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Step 1 > Breast & Male > Flashcards

Breast & Male Flashcards

1
Q

Clonality of neoplastic cells

A

Monoclonal

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2
Q

Clonality of B-lymphocytes

A

Determined by Ig light chain
Kappa: lambda 3:1

Lymphoma light chain 20:1 (or inverted)

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3
Q

Adenoma cell origin

A

Epithelium

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4
Q

Lipoma/Osteoma/Chondroma/Angioma cell origin

A

Mesenchyme

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5
Q

Papilloma cell origin

A

Epithelium

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6
Q

Number of divisions in cancer b4 clinical sx arise

A

30

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7
Q

How do tumor cells spread?

A
  1. Down regulation of E-cadherin
  2. Attaches to laminin & destroys BM
  3. Attaches to fibronectin –> spread –> vasc, lymph = mets
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8
Q

Carcinoma spread

A

Lymphatic

- breast

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9
Q

Sarcoma spread

A

Mesenchymal tissue –> lungs

Exceptions

  • Renal cell –> renal vein
  • HCC –> hepatic vein
  • Follicular
  • Choriocarcinoma
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10
Q

Ovarian carcinoma spread

A

Seeding into body cavity

“Omental caking”

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11
Q

Vimentin

A

Stains Mesenchyme

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12
Q

Desmin

A

Stains muscle

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13
Q

Chromogranin

A

Stains neuroendocrine cells (small cell lung, carcinoid)

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14
Q

ER stain

A

Breast epithelium

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15
Q

Single most important cancer prognostic factor

A

Metastasis (Stage)

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16
Q

Subareolar mass w/ nipple retraction in a smoker

A

Periductal mastitis

Smokers –> vit A deficiency –> squamous metaplasia –> blocking ducts

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17
Q

Periareolar mass w/ GREEN-brown discharge in multiparous post-menopasual women

A

Mammary duct ectasia (dilation) of subareolar ducts

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18
Q

Middle aged women, lumpy mass in upper outer quadrant with blue color

A

Fibrocystic change

#1 pre-menopasual change
BENIGN
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19
Q

Fibrocystic changes associated w/ B/L invasive breast carcinoma

A

Fibrosis, cysts, apocrine metaplasia - no cancer risk
Ductal hyperplasia, sclerosing adenosis - 2x
Atypical hyperplasia - 5x

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20
Q

Middle aged women with bloody nipple discharge with fibrovascular projections lined by epithelial and myoepithelial cells

A

Intraductal papilloma

Carcinoma = POST-menopausal women & NO myoepithelial cells

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21
Q

Most common benign tumor of the breast

A

Fibrous adenoma

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22
Q

Mobile, marble-like mass that grows with pregnancy and painful during menstrual cycle

A

Fibroadenoma

NO inc risk of cancer

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23
Q

Leaf-like projections w/ OVERGROWTH of fibrous component in older woman

A

Phyllodes tumor

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24
Q

Pre-menopausal breast changes

A

All benign

  • fibrocystic
  • fibroadenoma
  • papilloma
25
Q

Post-menopausal breast changes

A

All malignant (minus mammary duct ectasia)

  • Carcinoma
  • Phyllodes
26
Q

Breast cancer risk factor

A
  1. Early menarche/late menopause
  2. Obesity –> inc estrogen
  3. Atypical hyperplasia
  4. Nulliparity
27
Q

Calcification, proliferation of ductal cells w/ invasion of BM. Histology shows high-grade cells with necrosis and dystrophic calcification in the center of the duct

A

Ductal carcinoma in-situ - Comedo type

–> extends to skin of nipple = Paget disease

28
Q

Paget disease cancer assoc

A

Underlying ductal carcinoma

29
Q

Most common invasive breast cancer

A

Invasive ductal

30
Q

Mass on breast exam, dimpling of skin or retraction of the nipple with duct-like structures in a desmoplastic stroma

A

Invasive ductal carcinoma

31
Q

Subtypes of invasive ductal carcinoma

A
  1. Tubular - tubules lack myopeithelial cells
  2. Mucinous - carcinoma w/ abundant EC mucin
  3. Medullary
  4. Inflammatory
32
Q

“Tumor cells floating in mucous pool”

A

Mucinous breast carcinoma

70+ y/o

33
Q

Red inflamed, swollen breast that does not respond to antibiotics

A

Inflammatory invasive ductal carcinoma

  • tumor cell in dermal lymphatics
  • poor prognosis
34
Q

High grade cells in sheets assoc w/ plasma cells and lymphocytes in the breast

A

Medullary invasive ductal carcinoma

ASSOC W/ BRCA1

35
Q

Lobular carcinoma in-situ

A

Incidental finding in bx
Discohesive - No E-cadherin
Multifocal
B/L

Tx = tamoxifen to dec risk of progression to invasive

36
Q

Invasive Lobular carcinoma

A

SINGLE FILE - lack of E-cadherin

37
Q

Predict response to tamoxifen

A

Estrogen and Progesterone receptor

38
Q

Predict response to trastuzumab

A

HER2/neu amplification

-GFR on SURFACE of cells

39
Q

Triple negative breast carcinoma

A

African Americans

Poor prognosis

40
Q

Hereditary breast cancer

A
  1. 1st degree relative
  2. Early age
  3. Multiple
  4. BRCA1 - female
  5. BRCA2 - males
41
Q

Male breast cancer

A

Invasive ductal
BRCA2
Klinefelter syndrome

42
Q

BRCA1 cancers

A

Medullary carcinoma
Serous ovarian & fallopian
Breast in women

43
Q

Failure of urethral folds

A

Hypospadias

44
Q

Failure of genital tubercle

A

Epispadias

- bladder extrophy

45
Q

Leukoplakia of penile shaft

A

Bowen disease

46
Q

Erythroplakia of glans

A

Erythroplasia of Queyrat

47
Q

Orchitis in older men

A

E. coli or PA

48
Q

Most common type of testicular tumor

A

Germ cell

- cryptorchidism, klinefelter

49
Q

Testicular mass with large cells with clear cytoplasm, central nuclei. Radiosensitive, homogenous

A

Testicular germ cell SEMINOMA

50
Q

Testicular mass with immature cells with glands and areas of hemorrhage and necrosis, not radiosensitive, inc AFP, bhCG

A

Testicular germ cell Nonseminoma - embryonal carcinoma

51
Q

Most common testicular tumor in kids

A

Yolk Sac/endodermal

  • schiller-duval
  • AFP
52
Q

Most common testicular mass in men >60 y/o

A

Lymphoma

  • B/L
  • Large DIFFUSE type B-cell
53
Q

Male with dysuria, pelvic or LBP, WBCs but cultures (-)

A

chronic prostatitis

54
Q

BPH

A

Central/Periurethral zone

  • -> hydronephrosis, bladder diverticula
  • PSA 4-10
55
Q

BPH Tx

A

Terazosin - alpha1 blocker
Tamsulosin - alpha1-a blocker for normotensive
Finasteride - 5alpha reductase –> gynecomastia, sexual dysfxn

56
Q

Prostate cancer

A

Peripheral zone
PSA >10
Hard, knobby
Inc alk phos, prostatic acid phosphatase (PAP) w/ mets

57
Q

Prostate cancer risk factors

A

AA > White > asian
Age
High saturated fats

58
Q

Prostate cancer Tx

A

Surgery
Leuprolide (GnRH)
Flutamide - androgen receptor inhibitor

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