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Breast & Male Flashcards

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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

Study These Flashcards
A

All benign

  • fibrocystic
  • fibroadenoma
  • papilloma
25
Post-menopausal breast changes
All malignant (minus mammary duct ectasia) - Carcinoma - Phyllodes
26
Breast cancer risk factor
1. Early menarche/late menopause 2. Obesity --> inc estrogen 3. Atypical hyperplasia 4. Nulliparity
27
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
Ductal carcinoma in-situ - Comedo type --> extends to skin of nipple = Paget disease
28
Paget disease cancer assoc
Underlying ductal carcinoma
29
Most common invasive breast cancer
Invasive ductal
30
Mass on breast exam, dimpling of skin or retraction of the nipple with duct-like structures in a desmoplastic stroma
Invasive ductal carcinoma
31
Subtypes of invasive ductal carcinoma
1. Tubular - tubules lack myopeithelial cells 2. Mucinous - carcinoma w/ abundant EC mucin 3. Medullary 4. Inflammatory
32
"Tumor cells floating in mucous pool"
Mucinous breast carcinoma | 70+ y/o
33
Red inflamed, swollen breast that does not respond to antibiotics
Inflammatory invasive ductal carcinoma - tumor cell in dermal lymphatics - poor prognosis
34
High grade cells in sheets assoc w/ plasma cells and lymphocytes in the breast
Medullary invasive ductal carcinoma ***ASSOC W/ BRCA1***
35
Lobular carcinoma in-situ
Incidental finding in bx ***Discohesive - No E-cadherin*** Multifocal B/L Tx = tamoxifen to dec risk of progression to invasive
36
Invasive Lobular carcinoma
SINGLE FILE - lack of E-cadherin
37
Predict response to tamoxifen
Estrogen and Progesterone receptor
38
Predict response to trastuzumab
HER2/neu amplification | -GFR on SURFACE of cells
39
Triple negative breast carcinoma
African Americans | Poor prognosis
40
Hereditary breast cancer
1. 1st degree relative 2. Early age 3. Multiple 4. BRCA1 - female 5. BRCA2 - males
41
Male breast cancer
Invasive ductal BRCA2 Klinefelter syndrome
42
BRCA1 cancers
Medullary carcinoma Serous ovarian & fallopian Breast in women
43
Failure of urethral folds
Hypospadias
44
Failure of genital tubercle
Epispadias | - bladder extrophy
45
Leukoplakia of penile shaft
Bowen disease
46
Erythroplakia of glans
Erythroplasia of Queyrat
47
Orchitis in older men
E. coli or PA
48
Most common type of testicular tumor
Germ cell | - cryptorchidism, klinefelter
49
Testicular mass with large cells with clear cytoplasm, central nuclei. Radiosensitive, homogenous
Testicular germ cell SEMINOMA
50
Testicular mass with immature cells with glands and areas of hemorrhage and necrosis, not radiosensitive, inc AFP, bhCG
Testicular germ cell Nonseminoma - embryonal carcinoma
51
Most common testicular tumor in kids
Yolk Sac/endodermal - schiller-duval - AFP
52
Most common testicular mass in men >60 y/o
Lymphoma - B/L - Large DIFFUSE type B-cell
53
Male with dysuria, pelvic or LBP, WBCs but cultures (-)
chronic prostatitis
54
BPH
Central/Periurethral zone - -> hydronephrosis, bladder diverticula - PSA 4-10
55
BPH Tx
Terazosin - alpha1 blocker Tamsulosin - alpha1-a blocker for normotensive Finasteride - 5alpha reductase --> gynecomastia, sexual dysfxn
56
Prostate cancer
Peripheral zone PSA >10 Hard, knobby Inc alk phos, prostatic acid phosphatase (PAP) w/ mets
57
Prostate cancer risk factors
AA > White > asian Age High saturated fats
58
Prostate cancer Tx
Surgery Leuprolide (GnRH) Flutamide - androgen receptor inhibitor

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