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7 Cards in this Set

  • Front
  • Back
Possible problems associated with benign neoplasms:
1) strategic location (eg brain)
2) Hormone production
3) Cosmetics
4) Malignant transformation
Origin of Neoplasm =

Mixed examples:
a single cell, therefore neoplasms usually clonal (one cell type)

Some are mixed:
Mixed tumor of salivary gland - epithelial and myoepithelial cells
- both are neoplastic/clonal
Basal Cell Carcinoma
- epithelial and melanocytic
- only epithel is neoplastic
- Derived from totipotent cells (gonadal)
- Different along various germ lines (skin, fat, gut, teeth)
Malignant Neoplasm:
Invasion =
Process of invasion -

Metastasis =
Process of metastasis -
Malignant cells traverse boundaries such as BM
Malignant cells in blood adhere to endothelium -> Collagenase and other proteolytic enzymes expressed -> holes in capillary BM -> malignant cells move through holes -> invade interstitium

Malignant cells separate and move active or passively to new location
vascular invasion (enhanced by angiogenesis driven by tumor-induced growth factors) -> localize to target tissue (based on cell surface molecules and via vascular adhesion molecules) -> proliferation in target tissue
3 routes of metastasis:

Rates of invasion:
Seeding of Body cavities - peritoneal, pleural, pericardial

Lymphatic spread - carcinoma and sarcoma, there are predictable drainage pathways

Hematogenous spread - Sarcoma and carcinoma, Liver and lungs usually venous, arterial spread possible by alveolar capillaries -> arterial circ

vary widely depending on type of malignancy, and individual cases - not predictable with certainty
2 ways to ID Autonomous growth:

3 phenotypic expressions of altered differentiation:
1) In vivo: uncontrolled clone cell growth -> becomes a mass, tumor or spot
malignancy defined by - invasion, metastasis, transplantibility (to mouse)

2) In Vitro: in cell culture
defined by - loss of contact inhibition, ability to grow in soft agar (without attachment), immortality (grow indefinitely)

Diminished or inappropriate gene expression:
1) Loss of normal products
2) New products
3) Fetal Gene expression
Characteristics of Malignant cells:

Tumor Heterogeneity =
Functional Characteristics:
Less Differentiation
Lack response to normal growth control
immortality, lose contact inhib, lose apoptosis (in vitro)

Morphologic Characteristics:
Less differentiation/more anaplasia
Increased mitotic activity
Often central necrosis

Tumor Heterogeneity = all characteristics vary from area to area within tumor
Predictions of neoplasm behavior based on:
1) Tumor Type

2) Tumor Grade:
- to plan treatment based on AGGRESSIVENESS via degree of differentiation and Mitotic activity
- Greater predictor for some cancers (better for prostate than melanoma)
- Less helpful predictor than Stage

3) Stage:
- to plan treatment based on EXTENT OF TUMOR (basically size of primary neop, location, and extent of metastases)
- Two systems:
UICC (Union Internationale Contre Cancer)/TNM System =
T = tumor size
N = nodal involvement
M = distant metastases

American Joint Committee on Cancer Staging =
Stage 0 - IV based on
- size of primary neoplasm
- local invasion
- regional lymph nodes
- distant lymph nodes
- metastases to distant organs/tissues