Pathology Neoplasia, Immune

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"new growth"

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neoplasia
--the new growth is a neoplasm

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oncology

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greek -- oncos -- tumor
*the study of tumors or neoplasms

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common name for malignant tumors

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cancer

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why cancer? latin for crab?

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b/c a cancer adheres to any part that it seizes upon in an obstinate manner like the crab

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all tumors, benign and malignant, have 2 basic components

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1- proliferating neoplastic cells that constitute their parenchyma
2- supportive stroma made up of connective tissue and blood vessels

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these tumors are designated by attaching the suffix "oma" to the cell of origin

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benign
fibroblastic -- fibroma
cartilage -- chondroma
osteoblasts -- osteoma
etc

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term applie to the benign epithelial neoplasm that forms glandular patterns as well as to the tumors derived from glands but not necessarily reproducing glandular patterns

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adenoma

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benign epithelial neoplasms producing microscopically or macroscopically visible fingerlike or warty projections from epithelial surfaces are referred to as...

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papillomas

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form large cystic masses, as in the ovary

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cystadenomas

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some tumors produce papillary patterns that protrude into cystic spaces .....

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papillary cystadenomas

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polyp

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when a neoplasm, benign or malignant, produces a macroscopically visible projection above a mucosal surface and projects, for example, into the gastric or colonic lumen

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what should malignant polyps be designated as?

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polypoid cancers

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sarcoma

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malignant tumors arising in mesenchymal tissue

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rhabdomyosarcoma

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striated muscle cancer

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malignant neoplasms of epithelial cell origin, derived from any of the 3 germ layers, are called ____________

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carcinomas

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carcinomas with a glandular growth pattern microscopically is termed an _________

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adenocarcinoma

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carcinomas proucing recognizable squamous cells arising in any epithelium of the body would be termed ________

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squamous cell carcinoma

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infrequently divergent differentiation of a single line of parenchymal cells creates what are called ________

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mixed tumors

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mixed tumor of salivary gland
these tumors contain epithelial components scattered within a myxoid stroma that sometimes contains islands of apparent cartilage or even bone. All these elements, it is believed, arise from epithelial and myoepithelial cells of salivary gland origin; thus the preferred designation of these neoplasms is __________

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pleomorphic adenoma

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the great majority of neoplasms even mixed tumors, are composed of cells representattive of ________

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a single germ layer

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a ________ is made up of a variety of parenchymal cell types representative of more than one germ layer, usually all 3

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teratoma

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teratomas arise from _______ cells...these differentiate along various germ lines, producing, ie, tissues that can be identified as skin, muscle, fat, gut epithelium, tooth structures, and indeed any tissue of the body

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totipotential

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differentiates principally along ectodermal lines to create a cystic tumor lined by skin replete with hair, sebaceous glands, and tooth structures

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ovarian cystic teratoma (dermoid cyst)

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t-lymphocytes are mediators of

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cellular immunity

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t-lymphocytes are recognized by the membrane marker ______

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CD3

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t-helper lymphocytes are recognized by the membrane marker ______

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CD4

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t-cytotoxic lymphocytes are recognized by the membrane marker ______

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CD8

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normally the t-lymphocyte comprises about ______% of peripheral lymphocytes in the blood

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60-70

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normally the b-lymphocytes comprise about _____% of the peripheral lymphocytes in the blood

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10-20

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b-lymphocytes are recognized by the membrane marker

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CD19, CD20, CD21

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when stimulated by antigen some b-lymphocytes differentiate into

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plasma

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t/f
the principle roles of macrophages in cell mediated immunity is as antigen processing and presenting cells

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t

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normally the natural killer cells comprise about _____% of peripheral lymphocytes in the blood

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10-15%

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______ are:
able to lyse tumor cells
are CD3 negative and CD56 +
have an FC receptor for IgG

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natural killer cells

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the principle role of dendritic and langerhans cells in the immune response is

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antigen presentation

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cytokines in the immune response participate in:(3)

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regulate lymphocyte growth
activate inflammatory cells
affect leukocyte movement

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the principle fxn of MHC molecules is

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to bind antigens for presentation to select immune effector cells

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t/f
class I molecules are found on most nucleated cells while class II molecules are found on fewer cells

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true

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class I molecules are required for ______ activation

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cytotoxic t-cells

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the strongest association b/w HLA and a disease is found with

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Ankylosing Spondylitis

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class II molecules are required for _______ activation

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helper t-cells

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pallor/cyanosis of the fingers

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raynauds

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angioma formation

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telanglectasia

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fibrosis of the finger digits

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sclerodactyly

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the antibody involed in anaphylaxis is

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IgE

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the principle mediator involved in an anaphylactic rxn is

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histamine

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t/f
activation of complement and accumulation of polymorphonuclear cells are important components of immune complex mediated tissue injury

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true

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t/f
in immune complex mediated disease most pathogenic complexes tend to be very large

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false

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t/f
the arthus rxn is a systemic immune complex reaction

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false

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clonal energy is a process that ultimately leads to

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functional inactivation of lymphocytes

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t/f
an autoimmune disease is essentially an immune rxn against self antigens

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true

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t/f
immune tolerance and self tolerance are the same thing

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false

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loss of self tolerance may be the result of (3)

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modification of an antigen
deactivation of anergic autoreactive lymphocytes
emergence of sequestered antigens

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t/f
systemic lupus erythematosis is relatively common (1:2500)

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true

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t/f
systemic lupus erythematosis is more common in males than in females

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false

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t/f
systemic lupus erythematosis is more common and severe in caucasions

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false

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*is a systemic inflammatory disroder
*is very common (1%)
*affects principally the small joints of the hands and feet

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rheumatoid arthritits

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the cause of rheumatoid arthritis is

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unknown

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raynard's phenomenon typically involves the

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hands

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t/f
life expectancy does not change with rheumatoid arthritis

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false --> decreases

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t/f
juvenile rheumatoid arthritis essentially the same disease as adult rheumatoid arthritis except it occurs in children

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false

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t/f
most of the spondyloarthropathies are seropositve for RF

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false

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*dry eyes and xerostoma
*aka sicca syndrome
*predominately in women

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Sjogrens syndrome

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all of the following are components of CREST syndrome (4)

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raynaud phenomenon
esophogeal dysmotility
sclerodactyly
telangiectasia

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patients with defects in immunoglobulin, complement or phagocytic cells typically suffer from infections caused by

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pyrogenic bacteria

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most common immunodefiency

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burtons

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results from the lack of thymine influence on the immune system

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DiGeorges syndrome

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b-cell differentiation defect

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IgA deficiency

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a defect of both t & b cells

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SCIDS

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a malignant mesothelioma is related to exposure to

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asbestos

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esophageal carcinoma

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is most often a squamous cell carcinoma

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the most common cancer death in women is

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lung

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95% of primary lung tumors arise from

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brochial epithelium

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a mass or nodule of normal tissue in an abnormal site

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choristoma

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_______ tumors may be well differentiated

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both benign and malignant

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_______ tumors are usually well demarcated

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benign

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liver cancer is associated w/ exposure to

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aflatoxin B

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growth inhibiting cancer suppressor genes are also known as

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antioncogenes

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cervical cancer is associated w/

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papillomavirus

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genetic damage

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is a mutation

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familial adematous polyposis (FAP) syndromes

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have a high propensity for malignant transformation

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a tumor that has finger-like fronds

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papilloma

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the genetic hypothesis of cancer implies

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that a tumor mass results from clonal expansion of a single genetically damaged cell

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the most common cancer death in men is

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lung

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______ tumors tend to be invasive

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malignant

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in general the lung cancer with the best prognosis is

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bronchial carcinoid

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______ tumors may be clinically signifigant

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both benign and malignant

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excluding skin cancer and carcinoma-in-situ the most common cancer in women is

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breast

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a spider telangiectasia is most often

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found in patients with liver cirrhosis

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plays a role in the pathogenesis of cancer

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alteration of genes that regulate apoptosis

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dysplasia means

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disordered

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the tissue or organ that has the most primary neoplasms is

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colon

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willms tumor

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is a tumor of children

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a malignant neoplasm of epithelial origin

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carcinoma

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_______ tumors may metastasize

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malignant

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most chemical carcinogens are

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procarcinogens

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paraneoplastic syndromes are important to recognize

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they may represent the earliest manifestation of an occult neoplasm

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bladder cancer is associated w/ exposure to

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beta-naphthylamine

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most gastric carcinoma

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-is asymptomatic
-is found in the lesser curvature of the antrpyloric region
-occurs in males

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hypercalcemia, as a paraneoplastic syndrome, is associated with

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parathyroid hormone

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a tumor that produces a hollow cystic mass is a

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cystadenoma

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colorectal cancer is often

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an adenocarcinomas

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warts are associated with

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papillomavirus

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the most common or frequently occuring presenting clinical finding of kidney carcinoma

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hematuria

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oncoproteins

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are produced from transformed cells

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a neoplasm of more than one germ line or layer

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teratoma

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the most common malignant tumor of the kidney is

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renal cell carcinoma

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testicular cancer test

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HCG

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colorectal cancer test

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CEA

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liver cancer test

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alpha-fetoprotein

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the strongest risk factor associated with oral cancer

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smokless tobacco & pipe smoking

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fundamental to the origin of all neoplasms is

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loss of responsiveness to normal growth controls

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sir percival pott is associated with which type of lesion

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scrotal skin cancer

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Kaposi sarcoma

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in immunosuppresed patients may regress when immunosupressive therapy is discontinued

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with few exceptions all cancers can metastasize; the major exception are neoplasms of

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glial cells

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_______ tumors demonstrate significant anaplasia

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malignant

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leukemia is associated with exposure to

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atomic bombs

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the most common lung cancer in nonsmokers, women and those under 40y/o is

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adenocarcinoma

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aflatoxin b may cause

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hepatocellular carcinoma

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beta napthlamine may cause

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bladder cancer

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nitrosamines may cause

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gastric cancer

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uv light

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skin cancer

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a mass of disorganized tissue in a normal site

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hamartoma

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a malignant neoplasma of mesenchymal origin

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sarcoma