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MOD 2 > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

2 basic components of all tumors

A

1: neoplastic cells that constitute the tumor parenchyma
2: reactive stroma made up of connective tissue, blood vessels and variable numbers of cells of the adaptive and innate immune system

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2
Q

Classification of tumors and their biologic behavior are based primarily on what?

A

the parenchymal component

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3
Q

Tumor growth and spread are critically dependent on what?

A

the stroma

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4
Q

If connective tissue is scant in a tumor, describe the neoplasm?

A

soft and fleshy

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5
Q

If the parenchymal cells stimulate the formation of an abundant collagenous stroma, it’s referred to as what?

A

desmoplasia

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6
Q

Some desmoplastic tumors, for example, some cancers of the female breast are stony hard or _____.

A

Scirrhous

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7
Q

Benign suffix

A

-oma

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8
Q

Benign tumor arising from fibrous tissue

A

fibroma

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9
Q

benign cartilagenous tumor

A

chondroma

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10
Q

benign epithelial neoplasm derived from glands, although they may or may not form glandular structures

A

Adenoma

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11
Q

benign epithelial neoplasm producing micro or macroscopically visible fingerlike or warty projections from epithelial surfaces

A

papilloma

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12
Q

benign tumors that form cystic masses, such as in the ovary

A

cystadenomas

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13
Q

When a neoplasm, benign or malignant, produces a macroscopically visible projection above a mucosal surface and projects, for example, into the gastric or colonic lumen

A

polyp

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14
Q

if a polyp has glandular tissue

A

adenomatous polym

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15
Q

malignant tumors arising in solid mesenchymal tissues are usually called what?

A

sarcomas

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16
Q

malignant tumors arising from blood forming cells

A

leukemias or lymphomas

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17
Q

malignant tumors of lymphocytes or their precursors

A

lymphomas

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18
Q

Malignant neoplasms of epithelial cell origin, derived from any of the 3 germ layers

A

carcinomas

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19
Q

a lesion in which the neoplastic epithelial cells grow in a glandular pattern

A

adenocarcinoma

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20
Q

tumors contain epithelial components scattered within a myxoid stroma that may contain islands of cartilage or bone

A

mixed tumor (pleomorphic adenoma)

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21
Q

Tumor which contains recognizable mature or immature cells or tissues belonging to more than one germ layer

A

teratoma

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22
Q

A particularly common pattern of teratoma which differentiates principally along ectodermal lines to create a cystic tumor lined by skin replete with hair, sebaceous glands, and tooth structures

A

ovarian cystic teratoma (dermoid cyst)

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23
Q

Benign-sounding designations used for certain malignant neoplasms

A
  • lymphoma
  • melanoma
  • mesothelioma
  • seminoma
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24
Q

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

A

Hamartomas

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25
Q

lack of differentiation

A

anaplasia

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26
Q

when do you see intercellular bridges and nests of keratin pearls

A

well-differentiated squamous cell carcinoma of the skin

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27
Q

What is the hallmark of malignancy

A

anaplasia

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28
Q

Abnormal tripolar spindle and nuclear variation in size and shape

A

anaplastic tumor

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29
Q

morphological changes associated with anaplasia

A
  • Pleomorphism
  • Abnormal nuclear morphology
  • Mitosis
  • Loss of polarity
  • possibly large central areas of ischemic necrosis
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30
Q

When chromatin is more darkly stained than normal

A

hyperchromatic

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31
Q

Well-differentiated squamous cell carcinomas of the epidermis synthesize what?

A

keratin

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32
Q

well differentiated hepatocellular carcinomas elaborate what?

A

bile

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33
Q

What is characterized by a constellation of changes that include a loss in the uniformity of the individual cells as well as a loss in their architectural orientation

A

dysplasia

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34
Q

When dysplastic changes are marked and involve the full thickness of the epithelium, but the lesion does not penetrate the basement membrane

A

carcinoma in situ

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35
Q

once tumor cells breach the basement membrane, the tumor is said to be what?

A

invasive

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36
Q

neoplasms composed of tangled blood vessels

A

hemangiomas

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37
Q

Next to the development of metastases, what is the most reliable feature that differentiates cancers from benign tumors?

A

invasiveness

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38
Q

malignant neoplasms of the glial cells in the CNS

A

gliomas

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39
Q

Give 2 examples of malignant tumors that infrequently metastasize

A

gliomas and basal cell carcinomas of the skin

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40
Q

Dissemination of cancers may occur through what 3 pathways?

A
  • direct seeding of body cavities or surfaces
  • lymphatic spread
  • hematogenous
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41
Q

What is most often involved in seeding of body cavities and surfaces

A

peritoneal cavity from ovaries

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42
Q

Sometimes mucus-secreting appendiceal carcinomas or ovarian carcinomas fill the peritoneal cavity with a gelatinous neoplastic mass referred to as what?

A

pseudomyxoma peritonei

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43
Q

What is the most common pathway for the initial dissemination of carcinomas?

A

transport through lymphatics

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44
Q

Because carcinomas of the breast usually arise in the upper outer quadrants, they generally disseminate first where?

A

Axillary lymph nodes

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45
Q

Cancers of the inner quadrants of the breast drain where?

A

nodes along the internall mammary arteries and then the infraclavicular and supraclavicular nodes may become involved

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46
Q

Carcinomas of the lung arising in the major respiratory passages metastasize first to where?

A

perihilar tracheobronchial and mediastinal nodes

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47
Q

To avoid the considerable surgical morbidity associated with a full axillary lymph node dissection, what is often used to assess the presence or absence of metastatic lesions in the lymph nodes?

A

biopsy of sentinel nodes

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48
Q

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

A

sentinel lymph node

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49
Q

Hematogenous spread is typical of what?

A

sarcomas but it is seen with carcinomas

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50
Q

What organs are most frequently involved in hematogenous dissemination

A

lungs and liver

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51
Q

embolization through the paravertebral plexus is involved in what carcinomas?

A

thyroid and prostate

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52
Q

What cancers have a propensity for invasion of veins?

A
  • Renal Cell carcinomas

- hepotocellular carcinomas

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53
Q

Breast carcinoma preferentially spreads where?

A

bone

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54
Q

bronchogenic carcinomas tend to involve what organs?

A

adrenals and brain

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55
Q

neuroblastomas spread to where?

A

liver and bones

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56
Q

3 most common cancers of U.S. men

A
  • prostate
  • Lung
  • Colon/rectum
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57
Q

3 most common cancers of U.S. women

A
  • Breast
  • Lung
  • Colon/rectum
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58
Q

3 most common cancer of men in developing countries

A
  • Lung
  • Stomach
  • Liver
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59
Q

3 most common cancers of women in developing countries

A
  • breast
  • cervix
  • lung
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60
Q

individuals infected with what virus begin to develop hepatocellular carcinoma?

A

hepatitis C virus (HCV)

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61
Q

What is responsible for a large majority of cases of cervical carcinoma and an increasing fraction of head and neck cancers?

A

HPV

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62
Q

What has been called the single most important environmental factor contributing to premature death in the U.S.

A

Cigarette smoking

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63
Q

Cigarette smoke is implicated in what percent of lung cancer deaths?

A

about 90%

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64
Q

Arsenic and Arsenic compounds

A
  • Lung carcinoma

- skin carcinoma

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65
Q

Asbestos

A
  • Lung, Esophageal, gastric, and colon carcinoma

- mesothelioma

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66
Q

Benzene

A

Acute myeloid leukemia

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67
Q

Beryllium

A

-lung carcinoma

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68
Q

Cadmium

A

Prostate carcinoma

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69
Q

Chromium

A

Lung carcinoma

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70
Q

nickel

A

Lung and oropharyngeal carcinoma

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71
Q

Radon and its decay products

A

Lung carcinoma

72
Q

Vinyl chloride

A

Hepatic angiosarcoma

73
Q

What percent of deaths in children under 15 does cancer account for in the U.S.

A

slightly more than 10%

74
Q

Whats the most common general category of tumor in adults?

A

Carcinomas

75
Q

What cancers are responsible for approximately 60% of childhood cancer deaths?

A

Acute leukemia and distinctive neoplasms of the CNS

76
Q

What are the common neoplasms of infancy and childhood known as small round blue cell tumors?

A
  • neuroblastoma
  • Wilms tumor
  • retinoblastoma
  • Acute leukemias
  • rhabdomyosarcomas
77
Q

Acquired conditions that predispose to cancer can be divided into what?

A
  • Chronic inflamations
  • precursor lesions
  • immunodeficiency states
78
Q

Tumors arising in the context of chronic inflammation are mostly _______, but also include _________ and several kinds of _________.

A

carcinomas; mesothelioma; lymphoma

79
Q

Diagnoses and effective treatment of ________ with antibiotics can stop a chronic inflammatory condition that might otherwise lead to the development of a gastric cancer

A

Helicobacter pylori gastritis

80
Q

Squamous metaplasia of the bladder mucosa is a response to what?

A

schistosomiasis infection

81
Q

Colonic metaplasia of the stomach is a response to what?

A

pernicious anemia and chronic atrophic gastritis

82
Q

What is the most common noninflammatory hyperplasia precursor lesion?

A

endometrial hyperplasia

83
Q

What causes endometrial hyperplasia?

A

sustained estrogenic stimulation

84
Q

What is the precursor lesion that is a thickening of squamous epithelium that may occur in the oral cavity or on the penis or vulva and give rise to squamous carcinoma?

A

Leukoplakia

85
Q

What is the classic example of a neoplastic precursor lesion?

A

colonic villous adenoma

86
Q

Virally associated tumor are mainly what?

A

lymphomas

87
Q

What 2 genes are associated with breast cancer?

A

BRCA1 or BRCA2 tumor suppressor genes

88
Q

A polymorphism in one of what loci confers an inherited susceptibility to lung cancers in cigarette smokers?

A

P-450 loci

89
Q

All initiating chemical carcinogens are highly _________ that can react with ________ sites in the cell.

A

Electrophiles (have electron deficient atoms)

Nucleophilic (electron-rich)

90
Q

Describe direct acting carcinogens

A
  • Require no metabolic conversion to become carcinogenic

- Some are cancer chemotherapeutic drugs

91
Q

When a direct acting carcinogen such as an alkylating agent is used as treatment for certain types of cancer, it may evoke later a second form of cancer, usually what?

A

acute myeloid leukemia

92
Q

The carcinogenic product of metabolism of and indirect-acting carcinogen is called what?

A

ultimate carcinogen

93
Q

What are the potent indirect chemical carcinogens found in fossil fuels?

A

polycyclic hydrocarbons

94
Q

Whats the carcinogen that is the active component of soot?

A

benzopyrene

95
Q

What is formed during the high temperature combustion of tobacco in cigarettes and are implicated in the causation of lung cancer?

A

benzopyrene

96
Q

What are produced from animal fats during the process of broiling or grilling meats and are present in smoked meats and fish?

A

polycyclic hydrocarbons

97
Q

What is the principal active product in many hydrocarbons

A

epoxides

98
Q

What are the indirect-acting carcinogens that were widely used in the past in the aniline dye and rubber industries?

A

aromatic amines and azo dyes

99
Q

Most of the known carcinogens are metabolized by what?

A

cytochrome P-450 dependent mono-ocygenase

100
Q

The metabolism of polycyclic aromatic hydrocarbons is due to what gene?

A

CYP1A1

101
Q

Light smokers with the susceptible CYP1A1 genotype have how much greater risk of developing lung cancer?

A

sevenfold

102
Q

Cells that by chance suffer damage to oncogenes and tumor suppressors such as what, gain a potential selective advantage and are at risk for subsequent transformation

A
  • RAS

- TP53

103
Q

What is the naturally occurring chemical carcinogen produced by some strains of a mold called Aspergillus?

A

aflatoxin B1

104
Q

There is a strong correlation between dietary consumption of aflatoxin B1 and what cancer?

A

hepatocellular carcinoma

105
Q

Describe the mutation that aflatoxin often produces

A
  • TP53 gene
  • G:C –> T:A
  • transversion in codon 249
  • Arginine –> serine
106
Q

What type of UV rays are believed to be responsible for the induction of cutaneous cancers?

A

UVB

107
Q

The carcinogenicity of UVB light is due to formation of what?

A

pyrimidine dimers in DNA

108
Q

What type of cancer is most vulnerable to radiation

A

myeloid leukemias

109
Q

What virus causes adult T-cell leukemia/lymphoma (ATLL)?

A

HTLV-1

110
Q

What type of cells does HTLV-1 attack?

A

CD4+ T cells

111
Q

How is HTLV-1 transmitted in humans

A
  • sexual intercourse
  • Blood products
  • breast feeding
112
Q

A high fraction of leukemias such as ATLL due to HTLV-1 express what transcription factor

A

Fox3P, a marker of regulatory T cells

113
Q

The HTLV-1 genome contains the gag, pol, end, and long terminal repeat regions typical of all retroviruses, but in contrast to other leukemia viruses, it contains what other gene

A

Tax

114
Q

Tax contributes to what cancer hallmarks?

A
  • increased pro-growth signaling and cell survival

- increase genomic instability

115
Q

How does tax increase pro-growth signaling and cell survival

A
  • interacts with PI3K stimulating AKT
  • upregulates cyclin D2
  • represses CDK inhibitors
  • activate NF-kappaB
116
Q

Which HPVs cause benign squamous papillomas (warts)?

A

1, 2, 4, 7

117
Q

What are the high risk HPVs that have been implicated in the genesis of squamous cell carcinomas of the cervix, anogenital region, and head and neck?

A

16 and 18

118
Q

What are the low risk HPVs associated with genital warts

A

6 and 11

119
Q

The oncogenic potential of HPV can largely be explained by the activities of what two viral genes

A

The ones encoding E6 and E7

120
Q

What are the oncogenic activities of E6?

A

Degradation of p53 and expression of TERT

121
Q

What are the oncogenic activities of E7?

A
  • binds to RB protein and displaces the E2F transcription factors
  • inactivates the CDK inhibitors p21 and p27
  • those from high risk HPVs (16, 18, 31) bind and activate cycling E and A
122
Q

What are the most common EBV-associated tumors?

A

-those derived from B cells and nasopharyngeal carcinoma

123
Q

What the EBV attach to infect B cells?

A

Complement receptor CD21

124
Q

What is the EBV gene that acts as an oncogene?

A

LMP-1

125
Q

What does LMP-1 act like?

A

Active CD40 on B cells to stimulate B cell growth

126
Q

What signaling pathways are activated by LMP-1?

A

NF-kappaB nad Jak/STAT

127
Q

How does LMP-1 prevent apoptosis?

A

Activates BCL2

128
Q

EBV encodes what nuclear proteins that mimics an active Notch receptor?

A

EBNA-2

129
Q

Burkitt Lymphoma is associated with what viral infection?

A

EBV

130
Q

There is a strong association between hepatitis B and C viral infections and what type of cancer?

A

Liver cancer; hepatocellular carcinoma

131
Q

What are the dominant oncogenic effects of HBV and HCV?

A

Immunologically mediated chronic inflammation and hepatocyte death leading to regeneration and, over time, genomic change

132
Q

What bacterial infection is implicated in the Genesis of both gastric adenocarcinomas and gastric lymphomas?

A

H. Pylori

133
Q

What H. Pylori gene is directly implicated in oncogenesis?

A

CagA

134
Q

Cancer cachexia is associated with what?

A
  • Equal loss of both fat and lean muscle
  • Elevated basal metabolic rate
  • Evidence of systemic inflammation (increase in acute phase reactants)
135
Q

What is the leading suspect among several mediators released from immune cells that may contribute to cachexia?

A

TNF-alpha

136
Q

When a cancer-bearing individual develops signs and symptoms that cannot readily be explained by the anatomic distribution of the tumor or by the elaboration of hormones indigenous to the tissue from which the tumor arose

A

Paraneoplastic syndrome

137
Q

What is the most common endocrinopathy from a paraneoplastic syndrome?

A

Cushing syndrome

138
Q

About 50% of individuals with Cushing syndrome have what cancer?

A

Small-cell carcinoma of the lung

139
Q

How do you distinguish between Cushing syndrome and excess Corticotropin produced by the pituitary?

A

Elevated pro-opiomelanocortin

140
Q

What is the most common paraneoplastic syndrome?

A

Hypercalcemia

141
Q

What is the most important humoral factor associated with paraneoplastic Hypercalcemia of malignancy?

A

Parathyroid hormone-related protein (PTHRP)

142
Q

What tumors are most often associated with paraneoplastic Hypercalcemia?

A

Carcinomas of the breast, lung, kidney, and ovary

143
Q

Gray-black patches of thickened, hyperkeratotic skin with a velvety appearance

A

Paraneoplastic syndrome called acanthosis nigricans

144
Q

Hypertrophic osteoarthropathy is a paraneoplastic syndrome associated with what cancers?

A

Lung carcinoma

145
Q

Migratory thrombophlebitis (Trousseau Syndrom) may be encountered in association with deep-seated cancers, most often of what?

A

Pancreas or lung

146
Q

Disseminated intravascular coagulation associated with what cancers?

A
  • acute promyelocytic leukemia

- prostatic adenocarcinoma

147
Q

To judge the extent to which the tumor cells resemble or fail to resemble their normal counterparts

A

Grade

148
Q

Classification system for staging of a tumor

A

TNM system: T for primary Tumor, N for region lymph node involvement, M for metasteses

149
Q

What are the 3 sampling approaches when attempting to diagnose cancer

A
  • excision or biopsy
  • needle aspiration
  • cytologic smears
150
Q

What sampling technique is used most commonly for the assessment of readily palpable lesion in sites such as the breast, thyroid and lymph nodes?

A

Fine-needle Aspiration

151
Q

Antibodies specific to what are useful in diagnosis of undifferentiated malignant tumors

A

Intermediate filaments

152
Q

Antibodies to cytokeratins by immunohistochemistry

A

Epithelial origin (carcinoma)

153
Q

Antibodies for desmin by immunohistochemistry

A

Neoplasms of muscle cell origin

154
Q

CD20 antibodies by immunohistochemistry

A

B-cell tumors

155
Q

PSA antigen

A

Prostate origin

156
Q

thyroglobulin antigen

A

Thyroid origin

157
Q

Why is it good to find estrogen/progesterone receptors in breast cancer cells?

A

They are susceptible to antiestrogen therapy

158
Q

Proteins product of breast cancer

A

HER2 from gene ERBB2

159
Q

Positive immunohistochemistry staining for ALK protein

A

Lung cancers and lymphomas

160
Q

Used to identify cellular antigens expressed by “liquid” tumors, those that aris from blood-forming tissues

A

Flow cytometry

161
Q

What is used to distinguish between monoclonal (neoplastic) and polyclonal (reactive) proliferations

A

PCR-based evaluations

162
Q

Specific translocation so that activate oncogenes in leukemias or lymphomas are detected by what?

A

Routine cytogenetic analysis or by FISH

163
Q

Translocation specific for a Ewing Sarcoma

A

(11;22)(q24;q12)

164
Q

Prognosis for a neuroblastoma patient with amplification of the NMYC gene and deletions of 1p

A

Poor

165
Q

Prognosis for oligodendroglioma patient with loss of 1p and 19q

A

Respond well

166
Q

Prognosis for oligodendroglioma patient with intact 1p and 19q but with EGF receptor amplification

A

Poor

167
Q

Detection of minimal residual disease after treatment of patients with leukemia or lymphoma

A

PCR-based amplification

168
Q

PML-RARA fusion gene

A

Acute promyelocytic leukemia

169
Q

BCR-ABL fusion gene

A

Chronic myelogenous leukemia and acute lymphoblastic leukemia

170
Q

ERBB1 (EGFR) mutations and ALK gene rearrangements

A

Lung cancer

171
Q

BRAF mutations

A

melanoma

172
Q

What provides a snapshot of all the genetic alterations that exist in a particular tumor

A

Circos plots

173
Q

Human chorionic gonadotropin (HCG)

A

Testiculor tumors

174
Q

CA-125

A

Ovarian tumors

175
Q

Increased immunoglobulin levels

A

Multiple myeloma

MOD 2 (1 decks)

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