Micro/Path Neoplams Flashcards
1
Q
most deadly form of skin cancer (most deaths from skin disease)
A
melanoma
2
Q
the development of melanoma is related to
A
sun exposure
3
Q
Melanoma has 2 growth stages: radial (initial) and vertical (later phase) which phase has metastatic potential
A
vertical. = tumor invades (vertically) downward (vs initial radial where it moves horizontally)
4
Q
in radial phase = horizontal spread of melanoma in epidermis, tumor cells lack the capacity to
A
metastasize. (think R - radial comes before V = vertical) and also makes sense that at first they haven’t metastasized
5
Q
superficial spreading melanoma is the most __ type of melanoma. ___ phase predominates
A
common. radial phase predominates = large flat irregularly pigmented lesion
6
Q
nodular melanoma is the most __ type of melanoma,__ phase predominates
A
aggressive.
vertical growth phases = poorest prognosis
7
Q
lentigo maligna melanoma occurs on ___skin. __- phase predominates. most often develops from pre existing lentigo maligna called
A
sun exposed, radial growth phase, Hutchinson freckle
8
Q
Acral- lentiginous melanoma is the __ form of melanoma
A
least common. arise from pigmented lesions on the palm, sole or under the nail.
9
Q
pheochromocytomas are neoplasms made of __ cells
A
pheochromocytomas = chromaffin cells = synthesize catecholamines ( epinephrine (adrenaline), norepinephrine (noradrenaline) and rarely dopamine made from tyrosine)
10
Q
pheochromocytomas cause surgically correctable hypo/hypertention
A
hypertention (think catecholamines = epinephrine = SNS)
11
Q
pheochromocytomas rule of 10:
- 10% of pheochromocytomas are ___
- 10% of sporadic adrenal pheochromocytomas are __
- 10% of adrenal pheochromocytomas are biologicaly ___
- 10% of adrenal pheochromocytomas are not associated with __
A
- extra adrenal = called parangangliomas
- bilateral
- malignant
- hypertention
so, they are mostly adrenal, non malignant, cause hypertention
12
Q
___may be associated with MEN (multiple endocrine neoplasia), neurofibromatosis (von Recklinghausen’s disease), or von Hipple-Lindau disease - multiple hemangiomas
A
pheochromocytomas
13
Q
most common malignant tumor of childhood
A
neuroblastoma =catecholamine producing tumor originating from adrenal medulla
14
Q
First symptoms in this disease is a LARGE ABDOMEN, SENSATION OF FULLNESS AND ABDOMINAL PAIN. FOLLOWED LATER BY AN ABDOMINAL MASS. THIS TUMOR CUASES HYPERTENTION
A
NEUROBLASTOMA
15
Q
____Can convert to more differentiated form called ganglioneuroma
A
neuroblastoma
16
Q
most malignant neoplasm of lungs
A
bronchogenic carcinoma
17
Q
bronchogenic carcinoma spreads first to _ then to
A
Spreads to lymph nodes then liver/brain/bone (think LLBB) = lymph liver brain bone
18
Q
___ carcinomas form a mass in the periphery of the lung
A
adenocarcinoma
19
Q
epidermoid (squamous cell) carcinoma is a type of bronchogenic carcinoma most common in men/women and closely related to
A
men and smoking
20
Q
adenocarcinomas are smaller than bronchogenic carcinomas and located in the __ of the lung. and most common in men/women, smoker/non?
A
periphery, women non smokers
21
Q
___ is the most aggressive and highly malignant form of bronchogenic carcinoma.
A
small cell (oat cell) carcinoma Usually has already metastasized at time of diagnosis
22
Q
___carcinoma is composed of large undifferentiated malignant cells with variable location
A
large cell (anaplastic) carcinoma
23
Q
____ is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that generally arises from cells originating in the endodermal or ectodermal germ layer during embryogenesis. More specifically, a carcinoma is tumor tissue derived from putative epithelial cells
A
carcinoma
24
Q
- Most cancers are cancers of the ___. 2. Cancers of the epithelial cells are called ___.
A
- epithelial cells
- carcinomas
Carcinomas make up about 85 out of every 100 cancers (85%).
25
different types of epithelial cells can develop into diff kinds of cancer:
where are these:
1. Squamous cell carcinoma (of squamous cells)
2. Adenocarcinoma (of glandular cells)
3. Transitional cell carcinoma (of transitional cells)
1. Flat, surface covering cells called squamous cells - for example, the skin or the lining of the throat or food pipe (oesophagus).
2. Glandular cells called adenomatous cells - for example, kidney cells or breast cells
3. Layers of stretchy cells called transitional cells - for example, the lining of the bladder
26
Connective tissue is the name for the supporting tissues of the body - the bones, cartilage, tendons and fibrous tissue that support the body organs. Connective tissue cancers are called ___
sarcomas
27
1. Sarcomas are much___common than carcinomas. They are usually grouped into two main types - bone sarcomas (osteosarcoma) and soft tissue sarcomas. Altogether, these make up less than 1 in every 100 (1%) cancers diagnosed.
2. Cancer of the cartilage is called __,
3. cancer of a muscle is called ___
1. less
2. chondrosarcoma
3. rhabdomyosarcoma
28
1. Cancers of the blood cells - 2. Cancers of the lymphatic system - __
1. leukemia
| 2. lymphomas
29
Burkitt's lymphoma involves __ organs and is closely linked to __ virus
abdomenial,
| Epstein Barr virus (herpes simplex virus 4)
30
Non-Hodjkins Lymphoma = malignant tumors of lymph system. Most are B/T cell origin?
B
31
which cancer is associated with HIV, helicobacter pylori, EBV, herpes virus 8
non-hodjkins lymphoma
32
first indication of malignant lymphoma is
swelling of the lymph glands
| enlarged tonsils and andenoids, painless nodes
33
as malignant lymphoma progresses symptoms
fatigue, malaise, weight loss, fever, NIGHT SWEATS
34
Burkitt's lymphoma is an aggressive B/T cell lymphoma
B cell
35
the___ form of Burkitt's lymphoma involves the maxilla or mandible.
african
36
the __ form of Burkitt's lymphoma involves the abdominal organs
american
37
Reed Sternberg cells are found in patients with ___ disease
Hodgkin's lymphoma
38
Does malignant lymphoma have Reed Sternberg cells
no
39
malignant lymphoma show a STARRY SKY appearance of non neoplastic ___
macrophages
40
how can you differentiate bw malignant lymphoma and hodgkins disease
biopsy
41
extra-nodal presentation common in hodgkins/non hodgkins lymphoma
non
42
the ___ form of Burkitt's lymphoma is most closely associated with EBV (95% of cases) and affects children of ___ regions. Usually begins as a LARGE MASS IN THE JAW
African form
43
the __ form is less closely associated with EBV and usually begins as AN ABDOMINAL MASS. tumors of the jaw are rare
American form
44
invasion of dermis by sheets and islands of neoplastic epidermal cells with "KERATIN PEARLS" and related to sun exposure (mostly), chemical carcinogens such as arsenic, and radiation is characteristic of
squamous cell carcinoma
45
which is ore aggressive tumor:
| basal cell carcinoma or squamous cell carcinoma
squamous cell carcinoma bc can metastasize if untreated
46
squamous cell carcinoma (SCC) is most common on sun exposed sites in later life with ulcerated lesions on the lower/upper lip and ear are most aggressive
lower lip
47
SCC develops from what pre cancerous condition relating to sun exposure around the lips
actinic cheilitis
48
SCC = cancerous changes to __ cells
keratinoctyes (middle portion of epidermal skin layer)
49
SCC is most often __ invasive
locally. but can metastasize into lymph channels
50
SCC resembles what other cancer in histologic appearance and biological behavior
cervical cancer
to remember think: sCC = CC (cervical cancer)
51
malignant epithelial cells have an increased number of ___ receptors
Laminin = a glycoprotein in the basement membrane that promotes cell adhesion, migration, growth and differentiation
52
90% of all malignant cancers of the ORAL CAVITY ARE?
SQUAMOUS CELL CARCINOMA (SCC)
53
Cirrhosis is most common in men or women
men
54
most common invasive cancer in humans
basal cell cacinoma
55
basal cell carcinoma is the most common invasive cancer in humans but do they metastasize
rarely
56
is basal cell carcinoma ulcerative and indurated ( become firm or hard especially by increase of fibrous elements) and locally destructive
yes
57
___ carcinoma present as pearly papules containing prominent dilated subepidermal blood vessels (telangiectasias)
basal cell carcinoma
58
why are basal cell carcinomas (BCC) aka rodent ulcers
bc can ulcerate and locally invade bone or sinuses after many years of neglect
59
prognosis for BCC is
good = usually cured with surgery
60
basal cells are normal skin cells that may develop cancerous changes causing a __ that is painful/painless
painless lump. a new skin growth that ulcerates bleeds easily or does not heal well hints it may be BCC
61
darkly staining PALISADE ARRANGEMENT of nuclei cells at periphery of tumor cell is seen in
BCC
62
a __ is a stable, heritable change in the nucleotide seq of DNA resulting in an alteration in the products coded for by the gene
mutation
63
3 kinds of mutations:
1. ___ one base is inserted in place of another = results in a missense or non sense mutation
2. ___ occurs when one or more base pairs are added or deleted
3. ___ insertion sequences or deletions integrated into DNA
1. base substitution
2. frame shift mutation
3. transposons
64
mutations are caused by
chemicals, ionizing radiation, uv light, viruses
65
BENZPYRENE = chemical found in __ that binds to DNA bases and causes __ mutations
tobacco smoke = frame shift mutation
66
___ produce free radicals that can attack DNA bases
ionizing radiation (gamma and xrays)
67
UV light has lower energy than xray = causes what damage?
cross-linking of the adjacent pyrimidine bases to form dimers Uthymine dimers result in inability of the dna to replicate properly)
68
____ virus causes frame shift mutations or deletions
bacterial virus Mu (mutator bacteriophage)
69
cells with high/low proliferation are more sensitive to radiation
high
70
lymphocytes, bone marrow blood forming cells, reproductive cells and epithelial cells in GI tract are high/low radiosensitive cells
high bc proliferate a lot
71
nerve cells, mature bone cells, and muscle cells are low/high radiosensitive cells
low, bc don't regenerate much
72
what part of GI tract is the most common site of malignancy? least common?
most common is the colon. least common is the small intestine (makes up 75% of overall length of GI tract)
73
most common malignancy of the colon is sarcoma/adenocarcinoma/lymphoma
adenocarcinoma
74
most common malignancy of the SI is sarcoma/adenocarcinoma/lymphoma/carcinoid tumor
adenocarcinoma and carcinoid > lymphomas and sarcomas
75
colorectal adenocarcinoma represents 15% of all cancer related deaths in US and is second to? common in what age? men/women
lung cancer
| 60-70 y/o males
76
most colon cancers begin as
benign polyps that after many years develop into cancer. predisposing factor is ulcerative colitis
77
increased serum concentration of carcinoembryonic antigen (CEA) is related to what cancer
colorectal cancer
78
up to 4x increase in colorectal cancer if
relatives have the disease
79
a low fiber diet that is high in __ may predispose you to colorectal cancer
animal fat.
80
what part of colon is most common site of colorectal cancer
sigmoid colon
81
colorectal cancer: tumors on the __ side usually cause constipation and destruction while tumors on the __ side usually do not obstruct early
descending (LEFT) = obstruct
| ascending (RIGHT) = not obstruct early
82
Most common cancer in men
prostate
83
which cancer causes the most deaths in both men and women
lung
84
how can you confirm prostate cancer
biopsy
85
Prostate specific antigen (PSA) and acid phosphatase are elevated in
prostate cancer
86
most prostate cancers are adenocarcinoma/sarcoma?
adenocarcinoma
87
nodular hyperplasia of prostate:
benign or malignant?
causes?
is it premalignant?
benign enlargement of prostate due to hyperplastic nodules of stroma and glands distorting the prostate.
causes urinary tract obstruction.
It is NOT PREMALIGNANT
88
most common neoplasm in women?
leiomyomas =
89
Leiomyosarcoma is the malignant type.
| Leiomyoma = __ type
benign
90
good prognosis. profuse, painful menses and infertility are characteristic of this cancer
leiomyomas
91
cause of fibroid tumors are unknown. however it is suggested that fibroids may enlarge with
estrogen therapy (oral contraceptives) or pregnancy = shrink after menopause.
92
most common pelvic tumor
uterine fibroids
93
___arise from arrector pili muscles found in skin, nipples, scrotum, and labi
leiomyomas
94
neoplasms of muscles are rare but when encountered they are usually malignant/benign
malignant
95
rhabdomyosarcoma = malignant/benign neoplasm from SKELETAL (STRIATED) MUSCLE
poor prognosis
malignant
affects throat, bladder, prostate, vagina
96
the benign variety can arise in ___skeletal muscle of the body.
any
97
1. most common cancer in men
| 2. most common cancer in women
1. prostate
| 2. breast
98
strongest association w increased risk for breast cancer is
family history = esp in first degree relatives: mom/sister/daughter
99
breast cancer occurs more commonly in which breast and in what quadrant
outer upper quadrant of left breast
100
```
early menarche
late menopause
obesity
first pregnancy after 30 years of age
diet high in animal fat
positive family history
history of breast cancer in one breast
proliferative fibrocystic disease with atypical epithelial hyperplasia are all predisposing factors to
```
breast cancer
101
1. A painful/painless mass in the breast is usually initial sign of breast cancer.
2. retraction of ___
3. peau d'orange
4. enlarged
1. painless
2. nipple/skin
3. swollen pitted skin
4. axillary lymph nodes
102
most valuable prognostic predictor of breast cancer
lymph node involvement
103
___ of breast is most common cause of clinically palpable breast mass in women 28-44 years old
fibrocystic disease
104
5 year survival rate of bronchogenic carcinoma is
10% = leading cause of death from cancer in both men and women
105
Reed Sternberg cells = neoplastic cells of ___
Hodgkins lymphoma
reed sternberg are binucleated/multinucleated giant cells with eosinophilic inclusion like nucleoli
106
first sign of Hodgkin lymphoma
enlarged lymph node
107
Hodgkin lymphoma affects young/old more? women/men
young men
| except for nodular sclerosis = more in young women
108
Non Hodgkin lymphoma is a malignant lymphoma characterized by the absence of
Reed Sternberg cells
109
```
benign/malignant:
well differentiated
slow growth
encapsulated/well circumscribed
localized
movable
```
benign
110
benign/malignant:
```
less well differentiated (anaplastic)
rapid growth
invasion
metastasis
immovable
```
malignant
111
"punched out" bone lesions
bence jones protein (urine with immunoglobin light chains-kappa or lamda)
B-cell proliferation
multiple myeloma = plasma cell neoplasm
| elderly
112
NON-MALIGNANT cell growth. May proceed to malignant changes in the tissue. Associated w chronic irritation to tissue by a chemical agent, ie cigarette smoke or by chronic inflammatory inflammation. Tissue appears disorganized, atypical cells w/o invasion. Epithelium exhibits acanthosis = abnormal thickening of prickle cell layer.
dysplasia
113
substitution of one tissue normally found at a site for another. GERD = ex
metaplasia
114
Most common type of epithelial metaplasia is replacement of __ cells by ___epithelium
columnar
| stratified squamous
115
desmoplasia =
neoplasms that form fibrous stroma that makes tumor feel hard on palpation.
116
Most common primary MALIGNANT tumor of BONE:
osteogenic sarcoma
117
choristoma
benign mass of normal tissue MISPLACed WITHIN another organ
| ex liver tissue in intestinal wall
118
hamartoma
benign tumor like overgrowth of cell types that are regularly found within the affected organ. ex. hamangioma = irregular accumulation of bv's
119
Ewing sarcoma and primitive neuroectodermal tumor (PNET) are two variants of the same tumor but differ in the degree of neural differentiation:
1. tumors that demonstrate neural differentiation are
2. tumors that are undifferentiated are
1. differentiated = PNET's
2. undifferentiated = Ewing sarcoma
distinction has no clinical signifigance
120
1. most common malignant bone tumor
| 2. 2nd most common
1. osteosarcoma
| 2. Ewing sarcoma (undifferentiated neural tissue)
121
majority of Ewing sarcoma are in ages 10-20 and result from
chromosome rearrangement
122
Ewing sarcoma patients present with
severe bone pain
123
Schilling test used to detect
pernicious anemia
124
you need __ and ___ for dna synthesis
vitamin B-12 and folate
125
you need __ for heme synthesis
iron
