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106 Cards in this Set
- Front
- Back
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Normal cells
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normal cells w/ basal -> apical differentiation
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Hyperplasia
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cells have increased in number
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dysplasia
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abnormal prolif of cells w/ loss of size, shape, and orientation
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In situ carcinoma
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- neoplastic cells have not invaded basement membrane
- high nuclear/cyto ratio - clumped chromatin - neoplastic cells incompas entire thickness |
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how do cells invade the basement membrane?
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- via collagenases or hdyrolases
- will metastasize if it reaches blood or lymph |
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Normal Neoplastic Progression
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normal cells w/ basal -> apical differentiation
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Hyperplasia
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cells have increased in number
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dysplasia
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- abnormal prolif of cells w/ loss of size, shape, and orientation
- commonly reversible (preneoplastic) |
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In situ carcinoma
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- neoplastic cells have not invaded basement membrane
- high nuclear/cyto ratio - clumped chromatin - neoplastic cells incompas entire thickness |
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how do cells invade the basement membrane?
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- via collagenases or hdyrolases
- will metastasize if it reaches blood or lymph |
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metastasis
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- spread to distant organ
- must survive immune attack - "seed or soil" - seed = tumor embolus - soil = target organ |
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metaplasia
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- 1 adult cell type is replaced by another
- 2o to irritation or envorinment (think smokers) |
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anaplasia
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- abnormal cells lacking differentiation
- seen w/ undifferentiation malignant neoplasms - may form tumor giant cell |
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neoplasia
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uncontrolled and excessive clonal prolif of cells
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Tumor Grade
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- histologic apperance (I-IV)
- based on degree of diff and # of mitoses |
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Tumor Stage
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- based on 1o size and site
- more prognostic value - grade w/ TNM - size of Tumor, Node involvement, Metastases |
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epithelium tumor, benign and malignant
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B - adenoma, papilloma
M - adenocardinoma, papillary carcinoma |
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blood cell tumor, benign and malignant
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B - none
M - leukemia, lymphoma |
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blood vessel tumor, benign and malignant
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B - hemangioma
M - angiosarcoma |
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smooth muscle tumor, benign and malignant
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B - leiomyoma
M - leiomyosarcoma |
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skeletal muscle tumor, benign and malignant
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B - rhabdomyoma
M - rhabdomyosarcoma |
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bone tumor, benign and malignant
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B - osteoma
M - osteosarcoma |
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fat tumor, benign and malignant
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B - lipoma
M - liposarcoma |
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more than one cell type has a tumor, benign and malignant
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B - mature teratoma
M - immature teratoma |
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Aflatoxin ass. w/
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liver
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vinly chloride ass. w/
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liver
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nitrosamines w/
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esophagus, stomach
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asbestos ass. w/
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lung
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arsenic ass. w/
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skin
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CCl4 ass. w/
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liver
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naphthalene (aniline) dyes ass. w/
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bladder
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tissue lump or tumor will cause
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mass
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destruction of epithelial surfaces will cause
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nonhealing ulcer
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from ulcerated area or eroded vessel
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hemorrhage
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any site w/ sensory nerve endings will cause
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pain - tumors in brain are intitially painless
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tumor mass in brain will cause
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seizures
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obstruction of brouchus will cause
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pneumonia
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obstruction of bilary tree will cause
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jaundice
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obstruction of left colon will cause
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contstipation
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perforation of ulcer in viscera will cause
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peritonitis
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bathologic fracture, collase of bone will cause
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bone disturction
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inflam of serosal surface will cause
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pleural effusion, pericardial effusion, ascites
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rasied intracranial pressure w/ bain neoplasm will cause
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space-occupying lesion
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anemia due to bone marrow replacement
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space-occupying lesion
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compression or destruction of nerve will cause
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localized loss of sensory or motor function
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venous or lymphatic obstruction will cause
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edema
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skin - squamous cell cancinoma
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- very common - from exposure to sun
- usually on hands and face - locally invasive but rarly metastisizes - see keratin pearls on slide - actinic ketarosis is a precursor |
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skin - blast cell cancinoma
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- most common in sun exposed areas
- localy invasive, almost never metastisizes - - in gross path, will see pearly papules - tumor cells have palisading nuclei |
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skin - melanoma
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- significant risk fo metastasis
- ass. w/ sun exposure and fair skinned people - depth of tumor corrlates w/ risk of metastasis - dysplastic nevus is a precursor to melanoma |
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bone - osteochondroma (exoxtosis)
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- most common benign bone tumor - usually in med < 25
- commonly originates from long metaphysis - malignant tranformation to confrosarcoma is rare |
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bone - giant cell tumor
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- occurs at epiphseal end of long bones - commonly in 20-40 years
- locally agressive but benign - often around distal femur, prox tibial - double bubble or soap bubble on x-ray - on slide, spindle shaped nuclei w/ MN giant cell |
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bone - endochondroma
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- benign catrilaginous neoplasm found in intramedullary bone
- usually distal extrimities |
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bone - osteosarcoma (osteogenic carcinoma)
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- most common 1o malignant tumor - usally in men 10-20
- found in metaphysis of long bones - ass w/ pagets disease of bone, bone infarcts, radiation, familial retinoblastoma - codman's triangle (from elevated periosteum) on x-ray |
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bone - Ewings sarcoma
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- anaplastic small blue cell malignant tumor - boys <15
- very aggressive w/ early mets, but responsive to chemo - see onion skin in bone - "going out for E-wings and onion rings" - on diaphysis of long bones, pelvis, scapula, and ribs - 11;22 translocation |
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bone - chondrosarcoma
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- malignant cartilatinous tumor - mainly men 30-60
- usually in pelvis, spine, scapula, humerus, tibia, femur - 1o origin from osteosarcoma? |
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1o brain tumors - general
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- presentation due to mass effects (seizure, dementa, focal lesions)
- rarly mets - majority of supratentorial - majority of childrens infratentorial |
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glioblastoma multiforme (grade IV astrocytoma)
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- mainly adults, most common 1o brain tumor
- <1 yr life expectancy - found in hemisphere, can cross CC (butterfly glioma) - pseudopalisading tumor cells border central areas of necrosis and hemorrhage |
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Menangioma
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- mainly adults, 2nd most common 1o brain
- usually in convexities of hemispheres and parasagittal region - arises from external arachnoid cells - resectable - spindle cells concentrically arraged in a whorled pattern - psammoma bodies (laminated caclifications) |
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schwannoma
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- mainly adults, 3rd most common 1o brain
- schwann cell origin - often localized to 8th nerve -> acousitc schwannoma - bilateral found in neruofibromatosis type 2 - Antoni A is comact palisading nuclei - Antoni B is loose pattern |
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oligodendroglioma
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- mainly adults, pretty rare
- slow growing, often in frontal lobes - fried egg cells w/ round nuclei and clear cyto - often calcified |
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pituitary adenoma
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- mainly adults - prolactin secreting is common
- get bitemporal hemainopia due to pressure on optic chaism and hypopituatarism are sequelae - see rathke's pouch |
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low grad astrocytoma (pilocytic astrocytoma)
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- mainly in children - diffusely infiltrating glioma
- usually in posterir fossa - benign w/ good prognosis |
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medulloblastoma
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- mainly in children - very malignant cerebellar tumor
- from of primitive neruoectodermal tuomr (PNET) - can compress 4th ventricle, causing hydrodcephalus - rosettes or perivascular pseudorosette pattern - radiosensitive |
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ependymoma
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- mainly in children - ependymal cell tumor
- commounly found in 4th ventricle, so can cause hydrodcephalus - perivascular rosettes - rod shaped blepharoplasts (basal ciliary bodies) near nucleus |
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hemangioblastoma
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- mainly in children - often cerebellar
- associated w/ hippel-lindau syndrome when found w/ retinal angiomas - can produce ECO -> 2o polycythemia - foamy cells and high vasularity |
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Craniopharyngioma
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- mainly in children - benign - most common supratentorial
- counfused w/ bitemporal hemianopia - dervied from remnants of rathke's pouch - calcification is common |
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Mets to brain
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- Lots of Bad Stuff Kills Glia
- lung, breast, skin (melanoma) kidney (renal cell carcinoma) GI - about 50% of brain tumors form mets |
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Mets to liver
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- Mets >>> 1o liver
- Cancer Sometimes Penetrates Benign Liver - colon > stomach > pancreas > breast > lung |
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small cell lung cancinoma
- causes - effects |
- ACTH or ACTH like peptide
- Cushings symdrome |
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small cell lung cancinoma and intracranial neoplasms
- causes - effects |
- ADH or ANP
- SAIDH |
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squamous cell lung , renal cell, breast carcinomas, multiple myeloma, and bone mets
- causes - effects |
- PTH related peptide, TGF-B, TNF-A, IL-1
- hypercalcemia |
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renal cell cancinoma
- causes - effects |
- EPO
- polycythemia |
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thymoma, bronchogenic cancinoma
- causes - effects |
- Abs against presynaptic Ca channels at NMJ
- Lambert-Eaton syndrome |
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leukemias and lymphomas
- causes - effects |
- hyperuricemia due to excess nucleic acid turnover (cytotoxic therapy)
- gout, urate nephropathy |
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Male cancer epi
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- prostate incidence (32)
- lung incidence (16) - colon incidence (12) - prostate mortality (13) - lung mortality (33) |
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female cancer epi
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- breast incidence (32)
- lung incidence (13) - colon incidence (13) - breast mortality (23) - lung mortality (18) |
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well differentiated neoplasm
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a neoplasm that resembles the dissue of origin
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poorly differentiated neoplasm
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a neoplasm where there is little resemblance to the tissue of origin
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trademarks of malignant cells
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- pleomorphism
- hyperchomatism - increased N:C ratio - prominant nucleoli |
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carcinoma
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- malignant tumor of epithelial origin
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transitional cell carcinoma
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carcinoma of epithelium of the bladder
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adinocarcinoma
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- carinoma of glandular epi
- GI mucousa, endometrium, urinary tract - often associated w/ desmoplasion (tumor-induced prolif of non-neoplastic fibrous connective tissue) - esp in breast, pancrease, and prostate |
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sarcoma
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- malignant tumor of mesenchymal origin
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benign tumor characteristics
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- well differentiated
- no mets, grow slowly - tend to be ecapsulated - suffix -oma (usually_ |
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papilloma
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- benign neoplasm from surface epi (skin, larynx, tounge)
- finger like epi process over a core of connective tissue - may develop from transitional epi of bladderor renal pelvis |
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adenoma
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- benign neoplasm of gladular epi
- a papillary cystadenoma is a papillary process extending into cytsic spaces (ovary) - a febroadenoma has prolif of conncetive tissue (breast) |
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choristoma
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- small, non-neoplastic area of normal tissue misplaced w/in another organ
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hamartoma
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non-neoplastic, disorganized tumor-like overgrowht of cell tupes regularly found in that organ - hemangioma (think of baby dana)
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properties of neoplasms
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- monoclonality
- invasion and mets - cachexia and wasting - endocrine abnormalities |
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monoclonality in B-cells
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- b-cell malignancies have etiher kappa or lambda chain specificity, but not both
- also, neoplastic prolif results in a large number of cells all having the same Ig gene rearragement |
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monoclonality in T-cells
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- malignanty T cells have large numbers of cells w/ the same surface markers
- they also have the same Ig rearragement |
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invasion vs mets
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- invasion means its penetrated the basement membrane - doesn't mean mets
- mets is implantation in a distant site |
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mets steps
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- growth and vascularization of tumor
- penetration of basement membrane (invasion) - transport and survival in circulation - arrest of tumor emboli - overcoming target tissue defense - developing sucessful metastatic implants |
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mets preferential routes
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- carcinomas like lymph spread (except renal cell and hepato carcinomas)
- sarcomas like blood spread |
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mets target organs
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- usually liver, lungs, brain, adrenal glands, LNs, BM
- rarely SkM or spleen |
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tumor progression
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- characterized by accumulation of sucessive cytogenic or molecular abnormalities
- changes in APC, K-ras, DCC, and p53 genes go along w/ it |
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cachectin
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- excess causes wasting in malignant tumors
- a product of macrophages that promotes catabolism of fatty tissue |
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pituitary abnormalities w/ malignant tumors
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- prolacinoma -> amenorrhea, infertility, galactorrhea
- somatotropic (acidophilic) adenoma -> giantism in children and acromegally in adults - cortictropic (basophilic) adenoma -> cushings disease |
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adrenocrotical abnormalities w/ malignant tumors
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- adrenogenital syndrome, Conn syndrome, cushings syndrome
- all from adrenal cortical tumors |
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ovarian abnormalities w/ malignant tumors
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- granulosa-theca cell tumor -> hyperesterinism
- sertoli-leydig cell tumor -> excess androgen production |
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endocrinopathies from malignancies
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caused by ectopic production of hormones
- cushings - ACTH - increasee antidiuretic - often SSC of lung - hypercalicemia - bone - hypoglycemia - from insulin like hormones from hepatocullular, mesothelioma - polycythemia - inc EPO from renal tumors - hyperthyroidism - via hydration moles, choriocarcinomas, some lung |
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cachectin
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- excess causes wasting in malignant tumors
- a product of macrophages that promotes catabolism of fatty tissue |
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pituitary abnormalities w/ malignant tumors
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- prolacinoma -> amenorrhea, infertility, galactorrhea
- somatotropic (acidophilic) adenoma -> giantism in children and acromegally in adults - cortictropic (basophilic) adenoma -> cushings disease |
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adrenocrotical abnormalities w/ malignant tumors
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- adrenogenital syndrome, Conn syndrome, cushings syndrome
- all from adrenal cortical tumors |
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ovarian abnormalities w/ malignant tumors
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- granulosa-theca cell tumor -> hyperesterinism
- sertoli-leydig cell tumor -> excess androgen production |
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endocrinopathies
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caused by ectopic production of hormones
- cushings - ACTH - increasee antidiuretic - often SSC of lung - hypercalicemia - bone - hypoglycemia - from insulin like hormones from hepatocullular, mesothelioma - polycythemia - inc EPO from renal tumors - hyperthyroidism - via hydration moles, choriocarcinomas, some lung |
