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40 Cards in this Set
- Front
- Back
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Lymphoma with bcl-2 over-expression and an indolent course... what is it?
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Follicular lymphoma
- Arises from B cells - t(14;18) --> bcl-2 overexpression - Difficult to cure |
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What neoplasm does HTLV-1 cause?
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Adult T-cell lymphoma
- Adults present w/ cutaneous lesions; can have lytic bone lesions (--> hypercalcemia) |
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What is Sezary syndrome?
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Cutaneous T-cell lymphoma (mycosis fungoides) with neoplastic cells in the peripheral blood
- Cells have characteristic "cerebriform" nuclei |
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Punched-out lytic bone lesions on X-ray... what is it?
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Multiple myeloma
- Monoclonal plasma cell prolif. produces IgG (55%) or IgA (25%) - M spike, Bence Jones proteinuria, rouleaux formation of RBC, renal amyloidosis |
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What neoplasm is characterized by TdT (+) cells?
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Acute lymphoblastic leukemia/lymphoma
- TdT is a marker of pre-T and pre-B cells - Also CALLA (+) |
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Lymphocytosis with smudge cells in peripheral blood smear + warm antibody autoimmune hemolytic anemia... what is it?
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Small lymphocytic lymphoma or chronic lymphocytic leukemia (the latter just has increased peripheral blood lymphocytosis)
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Increased circulating myeloblasts + Auer rods... what is it?
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Acute myelogenous leukemia (AML)
- M3 (promyelocytic) has t(15;17) and responds to isotretinoin, which induces differentiation of myeloblasts |
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What is the Philadelphia chromosome and when is it seen?
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Philadelphia chromosome = t(9;22)
- Leads to expression of bcr/abl tyrosine kinase - Seen in CML |
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Increased WBC count with left shift and increased leukocyte alkaline phosphatase... what is it?
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Leukemoid reaction
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What are Auer rods?
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Peroxidase-positive cytoplasmic granules in granulocytes and myeloblasts, seen in acute promyelocytic leukemia
- Treatment can release Auer rods, leading to DIC |
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When do you see t(9;22)?
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CML (=Philadelphia chromosome)
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When do you see t(8;14)?
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Burkitt's lymphoma
--> c-myc activation |
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When do you see t(14;18)?
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Follicular lymphoma
--> bcl-2 activation |
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When do you see t(15;17)?
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Acute promyelocytic leukemia (M3 AML)
- Involves retinoic acid receptor-α gene - Explains APL's responsiveness to isotretinoin |
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When do you see t(11;22)?
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Ewing sarcoma
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When do you see t(11;14)?
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Mantle cell lymphoma
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Proliferation of dendritic (Langerhans) cells, (+) for S-100 and CD1a, with Birbeck granules on EM... what is it?
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Histiocytosis X (Langerhans cell histiocytoses)
= Letterer-Siwe disease, Hand-Schuller-Christian disease, and eosinophilic granulomas |
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Skull lesions, diabetes insipidus, and exophthalmos... what is it?
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Hand-Schuller-Christian disease (type of histiocytosis X)
- Proliferation of Langerhans cells |
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How do you reverse methotrexate toxicity?
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Leucovorin (folinic acid)
- MTX inhibits DHFR |
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How do you reverse 5-FU toxicity?
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Thymidine (5-FU is a pyrimidine analog)
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What electrolyte abnormalities do you see in tumor lysis syndrome?
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↑ uric acid, ↑ PO4, ↑ K, and ↓ Ca
- Can cause renal failure (due to uric acid and PO4 precipitating in renal tubules), hypocalcemia, and cardiac arrhythmias (--> SCD) |
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What is the major toxicity of doxorubicin and how would you prevent it?
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Cardiotoxicity--prevent with dexrazoxane (iron chelator)
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What's the major toxicity of bleomycin?
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Pulmonary fibrosis
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What's the major toxicity of cyclophosphamide and how would you prevent it?
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Hemorrhagic cystitis--can be partially prevented with mesna
- Cyclophosphamide can also cause SIADH |
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What are the major toxicities of the vinca alkaloids?
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Vincristine- neurotoxicity
Vinblastine- myelosuppression ("vinBLASTine BLASTS the bone marrow") |
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What are the major toxicities of the platinum agents (cisplatin, carboplatin)?
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Nephrotoxicity and ototoxicity--they're "the aminoglycosides of chemo"
- Also severe N/V |
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What is hydroxyurea, and what is it used for?
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Inhibits ribonucleotide reductase (inhibits DNA synthesis)
- Melanoma, CML, sickle cell disease (by increasing HbF levels) |
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What's the major toxicity of trastuzumab?
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Cardiotoxicity
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What is imatinib and what is it used for?
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Bcr-abl tyrosine kinase inhibitor; also inhibits c-kit tyrosine kinase
- Used for CML and GI stromal tumors (GISTs) - Toxicity: fluid retention |
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What risk factors are associated with the development of transitional cell carcinoma?
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- Phenacetin abuse (esp. for cancers in the renal pelvis)
- Aniline dyes (β-naphthylamine) - Cigarette smoking - Long-term cyclophosphamide tx (Transitional cell ca = most common tumor of the urinary collecting system) |
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Episodic hyperinsulinemia (and hypoglycemia), CNS dysfunction (confusion, anxiety, stupor) reversed by glucose admin, increased levels of C peptide... what is it?
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Insulinoma (most common islet cell tumor)
- C peptide = fragment of proinsulin molec |
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Watery diarrhea, hypokalemia, achlorhydria... what is it?
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VIPoma (endocrine tumor marked by secretion of vasoactive intestinal peptide, VIP)
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What's the most common soft tissue sarcoma in children?
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Rhabdomyosarcoma
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What's the most common soft tissue sarcoma of late middle and old age?
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Malignant fibrous histiocytoma
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What tumor marker is used for colon cancer?
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CEA
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What tumor marker is used for HCC?
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AFP
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What tumors are associated with BRCA-1? and BRCA-2?
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BRCA-1: breast and ovarian ca
BRCA-2: breast ca only |
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What are the DPC and DCC genes, and where are they located?
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Both are tumor suppressor genes on chromosome 18q
DPC = deleted in pancreatic cancer DCC = deleted in colon cancer |
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Where is the p16 gene located, and what cancer is it implicated in?
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Chromosome 9p
- Tumor suppressor gene - LOH implicated in melanoma |
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Where is the p53 gene located?
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Chromosome 17p
p53 = tumor suppressor Germline mutation --> Li-Fraumeni syndrome |
