

Yellow = lipid
Red = blood/angiogenesis?
8cm, partially rounded, variegated yellow, gold, tan, and red mass invading the kidney laterally

Front 5

What is the organ?
Describe what you see.
Why is the cytoplasm clear?

Back 5

Kidney
Cells with small round hyper-chromatic nuclei and abundant clear cytoplasm, making some attempt to form tubules, with lots of little blood vessels all around.
Lipid that makes the tumor yellow

Front 6

What is the most common type of adenocarcinoma?
Why would a higher percentage in non-smokers, young patients, women, and Asians be adenocarcinomas?
Why would a higher percentage of lung cancers in the periphery of the lungs be adenocarcinomas?

Back 6

Squamous cell carcinoma
Smokers = introduction of filter cigarettes (trap large particles that carry carcinogens to central airway but do not trap small particles that carry carcinogens out to the periphery)
Non-smokers = air pollution has small particles that could also carry carcinogens to the lung periphery

Front 7

True or false.
Cancer is a multi-step process of accumulating genetic alterations that usually takes many years.
What are the multiple steps leading to lung pulmonary adenocarcinoma?

Back 7

TRUE
Hyperplasia, dysplasia, carcinoma in situ

Front 8

What is the precursor to pulmonary adenocarcinoma in situ?

Back 8

Atypical adenomatous hyperplasia (AAH)

Front 9

Is AAH the same as dysplasia?
What is dysplasia in the breast also called?

Back 9

Yes!
"atypical hyperplasia"

Front 10

Lung primary adenocarcinoma can have EGFR mutation conferring responsiveness to tyrosine kinase inhibitor erlotinib, which can be ruined by...

Back 10

RAS mutation

Front 11

EGFR mutation is present in 10-15% of lung primary adenocarcinomas, conferring responsiveness to tyrosine kinase inhibitor erlotinib, but what mutation is present in 20-30% conferring resistance to erlotinib?

Back 11

KRAS mutation

Front 12

What is the guard at the G1-S checkpoint?

Back 12

Rb protein

Front 13

What is known as the "guardian of the genome?"
What does it do?
Does it have a long or short half-life?

Back 13

p53
Prevents propagation of genetically damaged cells
Binds to DNA
Arrests cell cycle for DNA repair
Initiates apoptosis if repair impossible

Very short half-life (20 minutes) ended by ubiquitin proteolysis

Front 14

With regard to p53, what is seen in 70% of tumors?
What is a resistance mechanism?
What is response to chemoradiotherapy mediated by?

Back 14

Bi-allelic loss
Increased MDM2 or E6 protein of HPV (both degrade p53)
p53

Front 15

Normal p53 resists tumor angiogenesis by inducing synthesis of ...?

Back 15

Thrombospondin-1 (TSP-1)

Front 16

Kidney tumors are a component of which hereditary cancer syndrome?

Back 16

Von Hippel Lindau (VHL)

Front 17

What would a germline mutation of VHL cause? Specific cancers.

Back 17

Kidney cancer, phreochromaocytoma (adrenal medulla tumor), retinal angioma and other tumors with second hit mutations

Front 18

What determines which cancer cells metastasize? Millions are release for each one that metastasizes.

Back 18

The ones with "metastaic oncogenes" such as SNAIL and TWIST that promote down regulation of E-cadherin expression, among other things.

Front 19

What are the characteristic patterns of metastases due to?
What are two typical patterns?

Back 19

Drainage pathways and organ tropism
Colon --> liver
Prostate and breast --> bone

Front 20

What determines organ tropism?

Back 20

Differential concentration of endothelial cell ligands for adhesion molecules in different organs.

Chemokines (CXCR4 and CCR7 receptors in breast cancer)

Front 21

What are gatekeeper and caretakers?

Back 21

Gatekeeper genes directly control tumor growth
Caretaker genes affect genetic stability by e.g. causing defective DNA repair

Front 22

What are some hereditary syndromes due to defects in DNA repair?

Back 22

BRCA-1 and BRCA-2
Hereditary non-polyposis colon cancer syndrome
Xeroderma pigmentosum
Ataxia telangiectasia
Bloom syndrome
Fanconi anemia