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230 Cards in this Set

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What is a stable, heritable change in the nucleotide sequence of genetic nucleic acid, resulting in an alteration in the products coded for by the gene?
Mutations
What are the three types of molecular changes that result in mutations?
Base substitutions
Frame shift mutations
Transposons
What mutation occurs when one base is inserted in place of another, resulting in either a missense mutation or a nonsense mutation?
Base substitutions
What mutations occur when one or more base pairs are added or deleted?
Frame shift mutation
What mutations occur when insertion sequences or deletions are integrated into the DNA?
Transposons/insertion sequences
What are some causes of mutations?
Chemicals
Ionizing radiation
Ultraviolet light
Viruses
What are some examples of chemicals that cause mutations?
NO and alkylating agents alter the existing base
Benzpyrene (found in tobacco smoke) bind to existing DNA bases and causes frame shift mutations
What are some example of Ionizing radiation that cause mutations?
Gamma and x-rays produce free radicals that can attack DNA bases
What are some examples of ultraviolet light that cause mutations?
Has lower energy than x-rays, causes cross-linking of the adjacent pyrimidine bases to form dimers (thymine dimers result in inability of the DNA to replicate properly)
How do viruses cause mutations?
Bacterial virus Mu (mutator bacteriophage) causes either frame shift mutations or deletions
What cells are very resistant to radiation?
Radioresistant Cells
Nerve cells
Mature bone cells
Muscle cells
What cells are very resistant to radiation?
Radioresistant Cells
Nerve cells
Mature bone cells
Muscle cells
What does a nodule and elevated PSA together strongly suggest?
Adenocarcinoma (a PSA value below 40 ng/ml is considered normal)
What is the most common cause of death in men over 75 years old?
Prostate cancer
What is the number one killer from CANCER in both men (prior to age 75) and women?
Lung cancer
What cancer is the 3rd most common cause of death in men of all ages?
Prostate cancer
Most prostatic tumors are ____________ that arise in peripheral glands, invade throughout the prostate, and may metastasize to bone and other tissues (i.e. lungs)
adenocarcinomas
What is the common laboratory findings for adenocarcinomic prostatic tumors?
Elevated levels of acid phosphatase and prostate-specified antigen (PSA)
What kind of testing has allowed most prostate cancers to be found before they cause symptoms?
The advent of PSA testing
What is a benign enlargement of the prostate due to hyperplastic nodules of stroma and glands distorting the prostate?
Nodular hyperplasia
What hyperplasia compresses the urethra and causes urinary tract obstruction?
Nodular hyperplasia of the prostate
What are the complications of nodular hyperplasia?
Pyelonephritis-urinary tract infection
Hydronephrosis-dilation of renal pelvis
Painful or difficult urination (dysuria)
T/F
Nodular hyperplasia of the prostate is considered premalignant
False
It is not considered premalignant
A 75-year-old healthy man is found to have a palpable firm nodule in the prostate gland on digital rectal examination. His serum prostate specific antigen (PSA) is 20 ng/mL. The microscopic appearance seen on biopsy of the prostate will probably be most consistent with what condition?
Adenocarcinoma
What is a benign tumor derived from smooth muscle, which may occur anywhere in the body, but is most frequently seen in the uterus?
Leiomyoma (also called a fibroid)
What are some areas you might find a leiomyoma and what is the prognosis of a patient diagnosed with this?
Uterus
Stomach
Esophagus
Small intestine
Good Prognosis
What is the most common pelvic tumor?
Uterine fibroids (leiomyomas) and may be present in 15-20% of reproductive age women, and 30-40% in women over 30
T/F
All neoplasms of muscle are rare, but when encountered they usually are malignant
True
What areas are most commonly affected in INFANTS who have rhabdomyosarcoma?
Throat
Bladder
Prostate
Vagina
What are the most commonly affected areas in elderly patients with rhabdomyosarcoma?
Large muscle groups of the arms and legs
What is a malignant neoplasm of striated muscle?
Rhabdomyosarcoma
What is a benign neoplasm of skeletal muscle?
Rhabdomyoma
How does a rhabdomyoma present?
This benign tumor produces a mass (swelling) in the affected muscle
What is the prognosis of a patient who has rhabdomyosarcoma?
Poor Prognosis
A 30-year-old woman had a firm nodule palpable on the dome of the uterus four years ago recorded on routine physical examination. The nodule has slowly increased in size and is now appears to be about twice the size it was when first discovered. She remains asymptomatic. What neoplasm is she most likely to have?
Leiomyoma - the slow growth of the nodule and the lack of symptoms suggests a benign course. Leiomyomas of the uterus are quite common (20% of women)
T/F
The cause of fibroid tumors of the uterus is unknown. However, it is suggested that fibroids may enlarge with estrogen therapy (such as oral contraceptives) or with pregnancy. Their growth seems to depend upon regular estrogen stimulation, showing up only rarely before the age of 20 and shrinking after menopause. As long as a woman with fibroids is menstruating , the fibroids will probably continue to grow, although growth is usually quite slow.
True
What size do fibroids tend to be?
Fibroids can be microscopic, but they can also grow to fill the uterine cavity, and may weigh several pounds.
What type of tumor is breast cancer most always?
The tumor is almost always an Adenocarcinoma
What is the #2 killer cancer of women 25-54(after lung cancer) and is the most common cancer affecting women?
Breast Cancer
Where is the most common location for breast cancer to develop? (specifically. seriously I know that you guys already know this happens in the breast)
Breast cancer occurs most commonly in the LEFT breast and in the OUTER UPPER quadrant.
At what ages does breast cancer affect women?
Most commonly from 25-menopause with increasing risk until menopause is reached.
What is the strongest association with an increased risk for breast cancer?
Family History
especially first-degree relatives (mother, sister, daughter)
How does widespread metastasis occur in breast cancer?
by way of Lymphatic system and Blood Stream, through the right side of the heart and lungs and eventually to the other breast, the chest wall, liver, bone and brain
What are the initial signs and symptoms of breast cancer?
A Painless Mass in the breast
Retraction of the skin or nipples
Peau d'orange (orange peel-like stippling)
Why is lymph node involvement the most valuable prognostic predictor?
With Adjuvant Therapy, 70-75% of women with negative nodes will survive 10 years or more, compared to 20-25% of women with positive nodes.
What is the most common cause of a clinically palpable breast mass in women 28-44 years old?
Fibrocystic disease of the breast
Is fibrocystic disease of the breast malignant?
No but it may lead to an increased chance of developing carcinoma.
What are the signs and symptoms of fibrocystic disease of the breast?
Lumpiness throughout both breast
Pain is common, especially prior to the menstruation
What is a rapidly metasticizing malignant tumor of placental tissue that typically causes profuse vaginal and intra-abdominal bleeding?
Choriocarcinoma
Why is lymph node involvement the most valuable prognostic predictor?
With Adjuvant Therapy, 70-75% of women with negative nodes will survive 10 years or more, compared to 20-25% of women with positive nodes.
What is the most common cause of a clinically palpable breast mass in women 28-44 years old?
Fibrocystic disease of the breast
Is fibrocystic disease of the breast malignant?
No but it may lead to an increased chance of developing carcinoma.
What are the signs and symptoms of fibrocystic disease of the breast?
Lumpiness throughout both breast
Pain is common, especially prior to the menstruation
What is a rapidly metasticizing malignant tumor of placental tissue that typically causes profuse vaginal and intra-abdominal bleeding?
Choriocarcinoma
What is a major risk factor for the development of Endometrial Carcinoma?
Hyperestrogenism
What is discovered by the appearance of a rising titer of human chorionic gonadotropin in the blood or urine?
Choriocarcinoma
a 35-year-old woman notes a lump in her left breast while taking a shower. Her physician notes a 4 cm firm, irregular, non-movable mass located in the upper outer quadrant of her left breast on physical examination. A fine needle aspiration of this mass is performed. Cells obtained from the mass are examined cytologically and are consistent with infiltrating ductal carcinoma. The mass is removed with a lumpectomy along with axillary lymph node dissection. Which of the following findings will best predict a better prognosis for this patient?

a. The tumor cells are strongly estrogen receptor positive
b. No metastases are found in the sampled lymph nodes
c. She has one relative who had a similar type of breast cancer
d. The tumor has a high grade
No metastes are found in the sampled lymph nodes
Usually, the main symptom of lung cancer is:

a. A persistent cough
b. Diarrhea
c. A low grade fever
d. A skin rash
A persistent cough (smoker's cough)
What is the most common cancer in women?
breast cancer
What is the most common cause of death from cancer in women?
Lung Cancer
What are the most common forms of lung cancer?
1. Epidermoid (squamous cell)
2. Adenocarcinoma
3. Small cell (oat cell)
4. large cell (anaplastic)
What are the symptoms of lung cancer?
1. A persistent cough
2. Hoarseness
3. Wheezing
4. Dyspnea
5. Hemoptysis
6. Chest pain
Many cancers that start elsewhere in the body spread to _________. Cancers spread to the lungs most commonly from the breast, colon, prostate, kidney, thyroid, stomach, cervix, rectum, testis, bone and skin.
the lungs
What are the causes of lung cancer?
Cigarette smoking
Carcinogenic industrial and air pollutants
Familial susceptibility
How many cases of lung cancer are inoperable by the time the patient is first seen in the hospital?
half
What is the route of metastasis from the lungs?
Through the lymphatic channels
Where do most lung cancers arise?
within the main bronchus (therefore bronchiogenic carcinomas)
What is the most common type of bronchogenic carcinoma?
Epidermoid (squamous cell) 35%
What are the frequencies of occurance for the different types of bronchogenic carcinomas?
Epidermoid (squamous cell) 35%
Adenocarcinoma 25%
Small cell (oat cell) 25%
Large cell (anaplastic) 15%
What is the very potent carcinogen found in cigarette smoke?
Benzpyrene
A 58-year-old-man who has an 85 pack/year history of cigarette smoking has had a persistant cough for the past 10 years. He has begun to lose weight during the past year. No abnormal findings are noted on physical examination. He has a chest radiograph that reveals a right hilar mass. A sputum cytology shows atypical, hyperchromatic squamous cells. What is the Most Common initial pathway of spread of this lesion?

a. bloodstream
b. pleural cavity
c. contiguous spread to chest wall
d. lymphatics
e. bronchi
Lymphatics
Who does lung cancer affect the most?
Males more than Females
4:1
Who does Hodgkins lymphoma affect the most?
Males twice as much as females and usually develops between the ages of 15 and 35
What is Hodgkins lymphoma?
It is a malignancy characterized by the painless, progressive enlargement of Lymphoid tissue.
What is the first sign of Hodgkins lymphoma?
Enlarged lymph node that appears without a known cause.
May spread to other lymph nodes, lungs, liver, bones or bone marrow
What malignancy is indicated by splenomegaly and the presence of Reed-Sternberg cells, which are the neoplastic cells?
Hodgkin's Lymphoma
What malignancy has symptoms that include enlarged lymph nodes, anorexia, weight loss, generalized pruritus, low-grade-fever, night sweats, anemia, and leukocytosis?
Hodgkin's Lymphoma
What is the prognosis of Hodgkin's lymphoma?
Prognosis is most favorable with early diagnosis and limited involvement. Lymphocyte predominance is also linked with a favorable prognosis.
What is the etiology of Hodgkin's Lymphoma?
Unknown
(although some believe that it starts as an inflammatory or infectious process and then becomes a neoplasm; others believe it to be an immune disorder.)
What is a malignant lymphoma characterized by the ABSENCE of Reed-Sternberg cells?
NON-Hodgkin's Lymphoma
A 31-year-old man has experienced low grade fevers, night sweats, and generalized malaise for the past 2 months. On physical examination he has non-tender cervical and supraclavicular lymphadenopathy. A cervical lymph node biopsy is performed. On microscopic examination at high magnification there are occasional Reed-Sternberg cells along with large and small lymphocytes and bands of fibrosis. Which of the following is the most likely diagnosis?

a. Burkitt's lymphoma
b. Hodgkin's disease
c. Mycosis fungoides
d. Multiple myeloma
Hodgkin's Disease
What are the characteristics of a Benign neoplasm?
Well-differentiated
Slow growth
encapsulated/well-circumscribed
Localized
Movable
What are the characteristics of Malignant Neoplasms?
Anaplastic (Less well-differentiated)
Rapid Growth
Invasion
Matastasis
Immovable
What is the most important characteristic that distinguishes malignant from benign?
Metastasis
A generalized classification system for the staging of lung cancer is the TMN system. What does TMN represent?
T: Tumor size (1=smallest through 4=largest)

M: Metastasis (0=absent, 1=present 2=worse)

N: Nodal involvement (0 through 3 depending on severity)
The ____________ is the basis of staging, which is critical to determine if a cure is likely. It is the most reliable indicator of Prognosis of malignant tumors.
Degree of Localization
T1-T4 how big it is
M0-M2 degree of metastasis
N0-N3 regional lymph node involvement
A study is performed to analyze characteristics of malignant neoplasms in biopsy specimens. The biopsies were performed on patients who had palpable mass lesions on digital rectal examination. Of the following microscopic findings, which is most likely to indicate that the neoplasm is malinant?

a. Pleomorphism
b. Atypia
c. Metastasis
d. Increased nuclear/cytoplasmic ratio
e. Necrosis
Metastasis
Multiple Myeloma is a cancer of:

a. Macrophages
b. Plasma cells
c. Erythrocytes
d. Monocytes
b. Plasma cells (most often arising in the bone marrow)
What malignancy is characterized by the excessive growth and malfunction of plasma cells in the bone marrow?
Multiple Myeloma
What is the etiology of Multiple Myeloma?
The growth of the extra plasma cells interferes with the production of red blood cells, WBCs, and platelets. The result is anemia, susceptiblitiy to infection, and increased tendencies toward bleeding.
What malignancy produces osteolytic lesions throughout the skeleton due to expanding cancer cells in the bone marrow?
Multiple Myeloma
What malignancy has:
a. Osteolytic lesions
b. X-rays show a punched out appearance
c. Renal failure (due to Ca++)
d. Bence Jones Proteins in urine
e. Anemia
f. Bone fractures
g. Amyloidosis
Multiple Myeloma
Who is affected most by multiple myeloma?
Mostly Men over the age of 40
multiple myeloma accounts for 1% of all cancers
Why is there elevated Ca++ in the blood and urine in patients with multiple myeloma?
Ca++ results from bone destruction
The presence of what substance is an absolute confirmation of Multiple Myeloma?
Bence Jones Proteins (caused by light chain dimers)
What is the most common cause of death for patients with multiple myeloma?
Infection
What is the earliest indication of multiple myeloma?
Severe, constant back and rib pain that increases with exercise and may be worse at night. The pain arises from pressure created by malignant plasma cells on the nerves in the periosteum of the bone.
All of the following statements concerning basal cell carcinoma are true except:

a. It is a fast growing, relatively benign skin tumor
b. It usually occurs in persons over the age of 40
c. It's more prevalent in blonde, fair-skinned males
d. It is the most common malignant tumor of the skin
a.
basal cell carcinoma is actually a SLOW-growing destructive skin tumor
What is by far the Most Common malignant tumor of the skin?
Basal Cell Carcinoma
75% of all skin cancers
What is the most common form of cancer in the united states?
Basal cell carcinoma
What are the characteristics of basal cell carcinoma tumors?
Tumor is invasive, ulcerative, often indurated, and locally destructive but does NOT metastasize. Rodent Ulcer
What is the prognosis for BCC?
Good prognosis for BCC
How is BCC treated?
BCC is usually cured by excision of the lesion, although, it does respond to radiation therapy if surgery is contraindicated or if the lesion cannot be fully excised.
T/F
BCC histologically is characterized by clusters of darkly staining cells with a typical palisade arrangement of the nuclei of the cells at the periphery of the tumor cell clusters
True
What is the MOST SEVERE tumor of the skin?
Malignant Melanoma
Neoplastic cells characteristically resemble prickle cells and form keratin pearls on the surface of lesions in:

a. Adenocarcinoma
b. Squamous Cell Carcinoma
c. Basal Cell Carcinoma
d. Malignant Melanoma
Squamous Cell Carcinoma
Which cancer involves cancerous changes to the cells (keratinocytes) of the middle portion of the epidermal skin layer?
Squamous Cell Carcinoma
What type of cancer accounts for 90% of all diagnosed malignant cancers of the oral cavity?
SCC (Squamous Cell Carcinoma)
What factors can contribute to SCC?
Sun damage
Chemical carcinogens (arsenic)
Radiation (x-ray exposure)
What other cancer does SCC resemble in histologic appearance and biologic behavior?
Cervical Cancer
T/F
SCC is more aggressive than BCC, but still may be relatively slow-growing.
True
What is more likely to spread (metastisize) SCC or BCC?
SCC
Where is SCC likely to originate?
may begin in normal skin
Burned skin
Scarred skin
Sun burned skin
Where does SCC most likely to originate?
Sun-damaged skin areas, such as Actinic Keratosis
What age is SCC most likely?
after age 50
What has happened to the incidence of skin cancer over the last 30 years?
Incidence has increased greatly
T/F
SCC is most often locally invasive, however SCC can infiltrate underlying tissue or metastasize in lymphatic channels. Treatment consists of complete excision or radiation therapy.
True
What do malignant epithelial cells have an increased number of?
Laminin receptors
Laminin (a glycoprotein) is a major component of basement membranes and has numerous biological activities including promotion of cell adhesion, migration, growth, and differentiation
What are teratogenic agents?
1. Physical agents
2. Maternal infection (torch)
3. Hormones
4. Vitamin deficiencies
5. Chemotherapy drugs
6. Antibiotics
What Teratogenic agents are associated with maternal infection?
TORCH complex
Toxoplasmosis
Other agents
Rubella
Cytomegalovirus
Herpes simplex
What Teratogenic agents are associated with Physical Agents?
Radiation
Hypoxia
Excessive carbon dioxide
Mechanical Trauma
What Teratogenic agents are associated with Hormones?
Sex
Corticosteroids
What Teratogenic agents are associated with Vitamin deficiencies?
Riboflavin
Niacin
Folic Acid
Vitamin E
What Teratogenic agents are associated with Antibiotics?
Mitomycin
Dactinomycin
Puromycin (used as chemotherapy agents)
_______ drugs act in different ways; they can inhibit, interfere, or block, metabolic steps critical for normal morphogenesis. Many drugs or viruses affect specific tissues or organs.
Teratogenic drugs
What two conditions must be met to induce Teratogenesis?
1. The teratogen must get into contact with the developing fetus
2. The time these are in contact must be during the phase where the organ systems are in the process of being formed.
When is the most common age that teratogenesis is induced?
The first trimester of pregnency
All of the following statements concerning teratology or teratogens are true except:

a. Teratology is the study of developing anomalies
b. Teratogens are chemical, physical, and biologic agents that cause developmental anomalies
c. Susceptibility to teratogens is variable
d. Susceptibility to teratogens is specific for each developmental stage
e. The mechanism of teratogenesis is specific for each teratogen
f. Teratogenesis is NOT dose dependent
g. Teratogens produce death, growth retardation, malformation, or functional impairment
f.
Teratogenesis IS DOSE DEPENDENT
Which of the following is a neoplasm derived from all three germ cell layers?

a. Carcinoma
b. Sarcoma
c. Teratoma
d. Apudoma
Teratoma
What is a tumor composed of multiple tissues (may contain elements of all three embryonic germ cell layers), including tissues not normally found in the organ in which they arise.
A teratoma
Where do teratomas most often occur?
In the ovary, where it is usually benign and forms dermoid cysts. It also occurs in the testis, where it is usually malignant, and uncommonly in other sites.
What is a malignant tumor of epithelial origin?
a Carcinoma
What are the different variations of Carcinomas?
Squamous cell carcinoma
Transitional cell carcinoma
Adenocarcinoma
What carcinoma originates from stratified squamous epithelium and is marked by the production of keratin?
Squamous Cell Carcinoma
What carcinoma arises from the epithelium of the urinary tract?
Transitional Cell Carcinoma
(transitional epithelium of the urinary tract)
What is a carcinoma of glandular epithelium?
Adenocarcinoma
What is a malignant tumor of mesenchymal origin?
Sarcoma
What are the different types of sarcomas?
1. Osteosarcoma (bone)
2. Leiomyosarcoma (smooth muscle)
3. Liposarcoma (adipose tissue)
What is a tumor characterized by amine precursor uptake and decarboxylation and the resultant production of hormone-like substances?
Apudoma (APUD)
Which of the following is a relatively common low-grade malignancy that originates in the pilosebaceous glands and pathologically resembles squamous cell carcinoma (SCC)?

a. Dermatofibromas
b. Seborrheic keratosis
c. Acrochordon
d. Keratocanthoma
e. Actinic keratosis
keratoacanthoma (KA)
What is a benign imitator of Squamous Cell Carcinoma?
Keratoacanthoma
Can keratoacanthoma become malignant?
Yes, rarely. That is why aggressive surgical treatment is often advocated.
What is characterized by rapid growth over a few weeks to months, followed by spontaneous resolution over 4-6 months in most cases. Sunlight and chemical carcinogens have been implicated as pathologic factors in growth of the tumor?
Keratoacanthoma
What are benign neoplasms that appear as small, red-to-brown bumps (nodules) that result from an accumulation of fibroblasts?
Dermatofibromas
What is an extremely common lesion, most often found on the neck, in the armpit, or the groin?
Acrochordon or a skin tag
What is a Premalignant epidermal lesion caused by exposure to sunlight. These are common, especially on light-skinned elderly people?
Actinic Keratosis
What is an extremely common Benign neoplasm of older people, which are flesh-colored, brown, or black growths that can appear anywhere on the skin?
Seborrheic Keratosis (Seborrheic Warts)
What is a cutaneous disorder marked by hyperkeratosis and pigmentation of the axilla, neck, flexures, and anogenital region. More than half of the patients with this disorder have Cancer (GI carcinomas, particularly the stomach)
Acanthosis Nigricans
Which of the following is a characteristic of malignant neoplasms in which there is no differentiation to suggest a particular cell type?

a. Dysplasia
b. Anaplasia
c. Metaplasia
d. Desmoplasia
Anaplasia
What is a measure of a tumor's resemblance to normal tissue?
Differentiation
grading of a cancer is based upon differentiation scale of 1-4. less clinical value than staging.
What is the absence of differentiation?
Anaplasia
What are the different histological features of malignancy?
1. Anaplasia-lack of differentiation (hyperchromatism and pleomorphism are signs of this)
2. Hyperchromatism-nuclei contain abundance of DNA and are darkly staines
3. Pleomorphism- variation of size and shape of cells and nuclei
4. Abnormal Mitosis
What is the most characteristic feature of a malignancy as opposed to inflammatory lesion?
A malignancy will grow after removal of the causative agent.
What is the most important feature of malignant neoplasms that distinguishes them from benign neoplasms?
Ability to invade and metasticize
What is a type of NONMALIGNANT cellular growth, but may precede malignant changes in the tissue?
Dysplasia
What causes dysplasia?
It is associated with chronic irritation of a tissue by a chemical agent, such as cigarette smoke, or by chronic inflammatory irritation, such as chronic cervitis.
Can dysplasia exhibit acanthosis?
Yes, dysplasia appears somewhat structureless and disorganized and may consist of atypical cells without invasion. Epithelium exhibits acanthosis (an abnormal thickening of the prickle cell layer)
What is the substitution of one tissue normally found at a site for another. It is common in the lower esophagus with gastroesophageal disease?
Metaplasia
What gives a malignant neoplasm tumor a characteristic firm or hard feel on palpation and what is this called histologically?
Fibrous stroma
histologically called **desmoplasia**. This connective tissue can fix the tumor to surrounding structures.
All of the following are benign tumors of mesenchymal origin except:

a. Leiomyoma
b. Rhabdomyoma
c. Osteosarcoma
d. Lipoma
e. Fibroma
f. Chondroma
Osteosarcoma
What is the most common primary malignant tumor of bone?
Osteosarcoma is a malignant tumor of mesenchymal origin
What is the most common soft tissue tumor?
Lipoma - derived from adipose tissue
What is a benign tumor derived from fibrous connective tissue?
Fibroma
What is a benign tumor derived from cartilage?
chondroma
What is a benign tumor derived from surface epithelium, such as squamous epithelium of the skin or tongue?
Papilloma
finger-like or warty projections from epithelial surface
What is a benign tumor derived from glandular epithelium?
Adenoma
What is a benign tumor derived from connective tissue?
Myxoma
What is a small benign mass of normal tissue misplaced within another organ, such as liver tissue within the wall of the intestine?
Choristoma
What is a benign tumor-like overgrowth of cell types that are regularly found within the affected organ, such as a hemangioma, an irregular accumulation of blood vessels?
Hamartoma is a malformation NOT a neoplasm i.e. cartilage in lung
What is the most dangerous type of skin cancer?
Malignant Melanoma
What are the most common types of melanoma?
1. Superficial spreading melanoma
2. Nodular melanoma
3. Lentigo maligna melanoma
4. Acral lentiginous melanoma
What is the least common form of melanoma?
Acral lentiginous melanoma
What type of melanoma usually occurs on the palms, soles, or under the nails and is more common in African Americans? (least common form of melanoma)
Acral Lentiginous Melanoma
What is the most common type of melanoma?
Superficial Spreading Melanoma
What type of melanoma is usually flat and irregular in shape and color, with varying shades of black and brown. It may occur at any age or site and is most common in Caucasians?
Superficial Spreading Melanoma
Which type of melanoma has the poorest prognosis?
Nodular Melanoma
What melanoma usually starts as a raised area that is dark blackish-blue or bluish red, although some lack color?
Nodular Melanoma
What type of melanoma usually occurs in the elderly. It is most common in sun-damaged skin on the face, neck, and arms. The abnormal skin areas are usually large, flat and tan with intermixed areas of brown?
Lentigo maligna melanoma
What develops from Hutchinsom freckle?
Lentigo maligna melanoma
(hutchinsons freckles are the same as lentigo maligna and may develop into lentigo maligna melanoma)
What is the least common skin cancer?
Malignant Melanoma
What is significant about a radial growth pattern within the skin?
Radial = does NOT metastasize
What is significant about a Vertical growth pattern within the skin?
Vertical = May Metastasize
What type of growth is associated with Nodular Melanoma?
Vertical (metastasis may occur)
What growth pattern is associated with spreading types of melanoma? (i.e. superficial spreading melanoma)
Radial growth is characteristic of spreading types
The cardinal sign of pheochromocytoma is:

a. persistant diarrhea
b. internal bleeding
c. persistent or paroxysmal (episodic) hypertension
d. hypoglycemia
Persistant or paroxysmal (episodic) hypertension**

(medullary carcinoma of the thyroid)
What is a chronic chromaffin-cell tumor of the adrenal gland medulla that secretes an excess of the catecholamines epinephrine and norepinephrine, which results in severe hypertension, increased metabolism, and hyperglycemia?
Pheochromocytoma
What is a highly malignant tumor of early childhood that usually originates in the adrenal medulla that involves invasion of abdominal organs by direct spread and metastasis to liver, lung or bone?
Neuroblastoma
T/F
A neuroblastoma is not a malignant tumor.
False
A neuroblastoma is a highly malignant tumor
What is the Most common malignant tumor of childhood and infancy?
Neuroblastoma
What are the symptoms of a neuroblastoma?
child has a large abdomen, a sensation of fullness, and abdomen pain. This is followed by an abdominal mass.
About 90% of neuroblastomas produce ______, such as ________, which can increase the heart rate and cause anxiety.
hormones
epinephrine
A 14-year-old boy complains of pain persisting in his right leg for 3 weeks. On physical examination his temperature is 101 deg F. A radiograph of the leg reveals a mass in the diaphyseal region of the right femur with overlying cortical erosion and soft tissue extension. A bone biopsy is performed and the lesion on microscopic examination shows numerous small round blue cells. Which of the following is he most likely to have?

a. Ewing's sarcoma
b. Neuroblastoma
c. Chondroblastoma
d. Osteoblastoma
Ewing's sarcoma
The tumor itself is composed of small round blue cells and is classified as a peripheral neuroectodermal tumor (PNET).
What is a nonosseous malignant bone tumor that can occur any time during childhood, but usually develops during puberty (teenagers) when bones are growing rapidly?
Ewing's Sarcoma
What are the most common symptoms of Ewing's Sarcoma?
There are few symptoms, but the most common is pain and occasionally swelling at the site of the tumor. Children may also break a bone at the site of the tumor after a seemingly minor trauma (pathologic fracture). Fever may also be present.
T/F
In Ewing's Sarcoma, the fever often spreads (metastasis) to the lungs and other bones. Metastasis is present in approximately 1/3 of the children with this condition at the time of diagnosis. Histologically, it is often difficult to distinguish this tumor from a neuroblastoma or a reticulum cell sarcoma.
True
How common are Primary Malignant Bone Tumors (also called sarcomas of the bone)?
Primary Malignant Bone tumors are rare, constituting less than 1% of all malignant tumors. Most bone tumors are secondary, caused by seeding from a primary site.
T/F
Bone tumors may originate in osseous or nonosseous tissue. Osseous bone tumors arise from bony structure itself and nonosseous tumors arise from hematopoietic, vascular, or neural tissues.
True
What are cancers that have spread to bone from their original site elsewhere in the body?
Metastatic bone tumors
What cancers are most likely to spread to bone?
Breast
Lung
Prostate
Kidney
Thyroid Cancers
All of the following are benign neoplasms except:

a. Adenoma
b. Fibroma
c. Carcinoma
d. Hemangioma
e. Lipoma
Carcinoma
A carcinoma is an invasive malignant tumor derived from epithelial tissue that tends to metastasize to other areas of the body.
What type of tumor is characteristically localized, has a fibrous capsule, limited potential for growth, a regular shape, and cells that are well differentiated.
Benign Tumor
______ tumors grow by expansion.
Benign Tumors
_____ tumors spread by local invasion and metastasis.
Malignant Tumors
______is the spread of a tumor to a secondary site distant and separate from its primary site and it an absolute indicator of malignancy.
Metastasis
________ metastasis, secondary tumor nodules develop in the liver, lung, brain, bone marrow, and sometimes spleen and soft tissues.
Hematogenous (bloodstream) metastasis
________ metastasis, the tumor first spreads to local and regional lymph nodes. From here the cancer disseminates via the blood.
Lymphatic metastasis
What is the most common Osseous bone tumor?
Osteogenic Sarcoma
What type of osseous bone tumor arises from bone-forming osteoblast and bone-digesting osteoclast?
Osteogenic Sarcoma
occurs most often in femur
usually in males ages 10-30
What type of osseous bone tumor develops on surface of bone instead of interior and progresses slowly; found most often in distal femur?
Parosteal Osteogenic Sarcoma
usually in females 30-40
What type of osseous bone tumor develops from cartilage, and grows slowly; usually painless;locally recurrent and invasive?
Chondrosarcoma
usually in males ages 30-50
occurs most often in pelvis, proximal femur, ribs, and shoulder girdle
What type of osseous bone tumors is found most often in long bones, more so in the knee area and arises from a benign tumor?
Malignant giant cell tumor arises from benign giant cell tumor.
usually in females ages 18-50
What are the different types of Osseous Tumors?
Osteogenic Sarcoma
Parosteal Osteogenic Sarcoma
Chondrosarcoma
Malignant Giant Cell Tumor
What are the different types of Nonosseous Tumors?
Chordoma
Ewing's Sarcoma
Fibrosarcoma
What are the most common types of bone tumors in children?
Osteogenic Sarcoma
Ewing's Sarcoma
Where do Nonosseous tumors arise from?
Hematopoietic, vascular, and neural tissues
Osseous bone tumors arise from the bony structure itself and include all of the following except:

a. Osteogenic Sarcoma
b. Parosteal Osteogenic Sarcoma
c. Ewing's Sarcoma
d. Chondrosarcoma
e. Malignant giant cell tumor
Ewing's Sarcoma
Nonosseous bone tumors arise from hematopoietic, vascular, or neural tissues and include all of the following except:

a. Ewing's Sarcoma
b. Fibrosarcoma
c. Malignant giant cell tumor
d. Chordoma
c. Malignant giant cell tumor is a Osseous bone tumor
Which nonosseous bone tumor is very radiosensitive?
Ewing's Sarcoma
Which nonosseous bone tumor occurs in males ages 10-20, originates in bone marrow and invades shafts of long and flat bones; usually affects lower extremities, most often in the femur, innominate bones, ribs, tibia, humerus, vertebra, and fibula; may metastasize in lungs; pain is increasing severe and persistant?
Ewing's Sarcoma
Which nonosseous bone tumor is usually found in males ages 30-40; originates in fibrous tissues of the bone; invades long or flat bones such as femur, tibia, and mandible; It also involves the periosteum and overlying muscle.
Fibrosarcoma
Which nonosseous bone tumor is usually found in males ages 50-60; derived from the embryonic remnants of notochord; progresses slowly. Usually found at the end of spinal column and in sphenooccipital, sacrococcygeal, and vertebral areas; characterized by constipation and visual disturbances?
Chordoma
What is the most common indication of primary malignant bone tumors?
Bone Pain
Greater intensity at night, associated with movement and is dull and usually localized
A 30-year-old woman had a firm nodule palpabe on the dome of the uterus four years ago recorded on routine physical examination. The nodule has slowly increased in size and is now appears to be about twice the size it was when first discovered. She remains asymptomatic. Which of the following neoplasms is she most likely to have?

a. Adenocarcinoma
b. Leiomyosarcoma
c. Rhabdomyosarcoma
d. Leiomyoma
Leiomyoma
The slow growth of the nodule and the lack of symptoms suggests a benign course. Leiomyomas of the uterus are quite common (20% of women)
Burkitt's Lymphoma is a high-grade B-cell lymphoma closely associated with the:

a. Influenza virus
b. Epstein-Barr Virus
c. Herpes Virus
d. Varicella-zoster virus
Epstein Barr Virus
What is a group of malignancies that originate most frequently within lymph nodes and usually spread throughout the body. They are characterized by the absence of Reed-Sternberg cells?
Non-Hodgkin's lymphomas
T/F
Non-hodgkin's lymphomas are less common than hodgkin's disease
False
Non-Hodgkin's lymphomas are MORE common than Hodgkin's disease.
What are the 2 forms of Burkitt's lymphoma?
1. African form is closely associated with EBV (95%). Affects children of the middle African regions. Usually begins as a large mass in the jaw.

2. American form is less closely associated with EBV. Usually begins as an abdominal mass; tumors of the jaw are rare.
What causes Burkitt's lymphomas?
Defective B-lymphocytes (the lymph nodes tend to be Spared)
What is a rare, persistent, slow-growing type of non-Hodgkin's lymphoma that originates from a mature T-lymphocyte and affects the skin and may progress to the lymph nodes and internal organs?
Mycosis fungoides
What is the name for Mycosis Fungoides if the neoplastic cell circulates?
Sezary syndrome