Flashcards in Neoplasia Deck (99)
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Provides tumor with structural framework for cells to grow
Stroma
1
The following are true about neoplasia except
A. Persistence of tumors result from genetic alterations
B. Autonomous, unregulated division
C. Independent from the host in terms of nutrition and blood supply
D. Means "new growth"
E. Tumors are clonal, meaning comes from 1 altered cell
C
2
What is a desmoplasia?
Abundant collagenous stroma derived from parenchymal stimulation
3
Suffix of benign tumors with a mesenchymal origin
-oma except lymphona, melanoma, mesothelioma,seminoma
4
Benign epithelial neoplasm derived from glands
Adenoma
5
Benign epithelial neoplasm with visible finger-like projections
Papilloma
6
Large, benign cystic masses e.g. of the ovary
Cystadenomas
7
Visible projection above a mucosal surface and projects into the gastric or colonic lumen
Polyp
8
Malignant tumors with mesenchymal origin
Sarcoma
9
Malignant tumors with epithelial origin
Carcinoma
10
What is an undifferentiated malignant tumor?
Malignant tumor composed of undifferentiated cells
11
Differentiate pleomorphic adenoma from teratoma
Teratoma - from totipotent cell, cells from more than 1 germ layer origin
Pleomorphic adenoma - diff cell types but from 1 germ cell layer
12
Differentiate benign from malignant teratoma
Benign teratoma has well differentiated cells but malignant teratoma has immature cells
13
[benign, malignant names] blood vessel tumor
Hemangiona, angiosarcoma
14
[benign, malignant names] lymph vessels
Lymphangioma, lymphangiosarcoma
15
[benign, malignant names] synovium
-, synovial sarcoma
16
[benign, malignant names] mesothelium
-, mesothelioma
17
[benign, malignant names] brain coverings
Meningioma, invasive meningioma
18
[benign, malignant names] hematopoietic cells
-,leukemia
19
[benign, malignant names] lymphoid tissue
-,lymphoma
20
[benign, malignant names] smooth muscle
Leiomyoma, leiosarcoma
21
[benign, malignant names] striated muscle
Rhabdomyoma, rhabdomyosarcoma
22
[benign, malignant names] stratified squamous
Squamous cell papilloma, squamous cell carcinoma
23
[benign, malignant names] basal cells of skin/adnexa
-, basal cell carcinoma
24
[benign, malignant names] epithelial lining of glands or ducts
Adenoma/papilloma/cystadenoma, adenocarcinoma/papillary carcinoma/cystadenocarcinoma
25
[benign, malignant names] respiratory passages
Bronchial adenoma/ bronchogenic carcinoma
26
[benign, malignant names] renal epithelium
Renal tubular adenoma, renal cell carcinoma
27
[benign, malignant names] liver
Liver cell adenoma,hepatocellular carcinoma
28
[benign, malignant names] urinary tract epithelium
Transitional cell papilloma, transitional cell carcinoma
29
[benign, malignant names] placental epithelium
Hydatidiform mole, choriocarcinoma
30
[benign, malignant names] testicular epithelium
-,Seminoma/embryonal carcinoma
31
What is Wilm's tumor
Malignant tumor if renal anlage
32
Disorganized but benign-looking masses composed of cells indigenous to the particular site
Hamartoma
33
Extent to which neoplastic parenchymal cells resemble normal parenchymal cells
Differentiation
34
Lack of cellular differentiation is referred to as
Anaplasia
35
[Benign vs. Malignant]differentiation and anaplasia
Benign: Well differentiated;mitoses scant
Malignant: wide range of differentiation; immature
36
Hallmarks of malignancy
1. Metastasis
2. Anaplasia
37
Variation in size and shape characteristic of anaplastic tumors
Pleomorphism
38
Tumor of melanocytes: benign, malignant
Nevus, malignant melanoma
39
Morphologic changes associated with anaplasia
Pleomorphism, abnormal nuclear morphology (large nucleus, hyperchromatic abundant chromatin), mitoses, loss of polarity, tumor giant cells, scant stroma, large central areas of necrosis
40
[Define] dysplasia
Disordered growth
41
When dysplastic changes are confined by the basement membrane the tumor is considered a preinvasive neoplasm and is referred to as
Carcinoma in situ
42
Which of the statements is true
A. Presence of Mitoses microscopically observed indicates malignancy
B. Dysplasia always lead to cancer
C. A transformed cell does not retain functional capability of a normal cell no matter how well differentiated it is
D. The more anaplastic a tumor is, the more likely will it take a specific role
E. NOTA
E
43
3 main factors in determining tumor rate of growth
Doubling time, fraction of tumor cells in replicative pool, rate at which cells shed or die
44
Portion of cells within the tumor in the replicative pool
Growth fraction
45
The following concepts are true about tumor cell kinetics except
A. Fast-growing tumors have high cell turnover, implying that rates of both proliferation and apoptosis are high
B. In chemotherapy, the fraction if cells in the replicative pool does not affect its effectivity
C. For tumor to grow, rate of cell proliferation must exceed rate of cell death
D. NOTA
B
46
Explain the principle behind combined modality strategy to fight certain tumors
Combined modality - excise tumor first causing surviving cells to join the replicative pool making them susceptible to drug therapy.
47
T/F In general, malignant tumors have a higher growth rate than benign tumors
T. Generally, yes, but there some benign tumors grow faster
48
The following are true about leiomyomas except
A. Growth is dependent on estrogen levels
B. Not necessarily excised especially in old, turning menopausal patients since the drop in estrogen levels will cause the leiomyoma to shrink
C. There is rapid growth of leiomyoma during pregnancy
D. AOTA
E. NOTA
E
49
True about cancer except
A. Cancers are immortal and have a limitless proliferative capacity
B. Cancer stem cells are rapidly dividing and susceptible to chemotherapeutic drugs
C. Elimination of cancer stem cells are fundamental in trying to cure cancer
D. Cancer stem cells arise from normal stem cells and differentiated cells that acquired the capacity to divide
C; however cancer cells espress drug resistant pfactors such as multiple drug resistance-1(MDR-1).
50
Cells that allow a human tumor to grow and maintain itself indefinitely
Tumor initiating cells (T-IC)
51
True about benign tumors except
A. Grow as a cohesive expansile mass
B. A fibrous capsule differentiates a benign tumor from the host tissue
C. A well defined cleavage plane is present in all benign tumors.
D. NOTA
C; some, like hemangiomas, do not have
52
True about malignant tumors except
A. Infiltration, invasion and destruction accompany malignancy
B. Anaplasia and metastasis are the hallmarks of malignancy
C. No malignant tumor grows inside a fibrous capsule
D. Malignant tumors recognize no anatomical boundaries
E. NOTA
C; they are pseudoencapsulated masses
53
All malignant tumors metastasize EXCEPT
Gliomas and basal cell carcinoma of the skin
54
Give 3 ways through which cancers may spread
1. Direct seeding of body cavities or surfaces
2. Lymphatics
3. Hematogenous spread
55
What is a pseudomyxoma peritonei?
Gelatinous neoplastic mass secreted by appendiceal carcinomas that fill the peritoneal cavity
56
Which lymph node will be affected in carcinomas of the breast arising from the upper outer quadrants?
Axillary lymph nodes
57
Which lymph node will be affected by breast carcinomas beginning in the inner quadrants?
Lymph nodes along internal mammary arteries
58
What may cause enlargement of nodes? Give 2
(1) Spread and growth of cancer cells, (2) reactive hyperplasia
59
T/F nodal enlargement proximal to a cancer necessarily mean dissemination of the primary lesion
F
60
Hematogenous spread is typical of
A. Sarcoma
B. Carcinoma
C. Neither
A
61
T/F arteries are more difficult to be penetrated by malignancies because they have thicker walls than veins
T
62
Which 2 organs are commonly involved in hematogenous dissemination (venous)?
Lungs (caval), liver (portal)
63
Where does cancers arising in clos proximity to the vertebrae embolizes?
Paravertebral plexus
64
T/F the larger and more undifferentiated the primary, the more likely are metastases
T
65
Usually a point mutation occurring in a single allele of a tumor suppressor gene; inheritance of a single autosomal dominant mutant gene
Autosomal dominant inherited cancer syndromes
66
Example of autosomal dominant inherited cancer syndromes
Retinoblastoma - mutant of Rb suppressor gene
Familial adenomatous polypoosis - mutation of APC
67
T/F HNPCC is an example of DNA replication defects
T
68
[human cancer site for which reasonable evidence is available] arsenic, arsenic compounds
Lung, skin, hemangiosarcoma
69
[human cancer site for which reasonable evidence is available] asbestos
Lung, mesothelioma, GI (esophagus, stomach, large intestine)
70
[human cancer site for which reasonable evidence is available] benzene
Leukemia, hodgkin lymphoma
71
[human cancer site for which reasonable evidence is available] beryllium, beryllium compounds
Lung
72
[human cancer site for which reasonable evidence is available] cadmium and cadmium compounds
Prostate
73
[human cancer site for which reasonable evidence is available] chromium
Lung
74
[human cancer site for which reasonable evidence is available] nickel compounds
Nose, lung
75
[human cancer site for which reasonable evidence is available] radon
Lung
76
[human cancer site for which reasonable evidence is available] vinyl chloride
Angiosarcoma, liver
77
[inherited predisposition] RB
Retinoblastoma
78
[inherited predisposition] p53
Li-Fraumeni syndrome
79
[inherited predisposition] p16/INK4A
Melanoma
80
[inherited predisposition] APC
Familial adenomatous polyposis(colon cancer)
81
[inherited predisposition] NF1,NF2
Neurofibromatosis 1,2
82
[inherited predisposition] BRCA1,2
Breast and ovarian tumors
83
[inherited predisposition] MEN1, RET
Multiple endocrine neoplasia 1,2
84
[inherited predisposition] MSH2, MLH1, MSH6
Hereditary nonpolyposis colon cancer
85
[inherited predisposition] PTCH
Nevoid basal cell carcinoma syndrome
86
[inherited predisposition] PTEN
Cowden syndrome (epithelial cancers)
87
[inherited predisposition] LKB1
Peutz-Jegher syndrome (epithelial cancers)
88
[inherited predisposition] VHL
Renal cell carcinomas
89
Examples of inherited autosomal recessive syndromes of defective DNA repair (4)
Xeroderma pigmentosum, ataxia-telangiectasia, bloom syndrome, Fanconi anemia, HNPC
90
[inherited predisposition] enumerate familial cancers
Breast, ovarian, pancreatic
91
True about familial cancers EXCEPT
a. Occurs in familial pattern
b. Include early age onset
c. Multiple or bilateral tumors
d. May include carcinomas of colon, breast, ovary and brain, melanomas and lymphomas
e. associated with specific marker phenotypes
E
92
People with ulcerative colitis, H. pylori gastritis, viral hepatitis, and chronic pancreatitis are prone to development of cancer. What may be part of the reason?
Chronic inflammation which is present in these cases increase the risk cancer development. This is due to compensatory proliferation of cells to repair damage.
93
Give (4) precancerous conditions
1. Chronic atrophic gastritis of pernicious anemia
2. Solar keratosis of the skin
3. Chronic ulcerative colitis
4. Leukoplakia (oral cavity, vulva, penis)
94
The following statements are true EXCEPT
a. Most of precancerous conditions lead to malignant neoplasms
b. benign neoplasias contribute to precancerous conditions
c. Neither a nor b
d. Both a and b
A
95
The following statements regarding the molecular basis of cancer are true EXCEPT
a. Nonlethal genetic damages lies at the heart of carcinogenesis
b. a tumor is made up of cells with polyclonal origin
c. Carcinogenesis is a multistep process at both the phenotypic and the genetic levels, resulting from the accumulation of multiple mutations
d. Mutant alleles of proto-oncogenes are considered dominant because they transform cells despite the presence of a normal counterpart
B; monoclonal
96
What are proto-oncogenes?
Regulatory genes promoting growth
97
What are tumor suppressor genes?
Regulatory genes inhibiting growth
98
