3: Neoplasia

Question 1

Neoplasia

Answer 1

New growth; a clonal process initiated by a genetic mutation conferring growth advantage on the cells involved

Question 2

Are neoplasias benign or malignant?

Answer 2

Neoplasia encompasses both

Question 3

Benign vs malignant

Answer 3

Benign: localized
Malignant: invades and metastasizes -> cancer

Question 4

Ways benign tumors can cause great harm

Answer 4

Spinal cord compression, airway compression, hemorrhage, hormone secretion

Question 5

Four types of cancer that are always malignant

Answer 5

1. Melanoma
2. Lymphoma
3. Seminoma
4. Leukemia

Question 6

Why cant hematopoietic malignancies be benign?

Answer 6

Its impossible for them to stay localized - theyre in the blood!

Question 7

Acute vs chronic leukemia

Answer 7

Acute: cancerous cells have halted maturation at the blast stage
Chronic: cancer cells consist of mature cells

Question 8

What is unique about metastasis of GI cancers?

Answer 8

Can spread via all three routes

Question 9

Sentinel LN biopsy

Answer 9

Tracer dye injected into a tumor -> first LNs to take up the dye are the sentinel nodes - these are removed and isolates the most likely site of metastasis for evaluation

Question 10

Virchow node

Answer 10

Supraclavicular LN often associated with carcinoma in the thorax or abdomen

Question 11

Why is Virchow’s node common in any CA of thorax or abdomen?

Answer 11

CA can metastasize into the thoracic duct -> L subclavian V -> Virchow’s node is along this

Question 12

TNM Staging

Answer 12

T: tumor size
N: degree and manner of nodal Mets
M: presence/absence of distant mets

Question 13

Most common three cancers in males vs females

Answer 13

Males: prostate, lung, colon/rectum
Female: breast, lung, colon/rectum

Question 14

Cancer that causes the most death in males and females

Answer 14

Lung cancer

Question 15

What sets many childhood cancers apart from adult cancers?

Answer 15

Germline mutations

Question 16

Two reasons screening for CA works?

Answer 16

1. ID cancers in early stages

2. ID cancers before they are cancers

Question 17

P450 haplotypes

Answer 17

Can make people more protected from cancer or more susceptible

Question 18

How does acute promyelocytic leukemia cause DIC?

Answer 18

Leukemic cells express tissue factor -> activates factor X -> endothelial injury and anticoagulant dysfunction -> thrombin release -> ischemic damage

Question 19

What does DIC stand for?

Answer 19

Disseminated intravascular coagulation

Question 20

Direct vs indirect carcinogen

Answer 20

Direct: carcinogenic immediately
Indirect: a metabolic process must take place for substance to become an active carcinogen

Question 21

Cytochrome p450 function in carcinogenesis

Answer 21

Converts most indirect carcinogens into their active form

Question 22

Pyrimidine dimers and what fixes them

Answer 22

Dimers that distort DNA due to UV rays; fixed by NER (nt excision repair)

Question 23

What happens if you lack NER?

Answer 23

Xeroderma pigmentosum - sporadic melanomas

Question 24

Pseudomyxoma peritonei

Answer 24

A distinct subtype of seeding body cavities, most commonly due to a primary carcinoma of the appendix

Question 25

What can pseudomyxoma peritonei cause?

Answer 25

Voluminous accumulation of gelatinous material in abdominal cavity (“jelly belly”)

Question 26

Most common pathway for initial dissemination of carcinomas

Answer 26

Lymphatic spread