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Flashcards in Neoplasia Deck (44):
1

Where is the most common benign tumor in women found? What is the most common tumor in males?

The uterus

Males: lipoma

2

What are benign tumors of glands called?

Adenomas

3

What disease can cause atrophy of the zona glomerulosa? What is a simple way to remember the three zones of the adrenal cortex?

Conn's syndrome - tumor secreting mineralocorticoids

GFR = Glomerulosa, Fasciculata, Reticularis

Salty, Sweet, Sexy - gets sweeter as you go deeper

4

What is the most common precursor lesion for colon cancer? What does it look like?

Adrenal adenoma - strawberry on a stick

5

What is the definition of a carcinoma?

Malignancy of EPITHELIAL tissues - squamous, glandular(adenocarcinoma), transitional

6

How do you recognize the three types of carcinoma?

Squamous - keratin pearls (small swirls of increased red brightness)

Glandular = ADENOCARCINOMA - glands containing stuff

Transitional - derived from BLADDER, RENAL PELVIS, AND URETER

7

What are aput tumors?

S-100 Ag (+) Tumors that are of neurosecretory or neural crest origin (neurosecretory granules on EM)

e.g. MELANOMA, Small cell carcinoma of the lung, bronchial carcinoid, carcinoid tumor of the tip of the appendix, neuroblastoma

8

A 2 year has many skin tumors that are S-100 (+) on biopsy.

Neuroblastoma - tumor from adrenal medulla that met'ed to the skin

9

What does it mean when a tumor is S-100 (+)?

Aput tumor - neurosecretory derived tumor that usually contains neurosecretory granules

10

What are sarcomas?

Malignancies of MESENCHYMAL tissue Smooth muscle - leiomyosarcoma
Striated muscle - rhabdomyosarcoma
Fat - liposarcoma
Bone - Osteogenic sarcoma

11

What is the diagnosis for a necrotic mass protruding from the vagina of a small girl that is keratin (-) and desmin (+)? What is important about this disease?

Embryonal rhabdomyosarcoma - see STRIATIONS of muscle


MOST COMMON SARCOMA IN CHILDREN

12

What is the most common salivary gland tumor? What tumor type should this not be confused with?

Mixed tumor - found in parotid gland and has TWO HISTOLOGIC TISSUE TYPES that are derived from THE SAME LAYER


Teratoma - DERIVED FROM ALL THREE LAYERS

13

A 16 year old girl has a sudden onset of RLQ pain and you confirmed that this is not due to an acute abdomen.

Cystic teratoma of the ovaries - GERM CELL TUMOR

14

Auer rod = ?

AML - Myeloblast

15

What can cause a hypersegmented neutrophil?

B12 and folate deficiency

16

What is the most common and second most common site in the body for a lymphoma to develop other than the lymph node?

1st = THE STOMACH
2nd = Payer's patches in TERMINAL ILEUM

17

A follicular B cell lymphoma is due to what cellular problem?

bcl-2 is an anti-apoptotic regulatory protein


14;18 translocation that causes moves the bcl-2 gene close to the Ig heavy chain locus and causes the OVERPRODUCTION OF bcl-2 THAT INACTIVES THE APOPTOTIC GENE in B cells

18

What is the most common polyp in the GI tract?

Hamartoma = hyperplastic polyp = NON-NEOPLASTIC WITH NO RISK FOR CANCER

19

Do malignant cells typically have a shorter or a longer cell cycle than their parent cells? How many doubling times does it take to get a tumor that can be clinically detected?

LONGER CELL CYCLE

30 DOUBLING TIMES

20

What enzymes are frequently found in many malignant cells and what type of metabolism do most go through?

Proteases to break through tissue and collagenases to break through the basement membrane


Anaerobic metabolism

21

For a carcinoma to become hematogenously, it usually first had to do what? What tumor does not follow this route? What does this second route mean for course of action in establishing extent of spread? What carcinoma uncharacteristically follows the second route?

Carcinoma - usually spread to a lymph node

Sarcoma - typically spread hematogenously first (worse prognosis) -> DO NOT DO A RADICAL DISSECTION OF THE AXILLA FOR AN ANGIOSARCOMA OF THE BREAST


Follicular carcinoma of the thyroid, Renal adenocarcinoma, hepatocellular carcinoma - hemat. spread first

22

In what organ is metastasis NOT the most common cancer?

Renal adenocarcinoma

23

What is the most common cancer that metastasizes to the bone? Why? What are the most common bones that are metastasized? How should you image for bone mets?

Breast cancer due to the Batsom system of venous drainage from the base of the skull to the sacrum that doesn't contain valves - this system sends tributaries to the vena cava and vertebral bodies before collecting around the spinal cord.


Most common - vertebral column
2nd most common - head of the femur

Imaging: radionucleide scan

24

What is the source of the most common cancer of the liver?

The lungs (NOT THE COLON)

25

Where are Virchow's nodes and what is the most common primary metastasis to them?

Left supraclavicular node - STOMACH = patient with weight loss and epigastric distress

26

Why do myeloma patients get punched out lesions in their skull? What lab value will be elevated?

Malignant plasma cells have IL-1 in them = OSTEOCLAST ACTIVATING FACTOR

AlkPhos will be elevated

27

What is the most common overall location for mets? What image or gross presentation is most indicative for mets?

Most common location = Lumbar vertebrae

Most indicative for mets = MULTIPLE LESIONS

28

What is the most common primary site for brain cancer that is also the most common cancer that kills men and women? What is the most common primary site for the organ identified above? For the first organ identified, where else do its metastases love to travel that should be checked with a CT?

Most common brain cancer met source = lung

Most common lung cancer met source = breast

Lung = MOST COMMON MET SOURCE FOR ADRENAL GLANDS

29

What is the best identifying stain for a carcinoma? For a sarcoma?

Keratin - carcinoma
Desmin - good stain for muscle -> rhabdomyosarcoma

30

What is the first step in malignancy? Second step? Third step?

Initiation = mutation

Promotion = make multiple copies of mutation

Progression = sub-specializing

31

What are some protooncogenes that code for receptors? What about those that code for messages sent from the cytosol to the nucleus? What about the genes that are stimulated by those messages in the nucleus? What are some suppressor genes that control the cell cycle?

Receptor Coding:
erb-2 = breast cancer
ret = MEN syndromes
Message creating:
ras = cell membrane located messenger
abl = lives in the cytosol close to the nuclear membrane
Stimulated by messages:
n-myc = neuroblastoma
c-myc = Burkitt's Lymphoma
Suppressor genes that control the cell cycle:
Rb suppressor gene
p53 suppressor gene
adenomatous polyposis coli (familial polyposis)
neurofibromatosis (nfm)
wilm's tumor gene
BRCA1/2

32

Which protooncogenes are knocked out by point mutation? By amplification? By translocation?

Point mutation: p53 and ras
Amplification: erb-2
Translocation: abl translocation on a Philly chromosome

33

What genetic adjustment can sometimes be made by Epstein-Barr Virus and what can result? What receptor does EBV use to gain entry into plasma cells?

8;14 translocation that translocates myc from 8 to 14 -> BURKITT'S LYMPHOMA

Receptor: CD21

34

What cancer is associated with a 15;17 translocation and what can treat it?

Acute progranulocytic leukemia

TREAT WITH VITAMIN A -> matures the blast and renders the malignant cell benign

35

A patient with Wegener's granulomatosis develops hematuria with abnormal cells on cytology studies.

Cyclophosphamide prescribed to treat Wegener's causes transitional cell carcinoma

36

A patient that works in the dye industry presents with dysuria and hematuria.

Papillary tumor of the bladder = transitional cancer caused by SMOKING

37

What is the diagnosis for non-pruritic raised red lesions?

Kaposi's sarcoma caused by HHSV 8

38

Aflatoxin B causes what? What disease can also cause this? What ethnicity most commonly gets this?

Hepatocellular carcinoma
Hepatitis B
Asian

39

The rapidly increasing incidence of primary CNS lymphoma can be directly attributed to what?

HIV

40

What virus can cause anal squamous cell cancer in homosexuals?

HPV

41

What is the most common type of leukemia associated with radiation?

CML - 9;22 translocation of abl

42

A patient was exposed to radiation in the head area and presents with non-tender, nodular masses in the cervical region. DDx?

Papillary carcinoma of the thyroid

43

What metal is associated with skin cancer and what country has a high level of exposure through the water? What type of cancer?

ARSENIC - Bangladesh - squamous skin cancer

44

What is the most common cause of white eye reflex in an infant?

Congenital cataract - NOT RETINOBLASTOMA