Ch9 Neoplasia EC Flashcards Preview

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Flashcards in Ch9 Neoplasia EC Deck (138):
1

"-oma"s are generally indicates a benign tumor. What are some exceptions?

Seminoma (testicular)
Lymphoma (lymph nodes)
Glioma (glial cells in brain)
Mesothelioma (Pleural serosa)
Neuroblastoma (neuroblasts)

2

Skin cancer that invades but does not metastesize

Basal Cell Carcinoma (most common)

3

Tumor with two patterns both from the same germ cell layer

Mixed tumor

(ie pleomorphic adenoma of parotid gland)

4

Tumor containing tissue from all three germ layers. Most common sites?

Teratoma

Midline structures (Ovary, Testes, Mediastinum, Pineal gland

5

Malignant tumor derived from epithelial tissue

Carcinoma

6

Most common sites for squamous cell carcinoma

Mouth
Larynx
Cervix

7

Malignant tumor composed of glands. Most common locations?

Adenocarcinoma

Distal esophagus
Rectum
Pancreas
Breast
Kidneys

8

Malignant tumor derived from connective tissue. Most common locations?

Sarcoma
(therefore all mesodermal)

(40% in lower extremities)
Osteogenic sarcoma
~Codman's triangle- b/c making bone

9

Malignant tumor of smooth muscle

Leiomyosarcoma

10

Malignant tumor of striated muscle

Rhabdomyosarcoma

11

Malignant tumor of fat

Liposarcoma

12

Biopsy from girl having necrotic mass coming out of vagina removed. Vimentin and Keratin -. Desmin +

Embryonal rhabdomyosarcoma

MC sarcoma of children (penis in boys)

13

Movable mass at angle of jaw

Mixed tumor in parotid (two types of tissue from SAME cell layer)

MC salivary tumor

14

Nonneoplastic overgrowth of tissue

Hamartoma

15

Normal tissue in foreign location (ie pancreatic tissue in stomach)

Choristoma

16

Neoplastic component of a tumor

Parenchyma

17

Nonneoplastic supporting tissue of a tumor

Stroma

18

Does cancer resemble parent tissue?

Grade

Low grade-keratin pearls, glands with lumen
High grade/anaplastic-no differentiating features

19

Changes in organelles in malignanct cells

Fewer mitochondria
Less prominent RER (don't secrete hormones for others)
LOSS OF CADHERINS (allows metastasis)
Nucleus/Nucleoli enlarged and irregular

20

Metabolism in malignant cells

Use anaerobic glycolysis
Store glycogen in cytosol

21

PET scan

Measures glucose uptake

Diagnosis, staging, monitoring of therapy in cancer

22

Monoclonality

Cancers arise from single precursor

ie G6PD A or B found in leiomyoma of uterus, not both

23

Upregulation of DAF (decay accelerating factor)

Inhibits C3 and C5 convertase and thus MAC complex - cannot be killed

24

Important in stimulating synthesis of angiogenesis factors

TNF (released by macrophages)

25

Drug that inhibits binding of VEGF to endothelial cells in new capillary sprouts

Bevacizumab

Treats metastatic colon cancer and non-small cell carcinoma of the lung

26

1st step in tumor invasion

Lose cadherins (cell to cell adhesion)

27

2nd step of tumor invasion

Attach to basement membrane (laminin) and degrade it (collagenases)

28

3rd step of tumor invasion

Attach to ECM (fibronectin) and degrade it

29

4th step of tumor invasion

Stimulate cell motility

30

Tumor invasion of capillaries to enter circulation

Intravasation

31

Most important criterion of malignancy

Metastasis

32

Lymphatic spread through lymphatics to regional nodes before entering systemic circulation

Carcinomas

33

Initially have hematogenous spread. Avoid lymph nodes

Sarcomas

34

Metastasis in liver, from what vein did it come?

Portal vein

35

Metastasis in lungs. From what vein did it come?

Vena cava

36

Exfoliation from serosal surface and invade tissue in a body cavity. What are some examples?

Seeding

Malignant surface-derived ovarian cancer --> Omental implants

Peripheral adenocarcinomas of lung seed pleural cavity

Glioblastoma multiforme uses CSF to seed brainstem and spinal cord

37

Most common site of bone metastasis. Why?

Vertebrae

Batson paravertebral plexus has connections with vena cava and vertebral bodies

38

Most common cause of osteoblastic metastases

1 Prostate cancer
2 Breast cancer

39

Increased serum ALP and radiodensities on radiograph

Osteoblastic metastasis

40

Radiolucencies in bone. Hypercalcemia, pathologic fractures.

Osteolytic metastases

*PGE2 and IL-1 produced by osteoclasts*

41

Most common osteolytic cancers

1 lung
2 kidney
3 breast

42

Increased risk of prostate cancer and multiple myeloma

African Americans

43

Decreased incidence of prostate and breast cancer

Japanese

44

Most common cancers in children

Leukemia (ALL)
CNS (cerebellar)
Neuroblastoma

45

Most common cancers in men

Prostate
Lung
Colon

46

Most common cancers in women

Breast
Lung
Colon

47

Most common sites of gynecologic cancers

Endometrium
Ovary
Cervix

48

Common sites of cancer deaths in men

Lung
Prostate
Colon

49

Common sites of cancer deaths in women

Lung
Breast
Colon

50

Common sites of gynecologic cancer death

Ovary
Endometrium
Cervix

51

AD Cancer syndromes

Retinoblastoma
Familial adenomatous polyposis
Li-Fraumeni syndrome
HNPCC
BRCA1/2

52

AR cancer syndromes of DNA repair

Xeroderma pigmentosum
Ataxia telangiectasia (chromosomal instability)
Bloom syndrome (chromosomal instability)
Fanconi syndrome (chromosomal instability)

53

Nasopharyngeal carcinoma and SCC of the esophagus geographic location

China (EBV and alcohol)

54

Stomach adenocarcinoma geographic location

Japan (smoked foods)

55

Hepatocellular carcinoma geographic location

Southeast Asia (HBV)

56

Burkitt lymphoma and Kaposi sarcoma geographic location

Africa (EBV and HHV-8)

57

What cancer does treatment of H. pylori prevent?

Gastric lymphoma

does NOT decrease adenocarcinoma of the stomach

58

Neoplasms associated with Down syndrome

ALL, AML

"ALL fall DOWN"

59

Neoplasms associated with Xeroderma pigmentosum and albinism

SCC
Melanoma
BCC

60

Neoplasms associated with Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants

Gastric adenocarcinoma

61

Neoplasms associated with tuberous sclerosis (facial angiofibroma, seizures, mental retardation)

Giant cell astrocytoma
Renal angiomyolipoma
Cardiac rhabdomyoma

62

Neoplasms associated with Actinic keratosis

SCC of the skin

63

Neoplasms associated with Barrett's esophagus

Esophageal adenocarcinoma

64

Neoplasms associated with Plummer-Vinson syndrome (decreased Fe)

SCC of the esophagus

65

Neoplasms associated with Cirrhosis (alcoholic, Hep B or C)

Hepatocellular carcinoma

66

Neoplasms associated with Ulcerative colitis

Colonic adenocarcinoma

67

Neoplasms associated with Paget's disease of bone

Secondary osteosarcoma and fibrosarcoma

68

Neoplasms associated with Immunodeficiency states

Malignant lymphomas

69

Neoplasms associated with AIDS

Aggressive malignant lymphomas (NHL)
Kaposi's sarcoma

70

Neoplasms associated with Autoimmune disease (Hashimoto's, myasthenia gravis)

Lymphoma

71

Neoplasms associated with acanthosis nigricans (hyperpigmentation and epidermal thickening)

Visceral malignancy (stomach, lung, uterus)

72

Neoplasms associated with dysplastic nevus

Malignant melanoma

73

Neoplasms associated with radiation exposure

Leukemia
Sarcoma
Papillary thyroid cancer
Breast cancer

74

Neoplasms associated with chronic irritation at sinus orifice or third degree burn scars

SCC

75

ABL proto oncogene (function, mutation, and cancers)

Nonreceptor Tyrosine Kinase

t(9;22) fusion forms BCR-ABL (Philadelphia chromosome)

CML (also ALL)

76

ERBB2 (Her-2Neu) proto oncogene (function, mutation, and cancers)

Receptor synthesis

Amplification results in

Breast carcinoma

77

C-MYC proto oncogene (function, mutation, and cancers)

Nuclear transcription

t(8;14) results in

Burkitt lymphoma

78

N-MYC proto oncogene (function, mutation, and cancers)

Nuclear transcription

Amplification results in

Neuroblastoma "N-myc Neuroblastoma"
SCC of the lung

79

RAS proto oncogene (function, mutation, and cancers)

GTP signal transduction

Point mutation results in

Colorectal carcinoma
Just about any cancer

80

RET proto oncogene (function, mutation, and cancers)

Receptor synthesis

Point mutation results in

MEN IIa/IIIb
Leukemia

81

SIS proto oncogene (function, mutation, and cancers)

Growth factor synthesis

Overexpression leads to

Osteogenic sarcoma
Astrocytoma

82

L-MYC proto oncogene (function, mutation, and cancers)

Transcription factor

Results in Lung tumor

"L-myc Lung tumor"

83

BCL-2 proto oncogene (function, mutation, and cancers)

Anti-apoptotic molecule

Associated with

Follicular lymphoma
Undifferentiated lymphoma

84

APC tumor suppressor gene (function, associated cancers)

Prevents nuclear transcription (degrades catenin, an activator of nuclear transcription)

Familial polyposis (inherited)
Colona & stomach cancer (somatic)

85

BRCA1/BRCA2 tumor suppressor gene (function, associated cancers)

Regulated DNA repair

Female breast and ovary cancer, male breast cancer (inherited)

86

NF1 tumor suppressor gene (function, associated cancers)

Inhibits RAS signal transduction (cell cycle inhibitor)

NF1: Pheochromocytoma, Wilms tumor (kidney), Neurofibrosarcomas (inherited)

Neuroblastoma (somatic)

87

NF2 tumor suppressor gene (function, associated cancers)

Cytoskeletal stability

NF2: Bilateral schwannomas, meningioma

88

p53 tumor suppressor gene (function, associated cancers)

Inhibits G1/S phase
Repairs DNA
Inhibits BCL2 antiapoptotic gene

Li-Fraumeni: Breast, Brain, Leukemia, Sarcoma

89

RB1 tumor suppressor gene (function, associated cancers)

Inhibits G1/S phase

Retinoblastoma, osteogenic sarcoma, breast, lung, colon

90

TGF-beta tumor suppressor gene (function, associated cancers)

Inhibits G1/S phase

Familial stomach cancer
Pancreatic, Colorectal cancers

91

VHL tumor suppressor gene (function, associated cancers)

Regulates nuclear transcription

von Hippel-Lindau: cerebellar hemangioma, retinal angioma, RCC (bilateral), pheochromocytoma (bilateral)

92

WT1 tumor suppressor gene (function, associated cancers)

Regulates nuclear transcription

Wilms tumor (kidney)

93

p16 tumor suppressor gene (function, associated cancers)

Melanoma

94

DPC4 tumor suppressor gene (function, associated cancers)

Pancreatic cancer

"DPC=Deleted in Pancreatic Cancer"

95

DCC tumor suppressor gene (function, associated cancers)

Colon cancer

"DCC=Deleted in Colon Cancer"

96

Ingestion of maize and peanuts grown in hot/humid climates and later develop HCC associated with Hep B

Aflatoxin (Aspergillus)

97

Oncology chemotherapy resulting in malignant lymphoma

Alkylating agents

98

Herbicides (vineyard workers), fungicides, animal dips, metal smelting, incidental poisoning leading to SCC of the skin, lung cancer, or liver angiosarcoma

Arsenic

99

Paints, printing inks, varnishes, leather, carpets, food products leading to hepatocellular carcinoma

Azo dyes

100

Roofing material, insulation of pipes in shipyards, old homes, old cars with brake liners later develop Bronchogenic carcinoma or mesothelioma

Asbestos

101

Component of light oil, used in print industry, dry cleaning, paint, adhesives and coatings leading to Acute leukemia and Hodgkin lymphoma

Benzene

102

Used in space industry leading to bronchogenic carcinoma

Beryllium

103

Industrial industries where ore is being smelted leading to prostate and lung cancer

Cadmium

104

Chemotherapy agent leading to transitional cell carcinoma of urinary bladder

Cyclophosphamide

105

Once used to treat women with threatened abortions daughters later develop clear cell carcinoma of the vagina/cervix

DES (diethylstilbestrol)

106

Workers in the rubber, chemical, leather, textile, metal, and printing industries who develop transitional cell carcinoma of the urinary bladder

Beta-Naphthylamine and aromatic amines

107

Nickel plating, byproduct of stainless steel welding, ceramics, batteries, spark plugs leads to bronchogenic carcinoma and nasal cavity cancer

Nickel

108

Leading to breast and cervical cancer and hepatic adenoma

Oral contraceptives

109

These are formed when coal, soot, wood, gasoline, oil, tobacco, or other organic material are burned leading to SCC of the skin, adenocarcinoma of esophagus, pancreas, or kidney, or transitional cell carcinoma

Polycyclic hydrocarbons

110

Found in plastic piping material adhesive plastics, refrigerant leading to liver angiosarcoma

polyvinyl chloride

111

By product of decay of uranium, hazard in quarries and underground mines leading to bronchogenic carcinoma

Radon

112

Chemical silicon dioxide, rock quarries, sandblasting leading to bronchogenic carcinoma

Silica

113

Substance released by cancer cells that causes degradation of skeletal muscle

PIF (proteolysis inducing factor)

114

Substance released by cancer cells that decreases body fat, Increases TNF which suppresses appetite and initiates apoptosis of fat cells

LIF (lipolysis mobilizing factor)

115

Marrow replacement by cancer/fibrotic tissue with immature normal cells in peripheral blood and teardrop RBCs

Myelophthisic anemia

116

Acanthosis nigricans

Stomach cancer

117

Myasthenia gravis-like symptoms with antibody directed against Ca channel (paraneoplastic syndrome)

Eaton-Lambert syndrome

associated with SCC of lung

118

Periosteal reaction of distal phalanx (paraneoplastic syndrome)

Hypertrophic osteoarthropathy

associated with bronchogenic carcinoma

119

Sterile vegetations on mitral valve (paraneoplastic syndrome)

Nonbacterial thrombotic endocarditis

Mucous secreting pancreatic and colorectal cancers

120

Sudden appearance of numerous pigmented seborrheic keratoses (Leser-Trelat sign)

Seborrheic keratosis

Stomach carcinoma

121

Release of procoagulants (Trousseau sign-Paraneoplastic)

Superficial migratory thrombophlebitis

Pancreatic carcinoma

122

Diffuse membranous glomerulopathy (paraneoplastic syndrome)

Nephrotic syndrome

Lung, breast, and stomach carcinomas

123

Cushings syndrome as a paraneoplastic syndrome (hormone and neoplasms)

ACTH or ACTH like peptide

SCC of lung

124

SIADH paraneoplastic syndrome (hormone and neoplasms)

ADH

SCC of lung
Intracranial neoplasms

125

Hypercalcemia paraneoplastic syndrome (hormone and neoplasms)

PTHrP (SCC of lung, RCC, breast cancer)

Calcitriol (vit D) - Lymphomas

126

Polycythemia paraneoplastic syndrome (hormone and neoplasms)

Erythropoietin

RCC, hemangioblastoma, HCC, pheochromocytoma

127

Used to follow up prostate carcinoma. Can also be elevated in BPH

PSA (prostate specific antigen)

128

Produced by 70% colorectal and pancreatic cancers (can also be gastric, breast, or thyroid carcinomas)

CEA (Carcino Embryogenic Antigen)

129

Normally made by fetus. Elevated in hepatocellular carcinomas and germ cell (yolk sac) tumors

AFP

130

Elevated in Hydatidiform mole and Choriocarcinomas

beta-HCG

131

Marker for ovarian cancer

CA-125

132

Marker for melanoma, neuronal tumors, schwannomas

S-100

133

Elevated in metastasis to bone, liver, Paget's disease

Alkaline phosphatase

134

Marker for Neuroblastoma, lung and gastric cancer

Bombesin

135

Elevated in Hairy cell leukemia (B cell neoplasm)

TRAP (Tartrate Resistant Acid Phosphatase)

136

Marker for pancreatic adenocarcinoma

CA-19-9

137

Marker for medullary thyroid carcinoma

Calcitonin

138

Laminated concentric, calcified pheres

Psammoma bodies

Papillary thyroid cancer
Serous cancer of ovary
Meningioma
Mesothelioma

"PSaMMoma"

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