Major types of Carcinoma

Question 1

Malignant tumors of epithelium arise from?

Answer 1

malignant stem cell -

Question 2

What distinguishes metastatic from benign

Answer 2

invasion and metastasis

Question 3

Cancer grade =

Answer 3

refers to extent of differentiation

low grade - well differentiated
high grade - poorly differentiate

Question 4

Cancer Stage =

Answer 4

refers to extent tumor spread at time of diagnosis

for many types of carcinoma: stage is the best predictor of prognosis

Question 5

TNM classification

Answer 5

T - size of tumor 1-4
N - lymph node involvement
M - metastasis - yes or no

Question 6

major types of carcinoma (4)

Answer 6

lung 16%
pancreas 5%
colorectal 65%
prostate 99%

percents are 5 year survival

Question 7

lung cancer deaths per year

Answer 7

124,000

Question 8

lung cancer survival correlated with

Answer 8

stage

Question 9

lung cancer cure requires

Answer 9

complete surgical excision

Question 10

% of preventable lung cancer cases

Answer 10

85-90% caused by smoking

Question 11

peak incidence lung cancer

Answer 11

70

Question 12

risk factors for lung cancer

Answer 12

smoking (pack years)

family history, exposure to industrial shit

Question 13

what percent of heavy smokers will develop lung cancer?

Answer 13

10

Question 14

how is small cell lung CA treated?

Answer 14

not surgically - only by chemotx

Question 15

4 major types of lung cancer

Answer 15

squamous cell
adenocarcinoma - includes bronchioloalveolar
large cell
small cell (oat)

Question 16

keratin pearls are diagnostic of

Answer 16

squamous cell carcinoma

Question 17

squamous carcinoma of lung
%
risk
features
endocrine?

Answer 17

25-40%
strongly linked to smoking
typically arise centrally, in major bronchi
cancer often exhibits central necrosis, as cancer growth exceeds blood supply
cancer cells appear squamous with keratin, formation of keratin pearls is common
rare cases can produce a parathyroid related protein and lead to hyper-calcemia

Question 18

acinar predominant
papillary predominant 
micropapillary predominant
solid predominant
invasive mucinous

these are all subtypes of?

Answer 18

adenocarcinoma of lung

Question 19

adenocarcinoma of lung 
%
risk
features
signals?

Answer 19

25-40% of cases
many cases linked to smoking
can occur centrally or periphery (in areas of scarring)
cancer cells attempt to form glands and produce mucin
sometimes occur in never smokers / some harbor mutations in EGFR and respond to gefitinib

Question 20

bronchioloalveolar carcinoma
variant of?
risk?
features
prognosis?

Answer 20

variant of adenocarcinoma

not linked with smoking

the tumor cells grow along the alveolar septae, and lung structures. Typically there is very little stroma produced by the tumor… can occur anywhere in the lung

prognosis is better than with other types of lung cancer

Question 21

large cell carcinoma of lung
%
grade?
features

Answer 21

10-15%
high grade cancer
cancer cells do not produce keratin, or mucin, or form glands
highly undifferentiated, anaplastic
very pleomorphic, bizarre looking cells with large nuclei, and bizarre mitotic figures

Question 22

small cell lung cancer
%
risk
features
endocrine?

Answer 22

25%
strongly linked to smoking
terrible prognosis - treat with chemo / no surgery
mets to brain are common
cancer cells appear small and dark staining, form clusters of cells
stain positive for neuroendocrine markers
can produce a paraneoplastic syndrome

Question 23

pancreatic cancer symptoms (4)

Answer 23

back pain
unexplained, painless jaundice due to growth of cancer blocking bile duct
migratory thromophlebitis
cachexia

Question 24

pancreatic cancer 
prog
feature
origin
mutations?
mets
best case?

Answer 24

terrible 5 year

Question 25

pancreatic cancer risk?

Answer 25

``` unknown age family slight association with smoking + alcohol and pancreatitis diabetes peutz-heghers/brca2 ```

Question 26

colon adenocarcinoma = ?% of carcinomas arising in colon

Answer 26

98%

Question 27

colon adenocarcinoma risk?

Answer 27

most cases are sporadic

Question 28

what are adenomatous polyps

Answer 28

benign overgrowths of glandular tissue - less differentiated than normal

Question 29

T4 in adenocarcinoma?

Answer 29

perforated through visceral pleura and/or invasion of organs

Question 30

most common non-skin cancer in adult males?

Answer 30

prostate

Question 31

prostate cancer new cases/yr

Answer 31

180,000

Question 32

is prostate cancer more common in us?

Answer 32

yes appears to be most common in us

Question 33

prostate cancer risk factors

Answer 33

age race genetics

Question 34

prostatic carcinoma | zone effected?

Answer 34

effects peripheral > transition zone

Question 35

gold standard for dx in prostate cancer?

Answer 35

blind random biopsy | only 50% sensitive

Question 36

prostate cancer by race

Answer 36

``` black most frequent then white hispanic indian asian ```

Question 37

what is prostatic intraepithelial neoplasia?

Answer 37

believed to represent noninvasive precursor to some cancers genetic changes are similar increases with age - peak prevalence 5-10yr b4 PCa 30-50% prostates with PIN harbor PCa

Question 38

prostatic adenocarcinoma dx criteria?

Answer 38

``` uniform round glands infiltrative pattern single cell layer (loss of basal) nuclear enlargement - prominent nucleoli perineural invasion ```

Question 39

prostatic carcinoma - prognostic factors (4)

Answer 39

grade stage tumor volume (PSA) molecular markers

Question 40

Gleason grading in PCa

Answer 40

based on morphologic resemblance to normal prostate / degree of invasiveness score 1-5 score = most + 2nd most common

Question 41

prostate cancer risk of progression 5 year (5 places)

Answer 41

``` pelvic lymph nodes 95% seminal vesicles 85% established capsular penetration 48% focal capsular penetration 33% organ confined 10% ```

Question 42

PCa deaths in 2016

Answer 42

26000

Question 43

what % men >50 have PCa

Answer 43

30% autopsy