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64 Cards in this Set
- Front
- Back
cancer cachexia
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wasting syndrome; progressive loss of body fat, lean body mass, weakness, anorexia, and anemia; IL1 and IFNg synergize with TNF; increase catabolism of muscle and fat
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paraneoplastic syndromes
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symptom complexes in ca pts that cannot be explained either by local or distant spread or by elaboration of hormones indigenous to tissue from which tumor arose; in 10%; first sign of occult ca; may mimic metastatic dz
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endocrinopathies (ectopic hormone production)
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cushing syndrome
SIADH hypercalcemia carcinoid syndrome polycythemia hypocalcemia |
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cushing syndrome
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most common; small cell ca of lung; pancreatic ca and neural tumors; mech: excessive production of ACTH, ACTH like peptides
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Syndrome Inappropriate ADH secretion (SIADH)
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small cell ca of lung, intracranial neoplasms
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hypercalcemia
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squamous cell ca of lung; breast, renal, ovarian, adult T cell leukemia/lymphomas; mech: PTHRP, IL1, TNFa, TGFa
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hypoglycemia
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fibrosarcomas, other sarcomas, hepatocellular ca; mech: secretion of insulin and insulin like substance
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carcinoid syndrome
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bronchial carcinoid, pancreatic and gastric ca,
mech: secretion of serotonin, bradykinin |
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polycythemia
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renal cell ca, cerebellar hemangioma, hepatocellular ca; mech: secretion of EPO
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hypocalcemia
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medullary ca of thyroid, seen in osteoblastic metastasis (lung, prostate, and breast)
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paraneoplastic syndromes
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nerve and muscle syndrome
dermatologic disorders ossesus, articular, and soft tissue changes vascular and hematologic changes renal dysfunction |
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nerve and muscle syndrome
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myasthenia gravis: thymomas*, breast and lung ca
disorders of central and peripheral NS--breast Ca eton lambert--small cell ca |
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dermatologic disorders
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acanthosis nigricans--seen in gastric, lung, and uterine determatomyositis (bronchogenic and breast)
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ossesus, articular, and soft tissue changes
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hypertrophic osteoarthropathy and clubbing of fingers--bronchogenic ca
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vascular and hematologic changes
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venous thrombosis (trousseau's phenomenon) noted in deep seated cancers, eg pancreatic; non bacterial thrombotic endocarditis (advanced ca), anemia
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renal dysfunction
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nephrotic syndrome
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radiation changes can mimic...
bone healing can mimic... |
carcinoma
osteosarcoma |
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frozen section
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fresh or in saline
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light microscopy
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in 10% neutral buffered formalin
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immunofluorescence
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in saline or michel's fixative
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molecular studies:
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RPMI
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electron microscopy
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glutaraldehyde
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trichrome
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stains fibrous tissue green
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periodic acid schiffs (PAS)
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stains glycogen and fungi pink
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gomori methanamine silver (GMS)
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stains fungi black
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acid fast bacilli (AFB)
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stains acid fast bacilli red
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iron stain:
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stains iron blue
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oil red O
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fat stain; red
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immunoperoxidase staining
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more sensitive, permanent prep, can be performed on paraffin embedded tissue
demonstrates presence of antigens in tissue sections; keep slides permanently; identifying cell of origin |
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epithelial markers
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epithelial membrane antigen (EMA) and cytokeratin (CK)
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mesenchymal markers
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vimentin
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muscle cell
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desmin
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skeletal muscle
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myoglobin
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endothelial cells
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facor 8, CD34
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histiocytic
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lysosome, CD68
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schwann cell
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s100
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melanocytic
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HMB 45, Melan A
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neuroendocrine
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synaptophysin, chromogranin, CD56
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astrocytic and glial
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glial fibrillary acid protein (GFAP)
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presence of alpha feto protein
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hepatocellular and germ cell ca
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carcinoembryonic antigen (CEA) present in...
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colon, bronchogenic and gastric carcinomas
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pancreatic oncofetal antigen present in
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pancreatic, colon, bronchogenic, and gastric carcinomas
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calcitonin
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nedullary ca of thyroid
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neuron specific enolase
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small cell ca of lung; neuroblastoma
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immunoglobins
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multiple myeloma
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PSA
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prostate carcinoma
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mucin and other glycoproteins
CA125 |
ovarian carcinoma
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CA19-9
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colon and pancreatic carcinoma
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CA15-3
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breast carcinoma
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tumor markers
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biochem indicators of presence of tumors; molecules that can be detected in plasma or other body fluids; support dx of cancer; determine response to therapy and indicate relapse in the follow up period
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HCG
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trophoblastic tumors (choriocarcinoma), non seminomatous testicular tumors
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calcitonin
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medullary carcinoma of thyroid
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catecholamine and metabolites
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vanillylmandellic acid and homovanillic acid noted in pheochromocytoma and related tumors
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CEA
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increased in 50-80% of colorectal ca, and pancreatic can; 25-50% of gastric ca, breast, and lung. false + elevation seen with cirrhosis, hepatitis, crohn dz, ulcerative colitis
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AFP
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inc in hepatocellular carcinoma and non seminomatous germ cell tumors of testis; false + in cirrhosis, hepatitis, non toxic liver injury and pregnancy
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PAP:
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elevated in benign prostatic hypertrophy and prostate adenocarcinoma; levels can rise following digital examination, hence blood should be drawn several days before
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neuron specific enolase
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small cell ca of lung and neuroblastoma
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serum amylase
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carcinoma of pancreas
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alkaline phosphatase
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non specific
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immunoglobins
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multiple myeloma and gammopathies
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squamous cell carcinoma on EM
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desmosomes and tonofilaments noted
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adenocarcinoma on EM
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desmosomes, tight junctions, microvilli
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EM of mesothelioma
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long microvilli
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EM of melanoma
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premelanosomes and melanosomes
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