Neoplasia complete Flashcards Preview

Pathology > Neoplasia complete > Flashcards

Flashcards in Neoplasia complete Deck (149):
1

Benign tumor origin

Epithelial or Connective tissue origin

2

Benign tumors of epithelial origin

Ectoderm, endoderm

3

Benign tumors of connective origin

mesoderm

4

Teratomas origin

Derives from ectoderm, endoderm, mesoderm

5

Origin of Carcinomas

Derive from squamous, glandular (adenocarcinoma), transitional epithelium

6

Origin of Sarcomas

Derive from connective tissue

7

Hamartoma

non-neoplastic overgrowth of tissue

8

Choristoma

normal tissue where it should NOT be

9

Neoplastic component of that determines the tumors biologic behavior

parenchyma (tissue that does the work)

10

Grade of cancer asks...

does the cancer resemble its parent tissue or not?

11

Features of Malignant tumors

↑ nuclear/cytoplasmic ratio; abnormal mitotic spindles

12

How many doubling times (cell cycles) are required b4 a tumor can be clinically evident

30

13

Benign and malignant tumors derive from a...

single precursor cell (monoclonality)

14

Why dont malignant tumors lose genetic material after multiple cell divisions?

d/t upregulation of telomerase activity

15

Feature of Basal cell carcinoma

invade tissue but do NOT metastasize

16

2nd most important criterion for malignancy

Invasion

17

Tissue resistant to invasion

Cartilage, elastic tissue

18

Loss of intercellular adherence (E-cadherin)

→ cell invasion

19

Extranodal metastasis (eg liver) has greater prognostic significance than...

nodal metastasis (TNM )

20

Routes of metastasis

lymphatic (carcinomas), hematogenous (sarcomas), seeding body cavities

21

Type of metastasis common w/ surface-derived ovarian cancers

Seeding

22

Bone metastasis

Vertebra MC site; paravertebral venous plexus

23

Feature of Osteoblastic metastasis

↑ serum alkaline phosphatase (dephosphorylates pyrophosphate which inhibits bone formation); seen in prostate cancer

24

Consequences of Osteolytic metastasis

hypercalcemia, pathologic fxs

25

Bone metastasis on X-ray

Osteoblastic-radiodense; Osteolytic-radiolucent

26

MC tissue metastasize to

Lymph node

27

2nd MCC death in US

Cancer

28

Lifetime risk for cancer

Men 〉 Women

29

Population w/ greatest overall risk for cancer

Blacks

30

MC cancer in children

Acute lymphoblastic leukemia (ALL)

31

Cancer incidence in men

Prostate 〉 Lung 〉 Colorectal

32

Cancer incidence in women

Breast 〉 Lung 〉 Colorectal

33

Incidence of gynecologic cancer

Endometrial 〉 Ovarian 〉 Cervical (lowest d/t pap smears)

34

MCC of cancer death in adults

Lung cancer

35

Cancer-related deaths in men

Lung 〉 Prostate 〉 colorectal

36

Cancer-related deaths in women

Lung 〉 Breast 〉 Colorectal

37

Most rapidly ↑ing cancer worldwide

Malignant melanoma

38

Cancer in china

Nasopharyngeal carcinoma 2ndary to EBV

39

Cancer in Japan

Stomach adenocarcinoma d/t smoked foods

40

Cancer of SE Asia

Hepatocellular carcinoma d/t Hep B and aflotoxins (produced by Aspergillus) in food

41

Cancer of Africa

Burkitts lymphoma d/t EBV and Kaposis sarcoma d/t HHV 8

42

AD cancer syndromes

Retinoblastoma, Familial Adenomatous Polyposis, Li-Fraumeni syndrome, Hereditary nonpolyposis colon cancer (Lynch syndrome), BRCA1 and BRCA2 genes

43

Retinoblastoma

point mutation inactivates RB suppressor gene; predisposition for osteogenic sarcoma in adolescence

44

Familial Adenomatous Polyposis (FAP)

inactivation of APC suppressor gene → malignant transformation of of polyps by age 50

45

Li-Fraumeni syndrome

inactivation of TP53 suppressor gene → ↑ risk for sarcomas, leukemia, carcinomas

46

Hereditary nonpolyposis colon cancer (HNPCC) aka Lynch syndrome

inactivation of DNA mismatch repair genes → cannot correct errors in nucleotide pairing; ↑ risk colorectal cancer w/o previous polyps

47

BRCA1 and BRCA2 genes

inactivation of genes ↑ risk for breast and ovarian cancer; can also be involved in Familial cancer syndromes

48

Autodomal recessive syndromes w/ defects in DNA repair

Xeroderma pigmentosum, Chromosome instability syndromes

49

Xeroderma pigmentosum

UV light → cross links adjacent pyrimidines (C&T) producing pyrimidine dimers; ↑ risk of skin cancer like basal cell carcinoma, squamous cell carcinoma

50

Chromosome instability syndromes

Chromosomes susceptible to damage by ionizing radiation and drugs→to cancer

51

Examples of Chromosome instability syndromes

Fanconi anemia, ataxia telangiectasia, bloom syndrome

52

Precursor of squamous cell carcinoma

Actinic (solar) keratosis

53

Most important factor in ↓ risk for cancer

Cessation of smoking

54

Name something that ↓ risk for hepatocellular carcinoma

HBV immunization

55

Name something that ↓ risk for cervical cancer

Human papillomavirus immunization

56

Least common gynecologic cancer in US

Cervical cancer

57

Test most responsible for ↓ incidence/mortality rate for cervical cancer

Cervical pap smear

58

Prostate-specific antigen (PSA)

more sensitive (yes,yes) than specific (no,no)

59

Rx H. pylori infection

↓ risk for developing gastric lymphoma/adenocarcinoma

60

Rx GERD

↓ risk for distal adenocarcinoma of esophagus

61

MC type of mutation in cancer

Point mutations

62

Genes involved in normal growth and repair

Proto-oncogenes

63

Genes that protect against unregulated cell growth

Suppressor genes

64

Antiapoptosis genes (prolife)

BCL2 gene family

65

apoptosis gene

BAX gene; activated by TP53 if DNA damage is excessive; BAX gene inactivates BCL2 antiapoptosis gene

66

Proto-oncogenes

ABL, HER (ERBB₂), MYC, N-MYC, RAS, RET, SIS

67

ABL

Nonrecptor tyrosine kinase; t(9;22); CML, chr. 22 Philadelphia chr

68

HER (ERBB₂)

Receptor synthesis; amplification mutation; Breast carcinoma (marker of aggression)

69

MYC

Nuclear transcription; t(8;14); Burkitts lymphoma

70

N-MYC

Nuclear transcription; amplification mutation; Neuroblastoma

71

RAS

GTP signal transduction; Point mutation; leukemia; lung, colon, pancreatic cancer

72

RET

Receptor synthesis; Point mutation; Multiple Endocrine Neoplasia IIa/IIb (MEN) syndromes

73

SIS

Growth factor synthesis; Overexpression; Osteogenic sarcoma, astrocytoma

74

Tumor suppressor genes

APC, BRCA1/BRCA2, RB, TGF-β, TP53, VHL, WT₁

75

Mutation common to tumor suppressor genes

Point mutation

76

APC

prevents nuclear transcription; Famililal adenomatous polyposis

77

BRCA1/BRCA2

Regulated DNA repair; Breast ovary, prostate cancers

78

RB

Inhibits G₁ to S phase; Retinoblastoma, osteogenic sarcoma, breast carcinoma

79

TGF-β

Inhibits G₁ to S phase; pancreatic and colorectal carcinomas

80

TP53

Inhibits G₁ to S phase, Repairs DNA, activates BAX; Lung, colon, breast carcinomas; Li-Fraumeni syndrome: breast carcinoma, brain tumors, leukemia, sarcomas

81

VHL

Regulates nuclear transcription; Von Hippel-Lindau syndrome; cerebellar hemanioblastoma, retinal angioma, renal cell carcinoma (bilateral), pheochromocytoma (bilateral)

82

Pheochromocytoma

Neuroendocrine tumor of medulla of adrenal glands; secretes excessive catacholamines

83

WT₁

Regulates nuclear transcription; Wilms tumor

84

Fxn of DNA repair genes

correct errors in nucleotide pairing; excise pyrimidine dimers

85

Enzymes involved in dimer excision

endonuclease, exonuclease, polymerase, ligase

86

Agent most responsible for cancer and cancer deaths in the US

Tobacco

87

Sequence of chemical carcinogenesis

Initiaion → promotion→ progression

88

Aflatoxin (from aspergillus)

HCC in assoc. w/ Hep B

89

Alcohol

Squamous cell carcinoma or oropharynx and upper/middle esophagus; pancreatic and Hepatocellular carcinomas

90

Alkylating agents

Malignant lymphoma

91

Arsenic

Squamous cell carcinoma of skin, lung cancer, liver angiosarcoma

92

Asbestos

Bronchogenic carcinoma, pleural mesothelioma

93

Benzene

Acute Leukemia

94

Beryllium

Bronchogenic carcinoma

95

Chromium

Bronchogenic carcinoma

96

Cyclophosphamide

Transitional cell carcinoma of urinary bladder

97

Diethylstilbestrol (DES)

Clear cell carcinoma of vagina/cervix

98

β-Naphthylamine (aniline dyes)

Transitional cell carcinoma of urinary bladder

99

Nickel

Bronchogenic carcinoma

100

Oral Contraceptives

Breast, cervical carcinomas

101

Polycyclic hydrocarbons

Squamous cell carcinoma: oral cavity, midesophagus, larynx, lung; Adenocarcinoma: pancreas, kidney; Transitional cell carcinoma: urinary bladder, renal pelvis

102

Silica

Bronchogenic carcinoma

103

Oncogenic RNA viruses

HCV , HTLV-1 (human T-cell lymphotropic virus)

104

HCV

produces postnecrotic cirrhosis; HCC

105

HTVL-1 (Human T-cell lymphotropic Virus)

Activates TAX gene, stimulates polyclonal T-cell proliferation, inhibits P53; T-cell leukemia and lymphoma

106

Oncogenic DNA viruses

EBV, HBV, HHV-8, HPV 16 and 18

107

EBV

Promotes polyclonal B cell proliferation, which ↑ risk for t(8;14); Burkitts lymphoma, CNS lymphoma in AIDS, mixed cellularity Hodgkins lymphoma, nasopharyngeal carcinoma

108

HBV

activates proto-oncogenes, inactivates p53; HCC

109

HHV-8

acts via cytokine released from HIV and HSV; Kaposis sarcoma in AIDS

110

HPV 16 and 18

Type 16: E6 gene product inhibits P53, Type 18: E7 inhibits RB; squamous cell carcinoma of vulva, vagina, cervix, anus, larynx, oropharynx

111

Pathogens and cancer

Viruses 〉 bacteria 〉 parasites

112

MC cancer d/t ionizing radiation

AML (acute myeloblastic leukemia) or CML (chronic myeloblastic leukemia)

113

MC cancer d/t excessive UV light exposure

Basal cell carcinoma

114

Squamous cell carcinoma in physical injury

3rd degree burns; chronically draining sinuses (chronic osteomyelitis)

115

Most effective host defense against cancer

Cytotoxic CD8 T cells

116

Most important prognostic factor

Staging criteria; TNM system

117

Least to most important prognostic factor

T 〈 N 〈 M (most important)

118

Molecule involved in Cachexia

TNF-α secreted by macrophages and tumor cells→suppresses appetite in hypothalamus and stimulates apoptosis

119

MC anemia in cancer

Anemia of chronic dz; normocytic anemic w/ corrected reticulocyte count 〈 3 %

120

Hemostasis abnormality in malignancy

Thrombogenic

121

MCC of death in cancer

Gram - sepsis

122

Skin abnormality that may be assoc. w/ stomach cancer

Acanthosis nigricans; black, verrucoid-appearing lesion

123

Signs of ectopic hormone production

hypercalcemia, hyponatremia, hypoglycemia, hypercortisolism, polycythemia

124

Eaton-Lambert syndrome

Small cell carcinoma of lung; Myasthenia gravis-like Sxs (muscle weakness); Ab against Ca channel

125

Hypertrophic osteoarthropathy

Bronchogenic carcinoma; Periosteal rxn of distal phalanx (often assoc. w/ clubbing of nail)

126

Nonbacterial thrombotic endocarditis

Mucus-secreting pancreatic and colorectal carcinomas; sterile vegetations on mitral valve

127

Seborrheic keratosis

Stomach carcinoma; Sudden appearance of numerous pigmented seborrheic keratoses (leser-Trélat sign)

128

Superficial migratory thrombophlebitis

Pancreatic carcinoma; Release of procoagulants (Trousseaus sign: hypercoagulability)

129

Nephrotic syndrome

Lung, breast, stomach carcinomas; Diffuse membranous glomerulopathy

130

Cushing syndrome

ACTH; small cell carcinoma of lung, medullary carcinoma of thyroid

131

Gynecomastia

hCG; Choriocarcinoma (testis)

132

Hypercalcemia

PTH-related protein: Renal cell carcinoma, 1° squamous cell carcinoma of lung, breast carcinoma; Calcitriol (VitD): malignant lymphoma (contain α1-hydroxylase)

133

Hypocalcemia

Calcitonin; Medullary carcinoma of thyroid

134

Hypoglycemia

Insulin-like facter; HCC

135

Hyponatremia

ADH; small cell carcinoma of lung

136

2° Polycythemia

EPO; Renal cell and Hepatocellular carcinoma

137

α-fetoprotein (AFP)

HCC, yolk sac tumor of ovary or testis

138

Bence Jones Protein

Multiple myeloma, Waldenströms macroglobulinemia

139

CA 15-3

Breast cancer

140

CA 19-9

Pancreatic, colorectal carcinomas

141

CA 125

Surface-derived ovarian cancer (eg serous cystadenocarcinoma; helpful in distinguishing malignant from b9

142

Carcinoembryonic antigen (CEA)

Colorectal and pancreatic carcinomas

143

Lactate dehydrogenase

Malignant lymphoma

144

Cytokeratin

epithelial origin

145

Vimentin

Connective tissue origin

146

Desmin

Muscle

147

GFAP

Neuroglia

148

Neurofilaments

Neurons

149

CD45+

Malignant lymphoma