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MOD Exam 2 > Ch 7: Neoplasia > Flashcards

Ch 7: Neoplasia Flashcards

1
Q

benign tumors

A

when tumor’s gross and microscopic appearances are considered relatively innocent

likely to remain localized, will not spread to other sites and is amenable to local surgical removal

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2
Q

malignant tumors

A

tumors that can invade and destroy adjacent structures and spread to distant sites (metastasize) to cause death

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3
Q

mixed tumors

A

tumors that contain multiple cell types due to divergent differentiation of a single neoplastic clone

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4
Q

teratoma

A

a tumor that contains recognizable mature and immature cells or tissues belonging to more than one germ cell layer (sometimes all 3)

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5
Q

hamartomas

A

disorganized but benign masses composed of cells indigenous to the involved site

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6
Q

choristoma

A

a heterotopic rest of cells

ex: a small nodule of well-developed and normally organized pancreatic tissue found on the submucosa of the stomach

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7
Q

benign tumor ends in…

A
  • oma

ex: squamous cell papilloma

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8
Q

malignant tumor ends in…

A
  • sarcoma
  • carcinoma

ex: squamous cell carcinoma

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9
Q

differentiation

A

the extent to which neoplastic parenchymal cells resemble the corresponding normal parenchymal cells both morphologically and functionally

benign tumors are well-differentiated

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10
Q

anaplasia

A

lack of differentiation

hallmark of malignancy

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11
Q

morphological changes associated with anaplasia

A 
pleomorphism – variation in size and shape
abnormal nuclear morphology
mitoses 
loss of polarity
areas of ischemic necrosis
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12
Q

metaplasia

A

replacement of one type of cell with another type due to tissue damage, repair and regeneration

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13
Q

dysplasia

A

disordered growth

*MAY lead to malignant transformation

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14
Q

carcinoma in situ

A

a pre-invasive lesion that involves the full thickness of the epithelium but does not penetrate the basement membrane

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15
Q

invasive carcinoma

A

tumor cells that have breached the basement membrane

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16
Q

growth characteristic of benign tumors

A

well-differentiated

develop a rim of compressed fibrous tissue called a capsule consisting of extracellular matrix deposited by fibroblasts activated during hypoxic damage (makes benign tumors easier to remove surgically

progressive and slow-growing –may come to a standstill or regress

do not invade or infiltrate surrounding normal tissues

no metastasis

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17
Q

growth characteristic of malignant tumors

A

anaplastic (lack differentiation)

erratic growth – may be slow or rapid

mitotic figures present

locally invasive

poorly demarcated from the surrounding normal tissue

frequent metastasis

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18
Q

metastasis

A

the spread of a tumor to sites that are physically discontinuous with the primary tumor

marks a tumor as malignant

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19
Q

pathways of metastasis spread

A
  1. ) direct seeding of body cavities
  2. ) lymphatic spread *most common
  3. ) hematogenous spread
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20
Q

sentinel lymph node

A

the first node in a regional lymphatic basin that receives lymph flow from the primary tumor

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21
Q

hematogenous spread

A

*more likely venous than arterial

tumor cells follow venous drainage flow and come to rest in the first capillary bed they encounter (ex: liver and lung cancers)

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22
Q

environmental factors

A

infectious agents
smoking
reproductive history
environmental carcinogens

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23
Q

arsenic causes which cancer?

A

lung carcinoma

skin carcinoma

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24
Q

asbestos causes which cancer?

A

lung, esophageal, gastric and colon carcinoma

mesothelioma if you or a loved one has been diagnosed with mesothelioma you may be entitled to compensation

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25
Q

benzene causes which cancer?

A

acute myeloid leukemia

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26
Q

beryllium causes which cancer?

A

lung carcinoma

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27
Q

cadmium causes which cancer?

A

prostate carcinoma

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28
Q

chromium causes which cancer?

A

lung carcinoma

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29
Q

nickel causes which cancer?

A

lung and oropharyngeal carcinoma

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30
Q

radon causes which cancer?

A

lung carcinoma

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31
Q

vinyl chloride causes which cancer?

A

hepatic angiosarcoma

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32
Q

how does age contribute to the incidence of cancer?

A

accumulation of somatic mutations associated with the emergence of malignant neoplasms

the decline in immune competence that accompanies aging

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33
Q

acquired predisposing conditions that increase the risk of cancer

A

chronic inflammation
precursor lesions
immunodeficiency states

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34
Q

IBD is associated with which cancer?

A

colorectal carcinoma

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35
Q

Lichen sclerosis is associated with which cancer?

A

vulvar squamous cell carcinoma

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36
Q

pancreatitis is associated with which cancer?

A

pancreatic carcinoma

*alcoholism

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37
Q

chronic cholecystitis is associated with which cancer?

A

gallbladder cancer

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38
Q

reflux esophagitis and Barett esophagus are associated with which cancer?

A

esophageal carcinoma

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39
Q

Sjogren syndrome and Hashimoto thyroiditis are associated with which cancer?

A

MALT lymphoma

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40
Q

Opisthorchis and cholangitis are associated with which cancer?

A

cholangiocarcinoma and colon carcinoma

*liver flukes (parasitic infection)

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41
Q

Gastritis is associated with which cancer?

A

gastric adenocarcinoma and MALT lymphoma

*H. pylori infection

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42
Q

hepatitis is associated with which cancer?

A

hepatocellular carcinoma

*Hep B or C infection

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43
Q

osteomyelitis is associated with which cancer?

A

carcinoma in draining sinuses

*bacterial infection

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44
Q

chronic cervicitis is associated with which cancer?

A

cervical carcinoma

*HPV infection

45
Q

chronic cystitis is associated with which cancer?

A

bladder carcinoma

*schistosomiasis (parasitic infection)

46
Q

molecular basis of cancer

A

nonlethal genetic damage
clonal expansion of a single precursor cell
mutation in regulatory genes
accumulation of complementary mutations

47
Q

driver mutations

A

the initiating mutation that contributes to the development of the malignant phenotype

48
Q

epigenetic modifications

A

DNA methylation – silences tumor suppressor genes
histone modifications – may dampen or enhance gene expression
RNA modifications

49
Q

physiological changes in cancer cells (8)

A 
self-sufficiency in growth signals
insensitivity to growth-inhibitory signals
altered cellular metabolism
evasion of apoptosis
limitless replicative potential (immortality)
sustained angiogenesis
ability to invade and metastasize
ability to evade host immune response
50
Q

oncogenes

A

created by mutations in proto-oncogenes and encode proteins called oncoproteins that have the ability to promote cell growth

51
Q

which signaling pathway is most frequently mutated in human neoplasms?

A

receptor tyrosine kinase pathway

52
Q

PDGFB

A

category: PDGF-B chain
mode of activation: overexpression
associated tumor: astrocytoma

53
Q

HST1

A

category: fibroblast growth factor
mode of activation: overexpression
associated tumor: osteosarcoma

54
Q

FGF3

A

category: fibroblast growth factor
mode of activation: amplification
associated tumors: stomach cancer, bladder cancer, breast cancer, melanoma

55
Q

TGFA

A

category: TGF-a
mode of activation: overexpression
associated tumor: astrocytoma

56
Q

HGF

A

category: HGF
mode of activation: overexpression
associated tumors: hepatocellular carcinoma and thyroid cancer

57
Q

ERBB1 (EGFR)

A

category: EGF-receptor family
mode of activation: mutation
associated tumor: lung adenocarcinoma

58
Q

ERBB2 (HER)

A

category: EGF-receptor family
mode of activation: amplification
associated tumor: breast cancer

59
Q

ALK

A

category: ALK receptor (RTK)
mode of activation: translocation or point mutation
associated tumor: lung adenocarcinoma, lymphomas and neuroblastoma

60
Q

KRAS

A

category: GTP-binding proteins
mode of activation: point mutation
associated tumor: colon, lung and pancreatic tumors

61
Q

HRAS

A

category: GTP-binding proteins
mode of activation: point mutation
associated tumors: bladder and kidney cancers

62
Q

NRAS

A

category: GTP-binding proteins
mode of activation: point mutation
associated tumors: melanomas and hematologic malignancies

63
Q

ABL

A

category: nonreceptor tyrosine kinase
mode of activation: translocation or point mutation
associated tumors: CML or ALL

64
Q

BRAF

A

category: RAS signal transduction
mode of activation: point mutation or translocation
associated tumors: melanomas, leukemias, colon carcinoma

65
Q

APC

A

function: inhibit WNT signaling
associated tumors: stomach, colon, and pancreas carcinoma and melanoma
familial syndromes: familial colonic polyps and carcinomas

66
Q

PTCH

A

function: inhibit SHH signaling
familial syndromes: Gorlin syndrome
associated tumors: basal cell carcinoma and medulloblastoma

67
Q

MYC

A

category: transcriptional activators
mode of activation: translocation
associated tumor: Burkitt lymphoma

68
Q

CCND1 (cyclin D1)

A

category: cyclins
mode of activation: translocation or amplification
associated tumors: Mantle cell lymphoma, multiple myeloma, breast cancer and esophageal cancer

69
Q

CDK4

A

category: cyclin-dependent kinase
mode of activation: amplification or point mutation
associated tumors: glioblastoma, melanoma and sarcoma

70
Q

NF1 (Neurofibromin 1)

A

function: inhibitor of RAS/MAPK signaling
familial syndromes: neurofibromatosis 1
associated tumor: neuroblastoma, juvenile myeloid leukemia

71
Q

NF2 (merlin)

A

function: cytoskeleton stability, Hippo pathway signaling
familial syndromes neurofibromatosis 2
associated tumors: schwannoma and meningioma

72
Q

RB

A

function: inhibitor of G1/S transition
familial syndromes: familial retinoblastoma syndrome
associated tumor: retinoblastoma, osteosarcoma, breast cancer colon cancer and lung cancer

73
Q

VHL

A

function: inhibitor of hypoxia-induced transcription factors
familial syndromes: von hippel lindau syndrome
associated tumors: renal cell carcinoma

74
Q

CDH1 (E-cadherin)

A

function: cell adhesion and inhibition of cell motility
familial syndrome: familial gastric cancer
associated tumors: gastric carcinoma and lobular breast cancer

75
Q

TP53

A

function: cell cycle arrest and apoptosis
familial syndrome: Li-Fraumeni syndrome
associated tumors: basically all cancers

76
Q

BRCA1 and BRCA2

A

function: repair of double-stranded breaks in DNA

familial syndrome: breast and ovarian cancer

77
Q

MSH

A

function: DNA mismatch repair
familial syndromes: hereditary nonpolyposis colon cancer
associated tumors: colonic and endometrial cancer

78
Q

WT1

A

function: transcription factor
familial syndromes: familial Wilms tumor
associated tumors: Wilms tumor and certain leukemias

79
Q

mechanisms by which tumor cells evade the immune system

A

selective outgrowth of antigen-negative variants
loss or reduced expression of MCH molecules
activation of immunoregulatory pathways
secretion of immunosuppressive factors
induction of Tregs

80
Q

PD-1

A

checkpoint protein on T cells that prevents attacking other cells in the body

certain cancer cells have large amounts of PD-L1 which allows them to evade immune attack

81
Q

PD-1 inhibitors

A

Pembrolizumab (Keytruda)
Nivolumab (Opdivo)
Cemiplimab (Libtaypo)

82
Q

PD-L1 inhibitors

A

Atezolizumab (Tecentriq)
Avelumab (Bavencio)
Durvalumab (Imfinzi)

83
Q

CTLA-4 (CD152)

A

protein receptor on T cells that functions as an immune checkpoint to downregulate the immune response – cancers are known to upregulate their expression

84
Q

CTLA-4 inhibitor

A

ipilimumab (yervoy)

*monoclonal ab that attaches to CTLA-4

85
Q

PDE4

A

major enzyme that degrades cAMP

*indicated in psoriasis and psoriatic arthritis

86
Q

DNMT3A

A

function: DNA methylation
tumor: AML

87
Q

MLL1

A

function: histone methylation
tumor: acute leukemia in infants

88
Q

MLL2

A

function: histone methylation
tumor: follicular lymphoma

89
Q

CREBBP/EP300

A

function: histone acetylation
tumor: diffuse large B cell lymphoma

90
Q

ARID1A

A

function: nucleosome positioning/chromatin remodeling
tumor: ovarian clear cell carcinoma and endometrial cancer

91
Q

SNF5

A

function: nucleosome position/chromatin remodeling
tumor: malignant rhabdoid tumor

92
Q

PBRM1

A

function: nucleosome positioning/chromatin remodeling
tumor: renal carcinoma

93
Q

HCG is associated with which cancers?

A

trophoblastic tumors

nonseminomatous testicular tumors

94
Q

calcitonin is associated with which cancer?

A

medullary carcinoma of thyroid

95
Q

catecholamine and metabolites are associated with which cancers?

A

pheochromocytoma

96
Q

a-fetoprotein is associated with which cancers?

A

liver cell cancer

nonseminomatous germ cell tumors of testis

97
Q

carcinoembryonic antigen is associated with which cancers?

A 
colon cancer
pancreatic cancer
lung cancer
stomach cancer
heart cancer
98
Q

prostatic acid phosphatase is associated with which cancers?

A

prostate cancer

99
Q

neuron-specific enolase is associated with which cancers/

A

small-cell lung cancer and neuroblastoma

100
Q

prostate specific antigen is associated with which cancer?

A

prostate cancer

101
Q

CA-125 is associated with which cancer?

A

ovarian cancer

102
Q

CA-19-9 is associated with which cancer?

A

colon cancer and pancreatic cancer

103
Q

CA-15-3 is associated with which cancer?

A

breast cancer

104
Q

CML translocation

A

(9;22) (34;11)

*genes: ABL 9q34 and BCR 22q11

105
Q

AML translocations

A

(8;21) (22;22)

15;17) (22;21

106
Q

Burkitt Lymphoma translocation

A

(8;14) (24;32)

107
Q

Mantle cell lymphoma translocation

A

(11;14) (13;32)

108
Q

Follicular lymphoma translocation

A

(14;18 (32;21)

MOD Exam 2 (3 decks)

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