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FoundSci III > Neoplasia II > Flashcards

Neoplasia II Flashcards

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1
Q

Compared to benign tumors, malignant tumor possess large numbers of ________

A

mitoses

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2
Q

The more abnormal the ________, the more likely the neoplasm/tumor is malignant

A

mitoses

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3
Q

Tumor angiogenesis has a dual effect on tumor growth. What is that dual effect?

A
  1. Provide nutrients and oxygen
  2. Newly formed EC stimulates the growth of adjacent tumor cells by secreting GF such as IGF and PDGF
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4
Q

What are wrong with tumor vessels?

A

They are leaky and dilated, permitted tumor cells access to abnormal vessels

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5
Q

Abnormal vessels contribute to _______

A

metastasis

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6
Q

A malignant tumor will have increased ______

A

vascularity (angiogenesis) in tumor stroma

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7
Q

What are the reasons a malignant tumor has increased vascularity?

A

VEGF, bFGF, and HIF

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8
Q

Tumor angiogenesis is controlled by the balance between ______ and _______ factors produced by tumor parenchymal and stromal cells

A

pro

anti-angiogenic factors

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9
Q

What are pro-angiogenic factors?

A

VEGF
bFGF (basic FGF)
HIF

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10
Q

What are anti-angiogenic factors?

A

Thrombospondin-1
Angiostatin
Endostatin
Tumstatin

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11
Q

Malignant tumor usually show _______ when it is big enough

A

central necrosis

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12
Q

Why do malignant tumors show central necrosis?

A
  1. Neoplastic transformation
  2. Production of tumor angiogenic factors (TAF)
  3. Tumor outgrows blood supply and areas of ischemic necrosis
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13
Q

_________ transformation of a ______ cell results in growth of a tumor nodule limited by the ability of nutrients to diffuse into it, to a diameter 1-2 mm

A

neoplastic
single

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14
Q

Production of tumor angiogenic factors (TAF) stimulates the _______ and ________ of blood vessels, enabling tumor growth to be supported by perfusion

A

Proliferation

Ingrowth

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15
Q

What are TAF? x3

A
  1. HIF, VEGF, bFGF
  2. Ras, myc
  3. Decreased p53 (p53 inhibits VEGF and promotes thrombospondin-1 production)
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16
Q

What are factors that determine growth rate? x3

A
  1. Doubling time
  2. Percentage of tumor cells in proliferative pool that do not differentiate
  3. Cell loss (apoptosis)
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17
Q

What is doubling time? 30 doublings means______
10 more doublings______

A

The shorter, the quicker of growth

30 doublings - 1g - clinically detectable mass
10 more doubling - 1 kg - max compatible with life

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18
Q

The higher percentage, the quicker of the growth. What is the percentage in normal tissue, benign tumor, and malignant tumor?

A

Normal: less than 1%
Benign tumor: 1-10%
Malignant tumor: 20-80%

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19
Q

The less of the apoptosis, the ________ of the growth

A

quicker

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20
Q

What is the indicator of proliferation?

A

Ki-67 and PCNA (proliferating cell nuclear antigen) score

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21
Q

Malignant neoplasms possess _______ of mitoses

A

large number

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22
Q

What occurs during prophase?

A

Chromatins condense to form chromosomes

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23
Q

What occurs during metaphase?

A

Chromosomes line up at the equatorial plane of the cell

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24
Q

What occurs during anaphase? What does it look like?

A

Chromosomes break at centromeres and sister chromatids move to opposite ends of the cell

2 thick strands

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25
What occurs during telophase?
Reappearance of the nuclear membrane and nucleolus Only counts for 2% of the cell cycle's duration
26
The more abnormal the mitotic figures are, the more likely the neoplasm is ________
malignant
27
What indicates apoptosis?
Apoptotic body
28
What is an apoptotic body?
Fragmentation of the nuclear chromatin Condensation of the nuclear chromatin
29
What is the clinical significance of difference in growth rate of tumors?
Cells within the cell cycle are susceptible to chemotherapy and radiotherapy
30
Cancers with rapid growth are _________ susceptible to chemotherapy
Highly
31
Cancers with slow growth are ________ to therapy
Resistant
32
What are the 2 things we should know about malignant tumors?
1. Compared to benign tumors, malignant tumors possess large numbers of mitoses 2. The more abnormal the mitoses (mitotic figure), the more likely the neoplasm/tumor is malignant
33
Neoplastic growth includes growth of ______ and _______
Parenchyma Stroma
34
Increased growth of ______ will result in increased stroma/parenchyma ratio. This is described as desmoplasia
Stroma
35
What is hyperplasia of activated fibroblasts and production of abundant collagen in stroma?
Desmoplasia
36
What are examples of desmoplasia?
1. Linitis plastica in diffuse stomach cancer 2. breast cancer (invasive ductal carcinoma) 3. Prostate cancer 4. Cholangiocarcinoma
37
What do you see on staining with desmoplasia?
Entrapped smooth muscle bundles Desmoplastic stroma - blueish in color
38
________ refers to the degree/extent to which neoplastic parenchymal cells resemble the corresponding normal mature parenchymal cells, both morphologically and functionally
Differentiation
39
Lack of differentiation is called _____
anaplasia
40
Neoplastic cells within cell cycle ________ differentiate
CAN NOT
41
Since neoplastic cells cannot differentiate in cell cycle, the degree of differentiation depends on _________
percentage of cells within cell cycle
42
Malignant tumors have about ________ of cells within cell cycle, __________ varies a lot. Thus, cells/tissues formed may or may not resemble normal mature cells/tissues
20-80% differentiation
43
Benign tumors have about ________ within cell cycle and they are usually __________. Thus, cells/tissues formed usually resemble normal mature cells/tissues
1-10% Well differentiated
44
What is differentiation like within malignant tumors? x4
Well differentiated, moderately differentiated, poorly differentiated, or anaplasia
45
What is differentiation like in benign tumors?
Well differentiated
46
______ is a hallmark of high grade malignant tumor
Anaplasia
47
What does a normal thyroid look like?
Well formed follicles with colloid
48
What does a thyroid adenoma look like?
Looks like normal thyroid, but forms encapsulated thyroid mass
49
What does a thyroid carcinoma (well-diff) look like?
May resemble normal thyroid tissue, but shows invasion
50
What does a poorly differentiated carcinoma of the thyroid look like?
Poor resemblance to normal thyroid Few follicles, scant colloid, has metastatic potential
51
What does anaplastic carcinoma of thyroid?
No resemblance to normal thyroid tissue No follicles, no colloid High metastatic potential
52
What 2 things can help identify the origin of poorly differentiated and anaplastic carcinoma?
1. Expression of cell markers 2. Cytogenetics or molecular diagnostics
53
What is the significance of recognizing anaplasia? x2
1. Presence of anaplasia implies a poorly differentiated 2. More aggressive tumor with poorer prognosis
54
What are other features associated with neoplasia?
Loss of cellular polarity Cellular atypia
55
_______ refers to spatial difference in the shape, structure, and function of cells. Almost all cell types exhibit some sort of _____, which enable them to carry out specialized functions
Polarity
56
Loss of polarity is seen with ______ and ______
dysplasia neoplasia
57
What does loss of polarization in dysplasia look like?
Can't tell up from down! All epithelial cells look alike
58
Loss of polarity in neoplasia leads to disturbance in orientation of neoplastic cell resulting in ___________ Orientation of anaplastic cell is markedly disturbed resulting in _________
Cell growth in disorganized fashion
59
What does loss of polarity look like under the scope with urothelium?
Numerous cells having enlarged and pleomorphic nuclei and loss of normal polarity
60
_________ is a condition of being irregular or nonstandard _____ is a pathological term for a structural abnormality in a cell See in only pre-malignant conditions and malignant tumors
Atypia
61
How would you recognize cellular atypia? x3
1. Cellular pleomorphism 2. Nuclear changes 3. Increased 1:1 N/C ratio (normal 1:5) (nucleus/cytoplasm)
62
_______ refers to variation in size and shape of cells and nuclei
Pleomorphism
63
_________ refers to abundant DNA and stains extremely dark
Hyperchromasia
64
What are tumor giant cells?
Represent anaplasia Single huge polymorphic nucleus or >/+ 2 nuclei Nuclei are hyper chromatic and large
65
What are cytologic features of anaplasia or poorly differentiated tumors?
Bizarre tumor giant cells

FoundSci III (22 decks)

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