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64 Cards in this Set

  • Front
  • Back
cancer cachexia
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
paraneoplastic syndromes
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
endocrinopathies (ectopic hormone production)
cushing syndrome
SIADH
hypercalcemia
carcinoid syndrome
polycythemia
hypocalcemia
cushing syndrome
most common; small cell ca of lung; pancreatic ca and neural tumors; mech: excessive production of ACTH, ACTH like peptides
Syndrome Inappropriate ADH secretion (SIADH)
small cell ca of lung, intracranial neoplasms
hypercalcemia
squamous cell ca of lung; breast, renal, ovarian, adult T cell leukemia/lymphomas; mech: PTHRP, IL1, TNFa, TGFa
hypoglycemia
fibrosarcomas, other sarcomas, hepatocellular ca; mech: secretion of insulin and insulin like substance
carcinoid syndrome
bronchial carcinoid, pancreatic and gastric ca,
mech: secretion of serotonin, bradykinin
polycythemia
renal cell ca, cerebellar hemangioma, hepatocellular ca; mech: secretion of EPO
hypocalcemia
medullary ca of thyroid, seen in osteoblastic metastasis (lung, prostate, and breast)
paraneoplastic syndromes
nerve and muscle syndrome
dermatologic disorders
ossesus, articular, and soft tissue changes
vascular and hematologic changes
renal dysfunction
nerve and muscle syndrome
myasthenia gravis: thymomas*, breast and lung ca
disorders of central and peripheral NS--breast Ca
eton lambert--small cell ca
dermatologic disorders
acanthosis nigricans--seen in gastric, lung, and uterine determatomyositis (bronchogenic and breast)
ossesus, articular, and soft tissue changes
hypertrophic osteoarthropathy and clubbing of fingers--bronchogenic ca
vascular and hematologic changes
venous thrombosis (trousseau's phenomenon) noted in deep seated cancers, eg pancreatic; non bacterial thrombotic endocarditis (advanced ca), anemia
renal dysfunction
nephrotic syndrome
radiation changes can mimic...
bone healing can mimic...
carcinoma
osteosarcoma
frozen section
fresh or in saline
light microscopy
in 10% neutral buffered formalin
immunofluorescence
in saline or michel's fixative
molecular studies:
RPMI
electron microscopy
glutaraldehyde
trichrome
stains fibrous tissue green
periodic acid schiffs (PAS)
stains glycogen and fungi pink
gomori methanamine silver (GMS)
stains fungi black
acid fast bacilli (AFB)
stains acid fast bacilli red
iron stain:
stains iron blue
oil red O
fat stain; red
immunoperoxidase staining
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
epithelial markers
epithelial membrane antigen (EMA) and cytokeratin (CK)
mesenchymal markers
vimentin
muscle cell
desmin
skeletal muscle
myoglobin
endothelial cells
facor 8, CD34
histiocytic
lysosome, CD68
schwann cell
s100
melanocytic
HMB 45, Melan A
neuroendocrine
synaptophysin, chromogranin, CD56
astrocytic and glial
glial fibrillary acid protein (GFAP)
presence of alpha feto protein
hepatocellular and germ cell ca
carcinoembryonic antigen (CEA) present in...
colon, bronchogenic and gastric carcinomas
pancreatic oncofetal antigen present in
pancreatic, colon, bronchogenic, and gastric carcinomas
calcitonin
nedullary ca of thyroid
neuron specific enolase
small cell ca of lung; neuroblastoma
immunoglobins
multiple myeloma
PSA
prostate carcinoma
mucin and other glycoproteins
CA125
ovarian carcinoma
CA19-9
colon and pancreatic carcinoma
CA15-3
breast carcinoma
tumor markers
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
HCG
trophoblastic tumors (choriocarcinoma), non seminomatous testicular tumors
calcitonin
medullary carcinoma of thyroid
catecholamine and metabolites
vanillylmandellic acid and homovanillic acid noted in pheochromocytoma and related tumors
CEA
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
AFP
inc in hepatocellular carcinoma and non seminomatous germ cell tumors of testis; false + in cirrhosis, hepatitis, non toxic liver injury and pregnancy
PAP:
elevated in benign prostatic hypertrophy and prostate adenocarcinoma; levels can rise following digital examination, hence blood should be drawn several days before
neuron specific enolase
small cell ca of lung and neuroblastoma
serum amylase
carcinoma of pancreas
alkaline phosphatase
non specific
immunoglobins
multiple myeloma and gammopathies
squamous cell carcinoma on EM
desmosomes and tonofilaments noted
adenocarcinoma on EM
desmosomes, tight junctions, microvilli
EM of mesothelioma
long microvilli
EM of melanoma
premelanosomes and melanosomes