Pathology Chapter 3

Front 1

Neoplasia is

Back 1

new tissue growth that is unregulated, irreversible, and monoclonal;

these features distinguish it from hyperplasia and repair.

Front 2

Clonality was historically determined by glucose-6-phosphate dehydrogenase

(G6PD) enzyme isoforms.

Back 2

Normal ratio of active isoforms in cells of any tissue is 1:1 (e.g., 50% of cells have

G6PDA, and 50% of cells have G6PDB

Front 3

Clonality o f B lymphocytes is determined by

Back 3

immunoglobulin (Ig) light chain

phenotype.

Front 4

Normal kappa to lambda light chain ratio is

Back 4

3:1.

Front 5

Ratio increases to > 6:1 or is inverted (e.g., kappa to lambda ratio = 1:3) in

lymphoma, which is.

Back 5

monoclonal

Front 6

Benign tumors remain

Back 6

localized and do not metastasize.

Front 7

Malignant tumors (cancer) characteristics

Back 7

invade locally and have the potential to metastasize.

Front 8

Cancer is the ..... leading cause of death in both adults and children.

Back 8

Cancer is the 2nd leading cause of death in both adults and children.

Front 9

leading causes of death in adults are

Back 9

(1) cardiovascular disease, (2) cancer,

and (3) chronic respiratory disease.

Front 10

The leading causes of death in children are

Back 10

(1) accidents, (2) cancer, and (3)

congenital defects.

Front 11

The most common cancers by incidence in adults are

Back 11

(1) breast/prostate, (2) lung,

and (3) colorectal.

Front 12

The most common causes of cancer mortality in adults are

Back 12

(1) lung, (2) breast/

prostate, and (3) colorectal.

Front 13

Approximately ——- divisions occur before the earliest clinical symptoms arise.

Back 13

30

Front 14

Goal of screening

Back 14

catch dysplasia (precancerous change) before it becomes

carcinoma or carcinoma before clinical symptoms arise

Front 15

Pap smear - detects

Back 15

cervical dysplasia (CIN) before it becomes carcinoma

Front 16

Mammography - detects

Back 16

in situ breast cancer (e.g., DCIS) before it invades or

invasive carcinoma before it becomes clinically palpable

Front 17

Prostate specific antigen (PSA) and digital rectal exam - detects

Back 17

prostate

carcinoma before it spreads

Front 18

Hemoccult test (for occult blood in stool) and colonoscopy - detect

Back 18

colonic

adenoma before it becomes colonic carcinoma or carcinoma before it spreads

Front 19

Cancer formation is initiated by damage to ______ of stem cells.

Back 19

Cancer formation is initiated by damage to DNA of stem cells.

Front 20

Carcinogens are agents

Back 20

that damage DNA, increasing the risk for cancer.

Important carcinogens include chemicals, oncogenic viruses, and radiation

Front 21

mutations of

proto-oncogenes form ....... that lead to unregulated cellular growth.

Back 21

oncogenes

Front 22

Categories of oncogenes include

Back 22

growth factors, growth factor receptors, signal

transducers, nuclear regulators, and cell cycle regulators

Front 23

Aflatoxins derived from ,and cancer association

Back 23

Hepatocellular carcinoma ,

Hint 23

Derived from Aspergillus, which can contaminate stored rice and grains

Front 24

Alkylating agents,cancer

Back 24

Leukemia/lymphoma ,derived from Side effect of chemotherapy

Front 25

Alcohol

Back 25

Squamous cell carcinoma of oropharynx and

upper esophagus, and hepatocellular carcinoma

Front 26

Arsenic is present in cigarette smoke.

Back 26

Squamous cell carcinoma of skin, lung cancer, and angiosarcoma of liver

Front 27

Asbestos

Back 27

Lung carcinoma and mesothelioma

Exposure to asbestos is more likely to lead to lung cancer than mesothelioma.

Front 28

Cigarette smoke

Back 28

Carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas

Front 29

Nitrosamines Found in smoked foods; responsible for high rate of stomach carcinoma in Japan

Back 29

Stomach carcinoma

Front 30

Naphthylamine

Back 30

Urothelial carcinoma of bladder , Derived from cigarette smoke

Front 31

Vinyl chloride

Back 31

Angiosarcoma of liver, Occupational exposure

Front 32

Nickel, chromium, beryllium, or silica

Back 32

Lung carcinoma

Front 33

TUMOR SUPPRESSOR GENES

Are

Back 33

P53 and Rb (retinoblastoma)

Front 34

ERBB2 [HER2/ neu]

Back 34

Subset of breast carcinomas

Front 35

In response to DNA damage, ..... slows the cell cycle and upregulates DNA

repair enzymes.

Back 35

P53

Front 36

If DNA repair is not possible, p53 induces apoptosis.

p53 upregulates ....., which disrupts Bcl2.

Cytochrome c leaks from the mitochondria activating apoptosis.

Back 36

BAX

Front 37

One or Both copies of the p53 gene must be knocked out for tumor formation (Knudson

two-hit hypothesis).

Back 37

Both

Front 38

Rb "holds", which is necessary for transition to the S phase

Back 38

the E2F transcription factor

Front 39

Rb mutation results in constitutively free ......, allowing progression through the

cell cycle and uncontrolled growth of cells.

Back 39

E2F

Front 40

One or Both copies of Rb gene must be knocked out for tumor formation (Knudson two-

hit hypothesis).

Back 40

Both

Front 41

Germline mutation of RB results in familial retinoblastoma (2nd hit is somatic),

characterized by bilateral retinoblastoma and.

Back 41

osteosarcoma

Front 42

Front (Term)

Back 42

Back (Definition)

Front 43

..... is overexpressed in follicular lymphoma.

Back 43

Bcl2

Front 44

....is necessary for cell immortality

Back 44

Telomerase

Front 45

PDGFB gene

Back 45

Astrocytoma

Front 46

Cancers often have ...... telomerase, which preserves telomeres.

Back 46

upregulated

Front 47

......(angiogenic factors) are commonly produced by tumor cells.

Back 47

FGF and VEGF

Front 48

Tumor cells can evade immune surveillance by downregulating expression of

Back 48

MHC class I.

Front 49

Immunodeficiency (both primary and secondary) increases /decrease risk for cancer.

Back 49

Increase

Front 50

Epithelial tumor cells are normally attached to one another by cellular adhesion

molecules called???

Back 50

(e.g., E-cadherin)

Front 51

Downregulation of E-cadherin leads to dissociation of attached cells in cancer

Cells attach to laminin and destroy basement membrane (collagen type IV) via

collagenase.

Back 51

Cells attach to fibronectin in the extracellular matrix and spread locally.

Entrance into vascular or lymphatic spaces allows for metastasis (distant spread).

Front 52

Lymphatic spread is characteristic of ......

Back 52

carcinomas

Front 53

Hematogenous spread is characteristic of .....

Back 53

sarcomas

Front 54

some carcinomas spread through hematogenously

Back 54

1. Renal cell carcinoma (often invades renal vein)

2. Hepatocellular carcinoma (often invades hepatic vein)

3. Follicular carcinoma of the thyroid

4. Choriocarcinoma

Front 55

.....is generally required before a tumor can be classified as benign or

malignant with certainty.

Back 55

Biopsy or excision

Front 56

RET

Back 56

MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid

Front 57

Benign tumors are usually well differentiated (Fig. 3.4A). Characteristics include

.......

Back 57

1. Organized growth 2. Uniform nuclei 3. Low nuclear to cytoplasmic ratio 4. Minimal mitotic activity 5. Lack of invasion (of basement membrane or local tissue) 6. No metastatic potential

Front 58

Malignant tumors are classically poorly differentiated (anaplastic, Fig. 3.4B).

Characteristics include

......

Back 58

1. Disorganized growth (loss of polarity)

2. Nuclear pleomorphism and hyperchromasia

3. High nuclear to cytoplasmic ratio

4. High mitotic activity with atypical mitosis

5. Invasion (through basement membrane or into local tissue)

Hint 58

1. Disorganized growth (loss of polarity)

2. Nuclear pleomorphism and hyperchromasia

3. High nuclear to cytoplasmic ratio

4. High mitotic activity with atypical mitosis

5. Invasion (through basement membrane or into local tissue)

Front 59

Keratin

Tissue type

Back 59

Epithelium

Front 60

Vimentin

Tissue type?

Back 60

Mesenchyme

Front 61

Desmin

Tissue type

Back 61

Muscle

Front 62

GFAP

Tissue type

Back 62

Neuroglia

Front 63

Neurofilament

Tissue type

Back 63

Neurons

Front 64

PSA

Tissue type

Back 64

Prostatic epithelium

Front 65

ER

Tissue type

Back 65

Breast epithelium

Front 66

Thyroglobulin

Tissue type

Back 66

Thyroid follicular cells

Front 67

KIT

Back 67

Gastrointestinal stromal tumor

Front 68

Chromogranin

Tissue type

Back 68

Neuroendocrine cells (e.g., small cell Chromogranin

carcinoma of lung and carcinoid tumors)

Front 69

ERBB2 [HER2/ neu] RET

KIT are

Back 69

GROWTH FACTOR RECEPTORS

Front 70

RAS gene family and ABL

Back 70

Are SIGNAL TRANSDUCERS

Front 71

RAS gene family

Back 71

Carcinomas, melanoma, and lymphoma

Front 72

ABL

Back 72

CML and some types of ALL

Front 73

Front (Term)

Back 73

Back (Definition)

Front 74

In response to DNA damage, .....gene slows the cell cycle and upregulates DNA

repair enzymes.

Back 74

In response to DNA damage, p53 slows the cell cycle and upregulates DNA

repair enzymes.