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204 Cards in this Set
- Front
- Back
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Approximately what percentage of brain tumors arise from metastasis?
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50%
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Are basal cell carcinomas invasive?
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Locally invasive but rarely metastasize
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Are Ewing's sarcomas likely to metastasize?
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Yes. They are extremely aggressive with early metastasis. However, they are responsive to chemotherapy.
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Are medulloblastomas radiosensitive?
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Yes
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Are meningiomas resectable?
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Yes
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Are squamous cell carcinomas of the skin invasive?
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Locally invasive but rarely metastasize
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Are the majority of adult tumors supratentorial or infratentorial?
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Supratentorial
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Are the majority of childhood tumors supratentorial or infratentorial?
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Infratentorial
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Common histopathology often seen in squamous cell carcinomas of the skin?
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Keratin pearls
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Define Anaplasia
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Abnormal cells lacking differentiation, like primitive cells of the same tissue. Often equated with undifferentiated malignant neoplasms. Tumor giant cells may be formed.
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Define Dysplasia
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Abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation. It is reversible but is often a preneoplastic sign.
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Define Hyperplasia
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Increase in the number of cells (reversible).
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Define Metaplasia
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One adult cell type is replaced by another (reversible); often secondary to irritation and/or environmental exposure (e.g. squamous metaplasia in the trachea and bronchi of smokers)
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Define Neoplasia
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Clonal proliferation of cells that is uncontrolled and excessive
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Do oncogenes cause a gain or loss of function?
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Gain of function
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Do tumor suppressor genes cause a gain or loss of function?
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Loss of function; both alleles must be lost for expression of disease
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Does a melanoma have a significant risk of metastasis?
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Very significant risk! The depth of the tumor often correlates with the risk of metastasis.
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From what cells do meningiomas most commonly arise?
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Arachnoid cells external to the brain
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Give 2 examples of a benign tumor of epithelial origin.
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1.Adenoma 2.Papilloma
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Give 2 examples of a malignant tumor of epithelial origin.
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1.Adenocarcinoma 2.Papillary carcinoma
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Give 2 examples of malignant tumors of blood cell (mesenchymal) origin.
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1.Leukemia 2.Lymphoma
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Give an example of a benign tumor of blood vessel (mesenchymal) origin.
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Hemangioma
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Give an example of a benign tumor of bone (mesenchymal) origin.
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Osteoma
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Give an example of a benign tumor of more than one cell type.
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Mature teratoma
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Give an example of a benign tumor of skeletal muscle (mesenchymal) origin.
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Rhabdomyoma
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Give an example of a benign tumor of smooth muscle (mesenchymal) origin.
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Leiomyoma
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Give an example of a malignant tumor of blood vessel (mesenchymal) origin.
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Angiosarcoma
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Give an example of a malignant tumor of bone (mesenchymal) origin.
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Osteosarcoma
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Give an example of a malignant tumor of more than one cell type.
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Immature teratoma
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Give an example of a malignant tumor of skeletal muscle (mesenchymal) origin.
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Rhabdomysarcoma
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Give an example of a malignant tumor of smooth muscle (mesenchymal) origin.
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Leiomyosarcoma
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Give an example of a neoplasm associated with Down's Syndrome.
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Acute Lymphoblastic Leukemia (ALL)- (we ALL fall DOWN together)
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How are tumor markers used?
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Tumor markers are used to confirm diagnosis, monitor tumor recurrence, monitor response to therapy. Should not be used as a primary tool for diagnosis.
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How is prostatic adenocarcinoma most commonly diagnosed?
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Digital rectal exam (detect hard nodule) or by prostate biopsy
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How often do primary brain tumors undergo metastasis?
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Very rarely
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In what population is osteochondroma most often found?
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Usually men under the age of 25
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In which age group is prostatic adenocarcinoma most common?
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Men over the age of 50
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Is malignant transformation in osteochondroma common?
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rare
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Name 1 common tumor staging system.
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TNM system T= size of tumor, N=node involvement, and M=metastases
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Name 3 herniation syndromes that can cause either coma or death when the herniations compress the brainstem
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1.Downward transtentorial (central) herniation 2.Uncal herniation 3.Cerebellar tonsillar herniation into the foramen magnum
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Name 4 factors that predispose a person to osteosarcoma.
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1.Paget's disease of bone 2.Bone infarcts 3.Radiation 4.Familial retinoblastoma
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Name 4 possible routes of herniation in the brain
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1.Cingulate herniation under the falx cerebri 2.Downward transtentorial (central) herniation 3.Uncal herniation 4.Cerebellar tonsillar herniation into the foramen magnum
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Name 5 primary brain tumors with peak incidence in adulthood.
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1.Glioblastoma multiforme 2.Meningioma 3.Schwannoma 4.Oligodendroglioma 5.Pituitary adenoma
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Name 5 primary brain tumors with peak incidence in childhood.
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1.Low-grade astrocytoma 2.Medulloblastoma 3.Ependymomas 4.Hemangioblastoma 5.Craniopharyngioma
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Name 5 sites from which tumor cells metastasize to the brain.
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1.Lung 2.Breast 3.Skin (melanoma) 4.Kidney (renal cell carcinoma) 5.GI
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Name a common histopathological sign of basal cell carcinoma nuclei
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The nuclei of basal cell tumors have 'palisading' nuclei
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Name a population at a greater risk for melanoma.
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Fair-skinned people (blue eyes and red hair have also been considered as factors)
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Name the 5 primary tumors that metastasize to the liver
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Colon > Stomach > Pancreas > Breast > Lung
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Name two of the most common sites of metastasis after the regional lymph nodes
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The liver and the lung
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Name two presenting sequelae of a pituitary adenoma.
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1.Bitemporal hemianopsia (due to pressure on the optic chiasm) 2.Hypopituitarism
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On which chromosome is the p53 gene located?
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17p
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On which chromosome is the Rb gene located?
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13q
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On which chromosomes are the BRCA genes located?
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BRCA 1 is on 17q and BRCA 2 is on 13q
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Out of the 6 primary tumors that metastasize to bone, which two are the most common?
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Metastasis from the breast and prostate are the most common
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T/F: Cancer is the 2nd leading cause of death in the U.S.?
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TRUE
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T/F: Deaths from lung cancer have plateaued in males, but continue to inc. in females?
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TRUE
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What 2 cancers are associated with EBV?
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1.Burkitt's lymphoma 2.Nasopharyngeal carcinoma
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What 2 neoplasms are associated with AIDS?
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1.Aggressive malignant lymphomas (non-Hodgkins) 2.Kaposi's sarcoma
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What 2 neoplasms are associated with Autoimmune disease (e.g.Hashimoto's thyroiditis, myasthenia gravis, etc.)?
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Benign and malignant thymomas
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What 2 neoplasms are associated with Paget's disease of bone?
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1.Secondary osteosarcoma 2.Fibrosarcoma
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What 2 neoplasms are associated with Tuberous Sclerosis (facial angiofibroma, seizures, and mental retardation)?
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1.Astrocytoma 2.Cardiac rhabdomyoma
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What are 2 characteristic findings in carcinoma in situ?
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1.Neoplastic cells have not invaded the basement membrane 2.High nuclear:cytoplasmic ratio and clumped chromatin
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What are 2 characteristic findings of an invasive carcinoma?
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1.Cells have invaded the basement membrane using collagenases and hydrolases 2.Metastasize if they reach blood or lymphatic vessels.
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What are 2 neoplasms associated with Xeroderma Pigmentosum?
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1.Melanoma 2.Basal squamous cell carcinoma of the skin
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What are 3 disease findings associated with Alkaline Phosphatase?
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1.Metastases to bone 2.Obstructive biliary disease 3.Paget's disease of bone
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What are 6 primary tumors that metastasize to bone?
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1.Prostate 2.Breast 3.Kidney 4.Thyroid 5.Testes 6.Lung
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What are ependymomas?
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Ependymal cell tumors most commonly found in the 4th ventricle; may cause hydrocephalus
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What are some of the clinical presentations due to brain mass effects?
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Seizures, dementia, focal lesions
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What are the 2 highest mortality associated cancers in men?
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Lung(33%), Prostate(13%)
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What are the 2 highest mortality associated cancers in women?
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Lung(23%), Breast(18%)
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What are the 3 most common cancers in men and their incidence?
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Prostate(32%), Lung(16%), Colon/rectum(12%)
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What are the 3 most common cancers in women and their incidence?
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Breast(32%), Lung(13%), Colon/rectum(13%)
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What are the key features of a craniopharngioma?
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Calcification of the tumor is common (tooth-like development); most common childhood supratentorial tumor.
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What are the steps in the progression of neoplasia?
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1.Normal 2.Hyperplasia 3.Carcinoma In Situ/Preinvasive 4.Invasion
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What are two signs of bone metastases in prostatic adenocarcinoma?
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An increase in serum alkaline phosphatase and PSA (prostate-specific antigen)
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What are two useful tumor markers in prostatic adenocarcinoma?
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Prostatic acid phosphatase and prostate-specific antigen (PSA)
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What can be associated with the risk of melanoma?
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Sun exposure
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What can result from having a medulloblastoma?
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Compression of the 4th ventricle causing hydrocephalus
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What cancer is associated with HBV and HCV (Hep B and C viruses)?
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Hepatocellular carcinoma
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What cancer is associated with HHV-8 (Kaposi's sarcoma-associated herpes virus)?
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Kaposi's sarcoma, body cavity fluid B-cell lymphoma
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What cancer is associated with the HTLV-1 virus?
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Adult T-cell leukemia
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What cancers are commonly associated with HPV (human papilloma virus)?
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Cervical carcinoma, penile/anal carcinoma
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What causes the local effect of tumors for a Mass?
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Tissue lump or tumor
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What causes the local effect of tumors for a Nonhealing ulcer?
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Destruction of epithelial surfaces (e.g. stomach, colon, mouth, bronchus)
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What causes the local effect of tumors for a space-occupying lesion?
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Raised intracranial pressure in brain neoplasms. Also seen with anemia due to bone marrow replacement.
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What causes the local effect of tumors for bone destruction?
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Pathologic fracture or collapse of bone
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What causes the local effect of tumors for edema?
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Venous or lymphatic obstruction
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What causes the local effect of tumors for hemorrhage?
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Caused by ulcerated area or eroded vessel
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What causes the local effect of tumors for inflammation of a serosal surface?
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Pleural effusion, pericardial effusion, or ascites
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What causes the local effect of tumors for obstruction in the biliary tree?
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Jaundice
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What causes the local effect of tumors for Obstruction in the bronchus?
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Pneumonia
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What causes the local effect of tumors for obstruction in the left colon?
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Constipation
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What causes the local effect of tumors for Pain?
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Any site with sensory nerve endings. Remember that tumors in the brain are usually painless.
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What causes the local effect of tumors for perforation of an ulcer in the viscera?
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Peritonitis or free air
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What causes the local effect of tumors for Seizures?
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Tumor mass in the brain.
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What causes the localized loss of sensory or motor function?
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Compression or destruction of nerve (e.g. recurrent laryngeal nerve by lung or thyroid cancer causes hoarseness)
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What causes the paraneoplastic effect gout?
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Hyperuricemia due excess nucleic acid turnover (secondary to leukemias, lymphomas, and cytotoxic therapy)
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What causes the paraneoplastic effect of Cushing's disease?
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ACTH or ACTH-like peptide (secondary to small cell lung carcinoma)
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What causes the paraneoplastic effect of hypercalcemia?
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PTH-related peptide, TGF-B, TNF-a, IL-1 (secondary to squamous cell lung carcinoma, renal cell carcinoma, breast carcinoma, multiple myeloma, and bone metastasis-lysed bone)
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What causes the paraneoplastic effect of Lambert-Eaton syndrome (muscle weakness)?
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Antibodies against presynaptic Ca2+ channels at NMJ (Thymoma, bronchogenic carcinoma)
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What causes the paraneoplastic effect of Polycythemia?
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Erythropoietin (secondary to renal cell carcinoma)
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What causes the paraneoplastic effect of SIADH?
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ADH or ANP (secondary to small cell lung carcinoma and intracranial neoplasms)
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What chemical carcinogen is commonly associated with bladder transitional cell carcinoma?
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Naphthalene
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What chemical carcinogen is commonly associated with liver centrilobar necrosis and fatty acid change?
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CCL4
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What chemical carcinogen is commonly associated with the esophagus and stomach?
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Nitrosamines
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What chemical carcinogen is commonly associated with the lungs?
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Asbestos (Causes mesothelioma and bronchogenic carcinoma)
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What chemical carcinogen is commonly associated with the skin (squamous cell carcinoma)?
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Arsenic
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What chemical carcinogen(s) are commonly associated with the liver?
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Aflatoxins (heptocellular carcinoma), Vinyl chloride (angiosarcoma)
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What is a chondrosarcoma?
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Malignant cartilaginous tumor.
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What is a common genetic finding in Ewing's sarcoma?
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11;22 translocation
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What is a common gross pathological sign seen in Ewing's sarcoma?
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Characteristic 'onion-skin' appearance of bone
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What is a common histopathological finding of meningiomas?
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Spindle cells concentrically arranged in a whorled pattern; Psammoma bodies
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What is a common origin of a chondrosarcoma?
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May be of primary origin or from osteochondroma
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What is a common sign found on the x-ray of a person with osteosarcoma?
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Codman's triangle (from elevation of periosteum)
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What is a craniopharyngioma?
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Benign childhood tumor, confused with pituitary adenoma because both can cause bitemporal hemianopsia.
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What is a Ewing's sarcoma?
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Anaplastic small cell malignant tumor.
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What is a giant cell tumor?
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Locally aggressive benign tumor around the distal femur, proximal tibial region.
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What is a gross pathological sign of basal cell carcinoma?
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Pearly papules
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What is a helpful mnemonic to remember the site of metastasis to the brain?
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Lots of Bad Stuff Kills Glia
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What is a helpful mnemonic to remember the types of cancer that metastasize to the liver?
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Cancer Sometimes Penetrates Benign Liver
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What is a helpful mnemonic to remember what tumors metastasize to bone?
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PB KTTL (Lead Kettle)
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What is a Hemangioblastoma?
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Most often a cerebellar tumor, assoc. w/ von Hippel Lindau syndrome when found with retinoblastoma.
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What is a low-grade astrocytoma (pilocytic astrocytoma)?
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Diffusely infiltrating glioma. In children, it is most commonly found in the posterior fossa.
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What is a medulloblastoma?
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Highly malignant cerebellar tumor; A form of primitive neuroectodermal tumor (PNET)
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What is a neoplasm associated with Actinic Keratosis?
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Squamous cell carcinoma of the skin
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What is a neoplasm associated with Barrett's esophagus (chronic GI reflux)?
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Esophageal adenocarcinoma
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What is a neoplasm commonly associated with Chronic Atrophic Gastritis, pernicious anemia, and postsurgical gastric remnants?
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Gastric adenocarcinoma
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What is an Enchondroma?
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Benign cartilaginous neoplasm found in intramedullary bone (usually distal extremities)
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What is an oligodendroglioma?
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A relatively rare, slow growing, benign tumor.
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What is CEA (carcinoembryonic antigen)?
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Very nonspecific antigen produced by 70% of colorectal and pancreatic cancers; also used for gastric and breast carcinomas
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What is considered a precursor to squamous cell carcinoma?
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Actinic keratosis
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What is considered to be a precursor to malignant melanoma?
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Dysplastic nevus
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What is meant by Tumor Grade?
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Histologic appearance of the tumor (graded I-IV); based on degree of differentiation and number of mitoses per high-power field.
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What is meant by Tumor Stage?
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Based on site/size of primary lesion, spread to regional lymph nodes, and presence of metastases.
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What is the 2nd most common primary brain tumor?
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Meningioma
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What is the 3rd most common primary brain tumor?
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Schwannomas
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What is the characteristic appearance of a giant cell tumor on an x-ray?
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Characteristic 'double bubble' or 'soap bubble' appearance
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What is the common histopathology associated with Ependymomas?
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Characteristic perivascular rosettes; Rod-shaped blepharoblasts (basal ciliary bodies) found near the nucleus.
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What is the common histopathology associated with Hemangioblastoma?
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Foamy cells and high vascularity; can produce EPO and leading to secondary polycythemia.
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What is the common histopathology associated with medulloblastomas?
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Rosettes or perivascular pseudorosette pattern of cells
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What is the common histopathology associated with oligodendrogliomas?
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Fried egg' cells-round nuclei w/ clear cytoplasm; Often CALCIFIED.
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What is the common histopathology associated with schwannoma?
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Antoni A=compact palisading nuclei; Antoni B=loose pattern
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What is the common histopathology found in Glioblastoma multiforme?
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Pseudopalisading' tumor cells border central areas of necrosis and hemorrhage (see color image)
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What is the differentiation pattern of normal cells?
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Basal to apical differentiation
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What is the histopathology associated w/ low-grade astrocytoma?
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Rosenthal fibers
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What is the histopathology commonly associate with giant cell tumors?
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Spindle-shaped cells with multi-nucleated giant cells.
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What is the most common benign bone tumor?
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Osteochondroma
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What is the most common location of basal cell carcinoma of the skin?
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Usually found in sun-exposed areas of the body.
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What is the most common location of osteosarcoma?
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Commonly found in the metaphysis of long bones
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What is the most common population to have chondrosarcoma?
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Men age 30-60 years old
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What is the MOST common primary brain tumor?
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Glioblastoma multiforme (grade IV astrocytoma)
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What is the most common primary malignant tumor of bone?
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Osteosarcoma
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What is the MOST common type of pituitary adenoma?
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Prolactin secreting
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What is the most likely population to have Ewing's sarcoma?
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Boys under 15 years old.
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What is the origin of a craniopharyngioma?
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Derived from the remnants of Rathke's pouch
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What is the origin of a Pituitary adenoma?
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Rathke's pouch
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What is the origin of the Schwannoma?
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Schwann cell origin. Often localized to the 8th cranial nerve (acoustic schwannoma). Bilateral schwannoma found in NF2.
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What is the peak incidence of giant cell tumor?
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20-40 years old
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What is the peak incidence of osteosarcoma?
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Men 10-20 years old
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What is the prognosis for a low-grade astrocytoma?
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Benign; good prognosis
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What is the prognosis for Glioblastoma multiforme?
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Prognosis is grave. Usually only have a year life expectancy.
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What neoplasias are associated with a-fetoprotein?
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Hepatocellular carcinoma, nonseminomatous germ cell tumors of the testis.
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What neoplasias are associated with B-hCG?
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HGC: Hydatidiform moles, Choriocarcinomas, and Gestational trophoblastic tumors.
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What neoplasias are associated with Bombesin?
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Neuroblastoma, lung/gastric cancer
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What neoplasias are associated with CA-125?
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Ovarian and malignant epithelial tumors
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What neoplasias are associated with S-100?
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Melanoma, neural tumors, and astrocytomas
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What neoplasias are associated with TRAP?
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Tartate-resistant acid phosphatase, Hairy cell leukemia
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What neoplasm is associated with Cirrhosis (due to alcoholism, Hep B, or Hep C)
|
Hepatocellular carcinoma
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What neoplasm is associated with Dysplastic nevus?
|
Malignant melanoma
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What neoplasm is associated with Immunodeficiency states?
|
Malignant lymphomas
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What neoplasm is associated with Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, and anemia; all due to iron deficiency)
|
Squamous cell carcinoma of the esophagus
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What neoplasm is associated with Ulcerative Colitis?
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Colonic adenocarcinoma
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What oncogene (gain of function) is associated with breast, ovarian, and gastric carcinomas?
|
erb-B2
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What oncogene (gain of function) is associated with Burkitt's lymphoma?
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c-myc
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What oncogene (gain of function) is associated with colon carcinoma?
|
ras
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What oncogene (gain of function) is associated with Follicular and undifferentiated lymphomas (inhibits apoptosis)?
|
bcl-2
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What oncogene (gain of function) is associated with Lung tumor?
|
L-myc
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What oncogene (gain of function) is associated with Multiple Endocrine Neoplasia (MEN) types II/III?
|
ret
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What oncogene (gain of function) is associated with Neuroblastoma?
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N-myc
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What tumor marker is associated with Prostatic carcinoma?
|
PSA (Prostatic acid phosphatase), used for screening
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What tumor suppressor gene is associated with Retinoblastoma and osteosarcoma?
|
Rb gene
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What type of metastases are common in the late stages of prostatic adenocarcinoma?
|
Osteoblastic metastases in bone
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What type of neoplasm is associated with Acanthosis Nigricans (hyperpigmentation and epidermal thickening)
|
Visceral malignancies (stomach, lung, breast, and uterus)
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What type of skin cancer is associated with excessive exposure to sunlight or arsenic exposure?
|
Squamous cell carcinoma
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Where are chondrosarcomas usually located?
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Pelvis, spine, scapula, humerus, tibia, or femur.
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Where are Ewing's sarcomas most commonly found?
|
Diaphysis of long bones, pelvis, scapula, and ribs
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Where are Glioblastoma multiformes found?
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Cerebral hemispheres
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Where do giant cell tumors most commonly occur?
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At epiphyseal end of long bones
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Where do meningiomas most commonly occur?
|
Convexities of hemispheres and parasagital region
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Where do oligodendrogliomas most often occur?
|
Most often found in the frontal lobes
|
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Where do osteochondromas commonly originate?
|
Long metaphysis
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Where do squamous cell carcinomas most commonly occur?
|
Hands and face
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Where does prostatic adenocarcinoma most commonly arise?
|
From the posterior lobe (peripheral zone) of the prostate gland
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Which has more prognostic value: tumor stage or grade?
|
Stage
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Which is more common: metastasis to bone or primary tumors of bone?
|
Metastatic bone tumors are far more common than primary bone tumors
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Which is more common: metastasis to the liver or primary tumors of the liver?
|
Metastasis to the liver is more common
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Which tumor suppressor gene is associated with most human cancers and the Li-Fraumeni syndrome?
|
p53
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Which tumor suppressor gene/chromosome is associated with Colon cancer?
|
DCC; 18q
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Which tumor suppressor gene/chromosome is associated with Colorectal Cancer?
|
APC; 5q
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Which tumor suppressor gene/chromosome is associated with Neurofibromatosis type-1?
|
NF1; 17q
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Which tumor suppressor gene/chromosome is associated with Neurofibromatosis type-2?
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NF2; 22q
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Which tumor suppressor gene/chromosome is associated with Pancreatic cancer?
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DPC; 18q
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Which tumor suppressor gene/chromosome is associated with Wilm's tumor?
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WT1; 11q
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Which tumor suppressor genes are associated with breast and ovarian cancer?
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BRCA 1/2
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