Path Exam 2 - Neoplasia

Front 1

anaplasia/cellular atypia (malignant tumor histologic features)

Back 1

lack of differentiated features in a cancer cell
1. pleomorphism - variation in size and shape of cells/nuclei
2. abnormal nuclear morphology - hyperchromatic nuclei, coarsely clumped chromatin, prominent nucleoli
3. aytpical mitoses - bizarre mitotic figures that produces tri/quadri/multipolar spindles
4. loss of polarity - the orientation of anaplastic cells is markedly disturbed
5. bizarre cells - tumor giant cells

Front 2

mitotic activity (malignant tumor histologic features)

Back 2

cell division, can be part of usual health

Front 3

growth pattern (malignant tumor histologic features)

Back 3

disorganized and random growth pattern leads to poor vascularization and often ischemic conditions in center of large tumor

Front 4

invasion (malignant tumor histologic features)

Back 4

in situ epithelial cancers display cytologic features of malignancy without invasion of basement membrane, curable

Front 5

metastases (malignant tumor histologic features)

Back 5

tumor implants discontinuous with primary tumor, mark of malignancy

Front 6

seeding of body cavities and surfaces (metastases)

Back 6

penetration of into body cavities, most commonly peritoneal cavity

Front 7

lymphatic metastases

Back 7

most common pathway for initial dissemination of carcinomas (epithelial tumors) and sarcomas (mesenchymal tumors)

Front 8

hematogenous metastases

Back 8

cancer cells invade capillaries/venules, lungs/liver most frequently involved, abdominal tumors = liver , systemic tumors = lungs

Front 9

chondroblastoma

Back 9

tumor resembles precursor of chondrocyte
enchondroma - when encased in bone

Front 10

eipithelioma

Back 10

benign, arising from squamous epithelium
papilloma - branched epithelioma

Front 11

teratoma

Back 11

bening, arising from germ cell

Front 12

adenoma

Back 12

benign, arising from glandular epithelium

Front 13

carcinoma

Back 13

epithelial cancers

Front 14

sarcoma

Back 14

mesenchymal cancers

Front 15

inactivation of p53

Back 15

causes resistance to apoptosis

Front 16

oncogenes

Back 16

genes that promote autonomous cell growth in cancel cells

Front 17

proto-oncogenes

Back 17

unmutated form of oncogenes

Front 18

retinoblastoma gene (Rb)

Back 18

tumor suppressor gene, located on chromosome 13, mutations in Rb gene permit unregulated cell proliferation

Front 19

p53 gene family

Back 19

tumor suppressor gene, located on chromosome 17, p53 cells present in high concentration in response to DNA damage, acts as guardian of the genome

Front 20

li-fraumeni syndrome

Back 20

inherited mutations of p53, predisposed to develop cancers

Front 21

other tumor suppressor genes

Back 21

APC gene - associated with cholorectal cancer
WT1 gene - wilms tumors (pediatric renal cancer)
PTEN - potent tumor suppressor gene, second most mutated after p53
NF-1 - NFM-1 increases risk for neurogenic sarcoma
VHL - von Hippel-lindau gene

Front 22

Disturbance in telomeres (oncogenesis)

Back 22

telomerase - extends length of telomeres which increase number of viable cell divisions

cancer cells reactivates telomerase, protects cancer cell by suppressing chromosomal abnormalities

Front 23

epigenetic (oncogenesis)

Back 23

changes in gene expression that are independent of DNA base sequence (ex. methylation)

Front 24

viral (5)/bacterial (1) carcinogens

Back 24

1. Human T-cell leukemia virus type 1
2. HPV - cervical carcinoma
3. hepatitis B/C - hepatocellular carcinoma
4. Epstein-Barr (EBV) - lymphatic cancer
5. Human herpes virus 8 - kaposi sarcoma
6. H. pylori - gastic adenocarcomas/lymphomas

Front 25

chemical carcinogens (5)

Back 25

1. polycyclic aromatic hydrocarbons - from coal tar, lung cancer
2. halogenated hydrocarbons - industrial plastics, angiosarcoma of liver
3. chemotherapeutic drugs - increases risk for hematologic malignancies
4. nitrosamines - nitrates are food preservatives, gastrointestinal neoplasms
5. aflatoxin - natural occuring fungal toxins can be found on vegetables, liver carcinogens

Front 26

physical carcinogens

Back 26

1. UV radiation
2. asbestos - pleural/peritoneal cavity malignant mesothelioma

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paraneoplastic syndromes

Back 27

remote effects produced by cancer not caused by tumor invasion or metastasis

1. fever
2. endocrine - hypercalcemia and inappropriate antidiuresis (ADH produced by tumor)
3. neurological/neuromuscular - sensory neuropathy/encephalomyelonneuritis, NMJ disorders (thymomas)
4. hematological disorders - hypercoaguable state: venous thrombosis, disseminated intravascular coagulation, nonbacterial thrombotic endocarditis
5. GI - malabsorption, hypoalbuminemia
6. cutaneous - pigemented lesions/keratomas
7. acanthosis nigricans
8. dermomatomyositis/polymyositis

Front 28

serum tumor markers

Back 28

α-fetoprotein (AFP) - hepatoma, testes
human chorionic gonadotropin (hCG) - trophoblastic tumors
prostate specific antigen (PSA) - prostate cancer
calcitonin - medullary carcinoma of the thyroid

Front 29

tumor grade

Back 29

histologic estimate of the malignancy of a tumor

degree of differentiation (low to high)

Front 30

tumor stage

Back 30

TNM

T - tumor growth
N - spread to regional lymph nodes
M - distant metastasis

Front 31

stomach cancer (ethnic predisposition)

Back 31

most common in japan

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colorectal cancer (ethnic predisposition)

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most common in USA

Front 33

liver cancer (ethnic predisposition)

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related to hepatitis B/C, endemic in sub-saharan Africa, Asia, Indonesia, Phillipines

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top 3 cancers in men (%)

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prostate (33), lung/bronchus (14), colon/rectum (11)

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top 3 cancers in women (%)

Back 35

breast (32), lung/bronchus (12), colon/rectum (11)