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56 Cards in this Set
- Front
- Back
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What is a solid neoplasm?
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Tumor
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Benign tumor = cell of origin + ?
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cell of origin + oma
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Define Adenoma
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Benign epithelial neoplasm forming glands
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Define Papilloma
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Benign epithelial neoplasm with finger-like warty projections
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Define Cystadenoma
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Benign epithelial neoplasm forming large cystic masses
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Define Polyp
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Neoplasm which produces a macroscopically visible projection above a mucosal surface and projects into a lumen
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Define Sarcoma
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Cancerous tissue of a mesenchymal tissue
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Define Carcinoma
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Cancerous tissue of epithelial cell origin (any germ layer)
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Define Teratoma
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Cancer derived from more than one germ layer
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Define Hamartoma
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Mass of disorganized but mature specialized cells indigenous to the particular site
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Define Choristoma
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Ectopic cancer tissue of a type not found normally in that area
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Define Seminoma, Melanoma, heaptoma
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Seminoma = malignant germ cell tumor
Melanoma= malignant tumor of melanocytes Hepatoma = malignant tumor of hepatocytes |
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Compared to metastatic cancer benign neoplasms are _______ differentiated
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Benign = Well differentiated
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Define anaplasia
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loss of differentiation
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What are the features of anaplasia?
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High nuclear/cytoplasmic ratio
Nuclear and cellular pleomorphism Hyperchromatic chromatin Abnormal chromatin Large multiple abnormal nucleoli Many/abnormal mitotic figures loss of polarity tumor giant cells |
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Compare the rate of growth of benign and cancerous growths
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Benign = slow
cancerous = fast However rapid growth can lead to tumor ischemia and necrosis |
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Compare the local invasion characteristics of benign and malignant tumors
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Benign = grow as cohesive expansile masses that remain localised
Usually develop a rim of compressed connective tissue (capsule) Cause problems by impingment on other structures Malignant tumors = infiltrate and invade surrounding tissues Poorly demarcated from surrounding tissue Next to metastasis, invasion is most reliable feature of malignancy |
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What is the hallmark feature of malignant tumors?
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Metastasis
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What cancers do no NOT metastasize?
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CNS gliomas
basal cell carcinomas |
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What are the pathways via which a metastasis can spread?
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Seeding of body cavities and surfaces (ovarian)
Lymphatic spread (usually carcinoma) Hematogenous spread (usually sarcoma but can be carcinoma) |
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What are the factors that influence tumor growth?
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Kinetics of tumor growth
Tumor angiogenesis Tumor progression and heterogeneity |
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Define doubling time
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The total life cycle time for many tumors is equal to or longer than corresponding normal cells.
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Define growth fraction
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Even in rapidly growing tumors the fractions of cells replicating is only 20%. The rest are G0 or G1. This is due to a lack of nutrients and oxygen
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What determines the rate a tumor grows?
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Excess of cell production over cell loss
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What types of cancers are most susceptible to chemotherapy?
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Rapidly dividing cells with high growth fractions
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Define latent period
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The period of time before a tumor becomes clinically detectable (can be years)
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What contributions does angiogenesis make to a developing tumors?
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Supplies oxygen and nutrients
New endothelial cells secrete growth factors that further stimulate tumor cell growth Provides route for metastasis |
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What are the 2 phases of metastatic cascade?
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Invasion of extracellular matrix
Vascular dissemination and homing of tumor cells |
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What are the events that take place in invasion of extracellular matrix?
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Detachment of tumor cells from each other by down grading E-cadherin
Attachment to extracellular matrix via laminin and fibronectin Degradation of extracellular matrix via proteolytic enzymes Migration of tumro to cell blood vessel |
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What are the events that take place in vascular dissemination?
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Intravasation into blood vessel
Survival in the circulation Tumor cells form emboli- affords some protection Extravasation from blood vessel Establishment of metastatic tumor |
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What are the factors that influence vascular dissemination?
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Vascular and lymphatic drainage from the site of primary tumor.
Interaction of tumor cells with organ specific receptors The microenvironment of the organ or site. |
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What is the 2nd leading cause of death in US?
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Cancer
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What is the highest incidence of cancers in women? Deaths?
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Incidence = Breast, lung, colorectal
Deaths = Lung, breast, colorectal |
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What is the highest incidence of cancers in men? Deaths?
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Incidence = prostate, lung, colorectal
Deaths = lung, prostate, colorectal |
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Match the environmental factor with its cancer location.
Arsenic Asbestos Benzene Beryllium Cadmium Chromium Ethylene oxide Nickel Radon Vinyl chloride |
Arsenic- lung, skin, hemangiosarcoma
Asbestos - lung, mesothelioma, GI tract Benzene - leukemia, Hodgkin disease Beryllium - lung Cadmium - prostate Chromium - lung Ethylene oxide - leukemia Nickel - nose, lung Radon - lung Vinyl chloride - angiosarcoma of liver |
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Describe the cancers that people in each age group are predisposed towards:
<15 15-34 35-54 55-74 |
<15 = leukemias and lymphomas, neuroblastomas, wilms tumors, retinoblastoma, bone and skeletal muscle (ewings sarcoma, rhabdomyosarcoma)
15-34 - leukemia, breast, brain and nervous system, cervix, colon, soft tissue, Non hodgkin's lymphoma 35-54 - lung, breast, colon, ovary, cervix, brain and nervous system, nonhodgkin lymphomoa, pancreas 55-74 - lung, breast, colon, prostate, ovary, pancreas, nonhodgkin lymphoma |
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What are some examples of autosomal dominant inherited cancer?
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Retinoblastoma, familial adenomatous polyposis, MEN syndroms, neurofibromatosis, von hippel lindau syndrome
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What is an autosomal recessive syndrome of defective DNA repair?
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Xeroderma pigmentosum
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Define dysplasia
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Disruption of normal patterns of cellular maturation and organization in epithelia resulting in cytologic atypia of the dysplastic cells within the epithelium
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Define carcinoma in situ
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When dysplasia involves the entire thickness of the epithelium but remains confined to the basement membrane, it is considered a preinvasitve neoplasm with a high probability of progression to invasive cancer
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Cirrhosis of the liver is a precursor to?
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Hepatocellular carcinoma
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Atrophic gastritis of pernicious anemia is a precursor to?
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Stomach cancer
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Chronic ulcerative colitis is a precursor to?
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Colonic adenocarcinoma
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Leukoplakia of oral and genital mucosa is a precursor to?
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Squamous cell carcinoma
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What are some examples of hyperplasias and metapasias that provide fertile soil for cancer?
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Endometrial hyperplasia
Bronchial mucosal metaplasia/dysplasia of smokers Barrett's metaplasia of esophagus |
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What are the ways in which tumors can effect the host?
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Impinge on adjacent structures
Functional activity (B-cell adenoma of the pancrease can cause fatal hypoglycemia) Bleeding and secondary infections when tumor ulcerates through natural surfaces Acute symptoms caused by rupture or infarction |
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What is cancer cachexia and what is it caused by?
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Progressive loss of lean body mass accompanied by profound weakness, anorexia and anemia
May be from cytokines produced by the tumor or by the host in response to the tumor -> TNFa, IL-1, IFN-y |
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What are paraneoplastic syndromes?
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Symptom complexes that cannot be explained by actions of the tumro directly.
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Paraneoplastic syndrome
Endocrinopathies |
Cushing syndrome- secretion of ACTH or ACTH like substance (usually due to small cell carcinoma of lung)
Hypercalcemia - production of calcemic humoral substances by extraosseus neoplasm (secreted by breast, squamous lung, kidney, ovary) |
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Paraneoplastic syndrome
Neuromyophatic |
Peripheral neuropaties, corticocerebellear degeneration, polymyopathy, myasthenia syndrome
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Paraneoplastic syndrome
Acanthosis nigricans |
Gray-black verrucous hyperkeratosis of skin (happens over 40 years)
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Paraneoplastic syndrome
Hypertrophic osteoarthropathy |
Periosteal new bone formation at the ends of long bones, clubbing of fingers, arthritis, occurs in patients with bronchogenic carcinoma
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Vascular and hematologic paraneoplastic syndrome
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Migratory thrombophlebitis
DIC Nonbacterial thrombotic endocarditis |
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How are tumors graded?
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By differentiation
I - well II - moderate III - poor IV - undifferentiated Correlates with aggresiveness OR Based on tumor size, extent of invasion, presence or absence of metastatsis in nearby lymph nodes and distant organs. |
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What is immunohistochemistry used for?
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Categorization of undifferentiated or poorly differentiated tumors
Intermediate filaments: cytokeratins = carcinoma desmin = muscle, vimentin Categorization of leukemias and lymphomas Determination of the site of origin of metastatic tumors Detection of molecules that have prognostic or therapeutic significance |
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What is Flow cytometru used for?
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Identification of cell-surface antigens in classification of leukemias and lymphomas
Detection of ploidy |
