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95 Cards in this Set

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"new growth"
neoplasia
n
• Used to denote uncontrolled growth of cells whose proliferation cannot be adequately controlled by normal regulatory mechanisms operating in normal tissues.
neoplasia
n
proliferation of neoplastic cells leads to formation of masses called
tumors
t
T or F:
•The terms neoplasia and tumor are used synonymously, but realize that not all neoplasms form tumors (I.e. Leukemias), and not all swellings are neoplasms (I.e. Inflammations)
t
have a limited growth potential and a good outcome. (have encapsulation – gives it its limited growth potential)
benign tumors
grow uncontrollably and may eventually kill the host. (invade and tap into other cells, do not have encapsulation
malignant tumors
the two hallmark features of malignant tumors:
necrosis and hemorrhage
n and h
• The capsule is usually composed of ________.
•______tumors have an expansile growth and usually compress the normal, surrounding tissue – but do NOT invade (it can still cause death)
connective tissue, benign
ct, b
malignant tumors invade surrounding tissue by:
infiltration
i
are composed of cells that resemble the tissue from which they have arisen. (encapsulation helps distinguish normal tissue from tumor tissue)
• The cells are composed of a uniform population in which all the cells have the same features, with regularly shaped round or oval nuclei, but all the same size with evenly-distributed chromatin with normal nucleoli.
• They have a well-developed cytoplasm.
benign tumors
benign tumors which show high degrees of “__________” (the extent to which parenchymal cells resemble comparable normal cells, both morphologically and functionally)
differentiation
d
• Malignant cells show prominent _________ in that they exhibit new features not inherent to the tissues of their origins.
anaplasia
a
•Malignant tumors consists of a heterogeneous population of cells that often show marked “___________” or variability.
•They have uneven, ________ (extensively blue = rapid mitotic activity) nuclei that vary in shape and size, are usually larger than normal and have prominent, multiple nucleoli
•Because they are rapidly proliferating, they have no specialized cytoplasmic function and therefore exhibit very little cytoplasm.
pleomorphism, hyperchromatic
p, h
•Denotes a process in which cells move from one site to another in the body.
•Only malignant tumor cells have this capacity
•Benign tumors always remain localized.
•It involves a spread of tumor cells from a primary location to some other site in the body.
•Not all malignant cells are capable of
metastasis
•***The spread of malignant cells occurs through three main pathways:
1. The lymphatics (i.e. Breast cancer)
2. The bloodstream (i.e. Many cancers)
3. Direct extension of the primary tumor, usually by seeding of the surface of body cavities (i.e.Renal cell carcinoma seeding to the adrenal gland)
benign edithelial
-adenoma
benign glandular
-adenoma
benign squamous
-papilloma
benign CT
-oma
benign mesenchymal
-oma
malignant epithelial
-carcinoma
malignant CT
-sarcoma
malignant mesenchymal
-sarcoma
•Not all tumors that end in “oma” are benign, the most important examples of this inconsistent nomenclature includes:
SLAM B
Lymphomas (blood)
Melanomas
Astrocytomas (#1 primary brain)
Seminomas (#1 testitucular) which are all malignant
Blastoma (embryonic tissue
•Malignant tumors composed of embryonic tissue are called
blastoma
b
•Tumors derived from the three germ cell layers, usually in the testes or ovaries, are named either
teratoma or teratocarcinoma
•Cytologic/Histologic grading is based on the degree of ______ and on the number of proliferating cells.
•__________ is determined by the shape and irregularity of the cells, large numbers of atypical mitoses, nuclear pleomorphism and tumor giant cells.
This is called:
anaplasia, anaplasia, cancer grading
•Most grading schemes classify tumors into three grades of increasing degrees of malignancy.
Grade I tumors are Well-Differentiated tumors.
Grade II tumors are Moderately Differentiated.
Grade III tumors are Poorly or Undifferentiated.
• The choice of a medical versus a surgical treatment approach to cancer is influenced by the ______q of a tumor, which refers to the extent of spread.
stage
•The staging is done by clinically assessing the extent of tumor spread, based on examination, radiographic studies, and biopsy results and takes into account:
-This criteria, called the TNM cancer staging system, gives a number designation status,
•There are marked variations of this system, depending upon the primary organ involved, and commonly used criteria includes:
tumor size
extent of local spread within the organ lymph node metastasis and distant metastasis
•Clearly, the presence of lymph node metastasis mandates more aggressive treatment than does their absence, whereas the presence of distant metastasis is generally a contraindication to surgical intervention other than for ______.
_________ care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.
palliation, palliative
p, p
• The cause of most human cancers is unknown, although many potential carcinogens have been identified.
• Because cancer is a multifactorial disease with numerous forms, the causes can be divided into two forms:
1) Exogenous Causes (chemicals, physical agents, and viruses
2) Endogenous Causes (resides in the genome of cells called Oncogenes: altered versions of normal genes that regulate normal cell growth and differentiation.
implicated as potent carcinogens causing GI Tract cancers, especially Esophageal and Stomach cancers. Nitrites, added to preserve processed foods, may react with other dietary components to form
nitrosamine
n
have been identified in cigarette smoke (3,4-benzpyrene causing lung cancer).
Others (Dibenzanthracene) have been implicated in causing cancers of the skin, soft tissue and breast. Vinyl Chloride (plastics) have been implicated in causing
polycyclic aromatic hydrocarbon
p a h
a natural product of the fungus Aspergillus flavus, is among the most potent liver carcinogens. The fungus can contaminate vegetables, grains and peanuts and is endemic to parts of Africa and Asia which favors the growth of the mold and toxin.
Aflotoxin B1
a
like Naphthylamine and Azo (aniline) dyes are both indirect acting, and may cause both urinary bladder and liver tumors because of liver metabolism. In the bladder there is hydrolysis to an active agent, Hydroxylamine, causing cancer.
aromatic amines
a a
Nickel (Lung and Nasal Cancer), Arsenic (Skin cancer), can react with cell macromolecules and depolymerize polynucleotides.
metals and inorganics
m and i
Cytoxin (Cyclophosphamide, can themselves cause bladder cancers, but the benefit of this drug for successful treatment of visceral cancers far exceed the low risk of a secondary cancer.
anticancer drugs
a d
•The effects of ________ on cells include enzyme inactivation, inhibition of cell division, mutagenesis, cell death and cancer
UV radiation
•The most important biochemical effect of UV radiation is the formation of _________ of DNA, a type of DNA damage that is not seen with any other carcinogen, and is both mutagenic and carcinogenic (I.e. Xeroderma pigmentosum)
pyrimidine dimers
p d
•The daughter products of ____ emit alpha particles that bind to dust in the home and may be inhaled and deposited in the lungs.
•Feared that environmental exposure to _____ is associated with Lung cancer, based on the increased findings of this cancer in Uranium miners.
radon, radon
r, r
survivors suffered a number of cancers including a ten-fold increase in Acute Leukemias, 5-10 years after exposure
•CML and CLL (Chronic Myelogenous Leukemia, Chronic Lymphocytic Leukemia)
were also seen as well as Multiple Myeloma and Lymphomas.
•Tumors of the Thyroid, Breasts, GI Tract, Lungs, were also seen in survivors.
atomic bomb radiation
________ fibers lodge in the respiratory tract, and the exposure increases the risk of both Mesotheliomas and squamous cell cancers, especially in smokers.
asbestos
asbestos linked to
mesotheliomas and squamous cell cancers
m
endemic to parts of Africa, Japan, and Caribbean, is the one human cancer linked to HTLV-I, and it is estimated that this leukemia develops in 1-4% of persons infected with HTLV-I.
human T-cell leukemia virus
•An RNA retrovirus that belongs to the same family as HIV, and attacks the same CD4+ T-cells, but causes malignant transformation
human T-Cell Leukemia virus
•A DNA virus that induces lesions that progress to Squamous Cell Carcinoma.
•Classified into more than 70 serotypes, (the lower the number, the more benign) several of which have been linked to genital warts (types 6 and 11), cervical dysplasia and carcinoma (types 16, 18 and 33).
human papilloma virus
isolated from invasive cervical cancer invariably belong to one of these three types
Condyloma:
CIN-I
CIN-II
CIN-III
human papilloma virus
•A DNA virus that only infects humans.
hepatitus B virus
•Epidemiological studies have clearly established an association between chronic infection with _____ (chronic hepatitis and cirrhosis) and the development of primary hepatocellular carcinoma.
•Chronic infection with HCV also carries a high risk of hepatocellular carcinoma.
hepatitis B virus
•A DNA Herpesvirus so widely disseminated that 95% of adults in the world have antibodies.
Epstein-Barr virus
•Infects B-cell lymphs and causes diseases such as Infectious Mono and Chronic Fatigue Syndrome as well as Burkitt Lymphoma, endemic to Africa and found in children, and finally Nasopharyngeal Carcinoma, endemic to Africa and Asia.
•Kissing virus
epstein-barr virus
•Associated to Kaposi sarcoma, a vascular neoplasm that is the most common neoplasm associated with AIDS patients.
•The virus has also been implicated in B-cell lymphoid malignancies.
Human herpesvirus 8
mutated normal cellular genes (proto-oncogenes) that normally encode for proteins important for basic cell function can be transferred into oncogenes by four basic mechanisms:
1) point mutation
2) gene amplification
3) chromosomal rearrangements
4) insertion of viral genome
pm, ga, cr, iovg
this event includes a single base substitution in the DNA chain, resulting in a miscoded protein that has an amino acid substituted for another amino acid
point mutations
p m
-Point mutations have been observed in a number of human cancers carrying a mutated “___” gene, as well as the “_____”, responsible for squamous carcinomas and cancers of the breast, ovary and stomach.
ras and erb-b
r and e
by this mechanism, the cell acquires an increased number of copies of the proto-oncogene.
gene amplification
g a
gene amplification: In the tumor ________, the tumor cells contain multiple copies of the N-myc gene, the more copies of the oncogene the cell contains, the more malignant is the tumor.
neuroblastoma
n
Translocation of one chromosomal fragment onto another, or deletion of a fragment of the chromosome, leads to juxtapositioning of genes that are normally distant from one another.
chromosomal rearrangement
c r
Such gene complexes may result in over-activation of proto-oncogenes, stimulated by an adjacent gene which act as a promoter for the other to produce a tumor.
-I.e. C-myc, which is normally located on chromosome 8, is positioned next to the immunoglobulin gene in ____________, owing to the translocation of chromosome 8 to chromosome 14. This immunoglobulin gene promotes the activity of C-myc, which ultimately results in tumor formation in the form of lymphomas because the immuno-globulin gene is active in lymphocytes.
Burkitt Lymphoma
B L
typical of slow, transforming viruses, results in the disruption of normal chromosomal architecture and genetic dysregulation.
-Hepatitis B virus is found incorporated into the genome of liver cancer cells.
insertion of viral genome
i v g
Normal cells have regulatory genetic mechanisms that protect them against activated or newly acquired oncogenes, such genes are called
tumor suppressor genes
t s g
If a malignant cell is fused with a normal cell, the resultant hybrid cell will be benign because the ______________ of the normal cell suppress the oncogenes contributed to the hybrid.
“force field” stop proto oncogenes into oncogenes
tumor suppressor genes
t s g
The two best known tumor suppressor genes, among many others, are the
1) Retinoblastoma gene (Rb-1) and
2) p53.
A loss of p53 or it’s mutation results in colon or breast carcinoma.
Other tumor suppressor genes include NF-1 (Neurofibromatosis), BRCA-1and 2 (Breast Cancer) and WT-1 gene (Wilms Tumor).
is the most common cause of death from cancer in men.
lung cancer
l c
rare in most of the world except in regions of China, Hong Kong and Singapore, and is associated with infection with Epstein-Barr Virus.
nasopharyngeal
n
the highest incidence occurs in Japan and Latin American countries, particularly Chile, and Ireland. The incidence is 10 times higher in these countries than in the U.S.
stomach cancer
s c
The cause is obscure, but a combination of smoking and alcohol abuse is associated is a extremely high risk. It is high among China and Northern Iran.
esophageal cancer
e c
The highest incidence is found in the U.S., 3-4 times more common than in India, Japan, Africa and L. America. The high fiber diet in these low risk areas and the high fat content in the U.S. are related to these differences.
colorectal cancer
c c
There is a strong correlation between Hepatocellular Carcinoma and the prevalence of Hepatitis B and C, as well as high levels of Aflatoxin B1, a contaminant of many foods in less developed countries. This is endemic to the Orient and the Philippines.
liver cancer
l c
Is universally rare among black populations, the rate about one-fourth that of whites, but higher than African blacks.
testicular cancer
t c
The rates vary with skin color and exposure to the sun. High rates have been reported in northern Australia, where the sun exposure is intense. Increased rates have also been seen in the white population in the American Southwest. The lowest rates are found among persons with pigmented skin (Blacks, Japanese, Chinese and Eastern Indians).
skin cancer
s c
Adenocarcinoma is the most common female cancer in many parts of Europe and North America. The rates in African and Asian populations are only 1/5 of those in the U.S. Although hormonal factors are clearly involved, along with genetics, the role of dietary fat in the pathogenesis in still debated.
breast cancer
b c
The incidence of squamous cell cancer differs between socioeconomic lines, where a higher incidence is seen in the lower vs. the higher groups. This cancer is directly correlated with early sexual activity and multiparity and is rare among women who are not sexually active. A strong association with HPV has been demonstrated.
cervical cancer
c c
very low incidences have been reported in the Asian populations, whereas the highest rates described are in American blacks, in whom the disease is 25 times more often. American and European white males fall between these two.
prostate cancer
p c
this Squamous carcinoma is virtually nonexistent among circumcised men of any race, but is common in many parts of Asia and Africa.
cancer of penis
c of p
an uncommon cancer of Trophoblastic differentiation, is found principally in women following a pregnancy, but can also present as a testicular cancer. The rates of this disease is particularly high in Singapore, Hong Kong, and Japan
choriocarcinoma
c
the rates for Transitional Cell Carcinoma, the most common type, are fairly uniform, but Squamous cell Carcinoma of the bladder has a higher incidence in areas where Schistosoma haematobium are endemic.
cancer of urinary bladder
c of u b
are caused by various substances secreted by the tumor cells and the signs and symptoms may be the first clinical manifestation of the malignant tumor and may allow early detection of the tumor, allowing a potential cure.m
paraneoplastic syndrome
p s
a disease of children, was first described in Uganda, where it accounted for half of all childhood tumors and is still endemic if parts of Africa today. It has been noted that these are areas where malaria is also endemic. Affects jaw.
Burkitt Lymphoma
b l
is uncommon among American whites, but displays a 3-4 times higher incidence in American and South African blacks. Plasma cell cancer
multiple myeloma
m m
is common among elderly persons in Europe and N. America, but is considerably less common in Japan.
chronic lymphocytic leukemia
c l l
anorexia, and weight loss are all very common in patients with cancer, often appearing before its malignant cause becomes apparent.
Caused by wasting secondary to the adverse effects of cancer on the body, which drains the energy and competes for nutrients (I.e. cancer of the GI tract may interfere with nutrition, the esophagus may impede swallowing, cancer of the stomach may impede absorption, pancreatic cancer may impede the entry of juices into the duodenum, all which may lead to malabsorption of nutrients).
cachexia
c
_________ attributed to cancer correlates with tumor growth, disappears after treatment, and reappears on recurrence (I.e. Hodgkins, renal cell carcinoma, and osteosarcoma).
Tumor cells may release pyrogens, or the responding inflammatory cells in the tumor stroma may release pyrogens.
fever
f
In some patients, cancer produces remote effects that are not attributable to the tumor invasion, and in some cases these symptoms may dominate the clinical course.
Causes by substances, such as hormones that are secreted by the tumor cells, and their inappropriate secretion can cause a variety of effects.
paraneoplastic syndromes
p s
Certain tumor products that result in ______________ provide a means of monitoring recurrence of the cancer in patients who have had surgical resection of the tumor or are undergoing chemo or radiation therapy.
paraneoplastic syndromes
p s
due to ectopic secretion of ACTH by a small cell carcinoma of the lung, may cause hypokalemia, HTN and muscle weakness, along with obesity, buffalo hump and a moon face.
Cushing's syndrome
c s
the production of ectopic ADH, also by a small cell carcinoma, or prostate, GI tract or pancreas cancer, may produce Na and H2O retention and intoxication, leading to altered mental status, seizures, coma and even death
inappropriate antidiuresis
i a
affects 10% of all cancer patients, and is usually caused by metastatic disease of bone, although ectopic production of a PTH-like peptide may occur in the absence of bony metastasis.
-Usually secreted by a squamous cell cancer of the lung or adenocarcinoma of the breast.
-In Multiple Myeloma and Lymphomas, ___________ is attributed to the secretion of an osteoclast activating factor.
hypercalcemia, hypercalcemia
h, h
an uncommon neuromuscular disorder that is strongly associated with small cell carcinoma of the lungs. The symptoms resemble Myasthenia Gravis presenting as muscular weakness, wasting, and fatigability of proximal limbs and trunk. This is caused by pathogenic antibodies to the neuromuscular junction.
Eaton-Lamber syndrome
e-l s
The most common hematologic complication of neoplastic disease results from direct infiltration of the marrow.
Cancer-associated polycythemia is a complication of renal cell carcinomas, or hepatocellular carcinomas and is associated with elevated Erythropoietin levels found in both the tumor and in the serum in patients.
paraneoplastic hematologic syndrome
p h a
One of the most common findings in patients with cancer is ANEMIA but the mechanism for this disorder is not clear. The anemia is usually a normocytic, normochromic, although iron-deficiency anemia is also common in some cancers that bleed into the GI tract, such as colon cancer.
paraneoplastic hematologic syndrome
There is an association between cancer of the pancreas and venous thrombosis, most commonly in the deep veins of the legs.
Other tumors associated with venous thrombosis are mucin producing adenocarcinomas of the GI tract and lung cancer. Tumors of the breast, ovary, and prostate occasionally are complicated.
paraneoplastic hypercoagulable state-venous thrombosis
cancers that spread to brain
liver, lung, brain
cancers that can spread from the bone
peanut butter kills the love bone: prostate, breast, kidneys, thyroid, lungs