Neoplasia 1 8-6-15

Question 1

What does neoplasia mean?

Answer 1

new growth

• disorder of cell growth
• triggered by series of acquired mutations of single cell and it clones
• monoclonal, autonomous, irreversible

Question 2

What is a tumor?

Answer 2

abnormal growth of tissue

Question 3

WHat is benign vs malignant?

Answer 3

benign- remain localized, do not metastasize

malignant- invade, destroy, and metastasize

Question 4

What is cancer?

Answer 4

generic term for malignant neoplasm

Question 5

THe two basic components of all tumors are parenchyma and stroma, describe parenchyma and stroma

Answer 5

Parenchyma

• neoplastic cells
• determine biological behavior
• source for the name of neoplasm
• neuroectodermal, epithelial, or mesenchymal in origin

Stroma

• connective tissue, blood vessels, immune system cells
• support growth and spread of neoplasm

Question 6

How are tumors classified? What is oma vs. sarcoma

Answer 6

according to their cell of origin
oma=benign
sarcoma=malignanat

Question 7

What is a mixed tumors derived from 1 germ layer?

Answer 7

• single neoplastic clone capable of divergent differentiation
• derived from 1 germ cell
• more than 1 neoplastic cell type

Example: Salivary Gland
-Clone capable of epithelial and myoepithelial differentiation

-Pleomorphic adenoma-neoplastic epithelial cells scattered in neoplastic myxoid stroma

Question 8

What are teratomas?

Answer 8

-rare tumors contain cells from more than one germ layer

Question 9

What is a mixed tumor derived from more than 1 germ layer?

Answer 9

totipotent germ cells differentiate into any cell types found in human body
-neoplasms originate in gonads, abnormal midline embryonic rests

Question 10

What is the cell morphology, rate of growth, spread of tumor for a benign tumor?

Answer 10

Morphology
-Well-differentiated(resemble normal tissue compartment) to dysplastic 
Rate of Growth 
-Grow more slowly
Spread of Tumor
-Most encapsulated and stay localized

Question 11

What is the cell morphology, rate of growth, spread of tumor for a malignant tumor?

Answer 11

Morphology

• well differentiated to very de -differentiated (anaplastic)
• pleomorphic (variation in nuclear shape and size)
• Abnormal nuclear morphology (high N/C ratio, hyperchromatic, prominent nucleoli)
• Mitosis

Rate of Growth

• Highly variable and unpredictable
• Usually varies with degree of differentiation

Spread of Tumor

• Infiltrate and destroy locally
• ability to metastasize

Question 12

What do well-differentiated squamous cell carcinomas of the skin look like?

Answer 12

-tumor cells strikingly similar to normal squamous epithelial cells with intracellular bridges and nest of keratin (keratin pearls)

Question 13

What is dysplasia?

Answer 13

disordered growth

• principally found in epithelium
• mutations leading to cytological and architectural changes of
• may be a PRECURSOR to malignant transformation
• mild to moderate dysplasias may regress (ie reversible)-particularly if inciting causes are removed

Question 14

What is squamous carcinoma in-situ?

Answer 14

entire thickness of epithelium is replaced by atypical dysplastic cells

• no orderly differentiation of squamous cells
• basement membrane is intact and there is no tumor in the subepithelial stroma

Question 15

Where does dysplasia often occur?

Answer 15

metaplastic epithelium
EX
-squamous cell carcinoma of the uterine cervix
-squamous cell carcinoma of the lung

Question 16

How does metastasis occur?

Answer 16

1. seeding within natural body cavities
   - ovarian carcinomas seed peritoneal cavities
2. lymphatic spread
   - more typical of carcinomas
3. hematogenous spread
   - more typical of sarcomas

Question 17

Why does cancer incidence vary with geography?

Answer 17

exposure to different environmental carcinogens

Question 18

What are some proposed mechanisms to why obesity is associated with cancer?

Answer 18

• elevated insulin levels
• increased estrogens
• decreased adiponectin
• proinflammatory state

Question 19

coal products, tar and mineral oils lead to …
aromatic amines and azo dyes in dye and rubber industry lead to…
asbestos exposure in construction and ship building lead to…

Answer 19

lung cancer
bladder
lung

Question 20

Most cancers occur in greater 55 year olds, what is the most common cancer?

Answer 20

• carcinomas
• likely increased incidence of somatic mutations
• decline in immune competence with age

Question 21

Cancer accounts for greater than 10% of deaths in children

Answer 21

• CNS neoplasms most common

- also theres leukemias

Question 22

What are two autosomal dominant cancer syndromes?

Answer 22

1. familial adenomatous polyps of colon: nearly 100 develop colon cancer
2. familial retinoblastoma
   - 100,000 times risk of cancer than in general population

Question 23

What is a type of recessive syndrome of defective DNA repair that has the tendency to lead to cancer?

Answer 23

-xeroderma pigmentosum

Question 24

Familiar cancers of uncertain inheritance have?

Answer 24

unclear pattern of inheritance and evident familial clustering

Question 25

If you have chronic inflammation particularly T-cell deficiencies, is this a acquired predisposing condition?

Answer 25

yes