Neoplasia II

Question 1

Differentiation

Answer 1

How much the tumor cells resemble its cell of origin

Question 2

If a tumor cell resembles its cell of origin it is _______.

Answer 2

Well-differentiated

Question 3

If a tumor cell sort of resembles its cell of origin it is ____.

Answer 3

Moderately-differentiated

Question 4

If a tumor cell doesn’t resemble its cell of origin at all it is ____.

Answer 4

Poorly-differentiated

Question 5

Benign tumors are usually _____ differentiated.

Answer 5

Well

Question 6

What type of differentiation can malignant tumors be?

Answer 6

Any level

Question 7

Anaplasia

Answer 7

A state of complete un-differentiation

Really it means that the individual cells are poorly-differentiated which almost always indicates malignancy

Question 8

If a cell shows anaplasia what would you see?

Answer 8

Pleomorphism (multiple sizes and shapes)
Hyperchromatic (deeply colored)
Bizarre nuclear shapes, distinct nucleoi
Lots of mitoses, atypical mitoses
"Architectural anarchy"

Question 9

Dysplasia

Answer 9

Disordered growth

Used to describe disorderly changes in non-neoplastic epithelial cells, is a step toward cancer

Question 10

How is dysplasia measured?

Answer 10

Mild (frequently reversible)
Moderate (usually reversible)
Severe (usually progresses into carincoma in situ

Question 11

What would you see in dysplasia?

Answer 11

Pleomorphism
Hyperchromatic, large nuclei
Lots of mitoses
Architectural anarchy

Question 12

What is tumor growth dependent on?

Answer 12

Blood supply
Hormonal factors
Emergence of aggressive sub-clones

Question 13

Which grows faster; malignant or benign?

Answer 13

Malignant

Question 14

Which grows faster; poorly or well defined?

Answer 14

Poor

Question 15

Growth fraction (GF)

Answer 15

Cells that are actively dividing

Question 16

Describe the tumor growth based on its age?

Answer 16

Early (subclinical) - GF high

Late (clinically detectable) - GF low

Question 17

Which types of cancers have a high growth fraction?

Answer 17

Leukemias, lymphomas, small-cell lung cancer

Question 18

Which types of cancers have a low growth fraction?

Answer 18

Breast, colon

Question 19

If you are presented with a high GF tumor, what is the treatment?

Answer 19

Chemotherapy/radiation

Question 20

If you are presented with a low GF tumor, what is the treatment?

Answer 20

Treat by debulking with chemotherapy/radiation

Question 21

What is the characteristic of a local invasion by a benign tumor?

Answer 21

Stay where it is
Can’t invade or metastasize
Usually encapsulated

Question 22

What is the characteristic of a local invasion by a malignant tumor?

Answer 22

Infiltrate, invade and destroy surrounding tissue
Metastasize to other body parts
Not encapsulated

Question 23

Metastasis

Answer 23

Development of secondary tumor implants in distant tissue

Question 24

How many pts with have malignancies at stage 4 by the time its located?

Answer 24

1/2

Question 25

What does a metastasis depend on?

Answer 25

Type of tumor
Size of tumor
Degree of differentiation of tumor

Question 26

Which types of tumor will metastasize the fastest?

Answer 26

Neuroendorcine > adeno > squamos

Question 27

What are the three types of metastasis?

Answer 27

Seeding (direct extension)
Lymphatic spread
Hematogenous spread

Question 28

What is seeding metastasis?

Answer 28

Tumor invades body cavity (plueral, pericardial, peritoneal, intracranial)
Bits break off and surface implants

Question 29

What is lymphatic spread?

Answer 29

Tumor spreads to local lymph nodes
Sentinel lymph node first
Moves through thoracic duct
Empties into subclavian vein

Question 30

What is hematogenous spread?

Answer 30

Veins are easier to invade arteries

Liver and lungs are most common sites

Question 31

How do carcinomas like to spread?

Answer 31

Lymphatic spread

Question 32

How do sarcomas like to spread?

Answer 32

Hematogenous spread