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Neoplasia III Flashcards

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1
Q

What are the four places that tumor cells can invade?

A
  1. Adjacent tissue
  2. Penetrate body cavity
  3. Lymph nodes
  4. Small venules/capillaries
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2
Q

What is the protein that attaches cells to each other?

A

Cadherins

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3
Q

What type of collagen forms BM?

A

4

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4
Q

What are laminins?

A

A cell surface molecule that attaches to the ECM to degrade it

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5
Q

What happens to E-cadherin in tumor cells? What is the consequence of this

A

Downregulated or not expressed–leads to ability of tumor cell to metastasize

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6
Q

How do tumor cells get through a BM?

A

induce inflammatory cells to release collagenases (MMPs) to degrade collagen IV

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7
Q

What allows tumor cells to migrate through the BM?

A

Binding of fibronectin to its receptor

Other motility factors secreted

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8
Q

What is a metastasis?

A

Tumor implantation that is discontinuous with primary tumor

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9
Q

What are the four steps of tumor metastatic cascade?

A
  1. Invasion of BM
  2. Movement through ECM
  3. Vascular dissemination
  4. Homing
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10
Q

What do NK cells do in vascular dissemination?

A

Kills tumors

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11
Q

What is CD44?

A

Expression of CD44 on tumor cells seems to favor metastasis

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12
Q

What protects tumor cells in the circulation?

A

Clumped up or covered by platelets

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13
Q

How do tumor cells migrate to the blood via lymphatic ducts?

A

Through the thoracic duct

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14
Q

What are the three routes of metastases?

A
  1. Seeding of body cavities
  2. Lymph spread
  3. Hematogenous
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15
Q

What is the most common type of spread for tumors?

A

Lymphatic spread

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16
Q

Which type of tumor uses lymphatic spread: carcinomas or sarcomas?

A

Carcinomas

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17
Q

What is the pattern of lymphatic spread of tumors?

A

Up the lymphatic chain (e.g. breast CA migrates to axillary node)

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18
Q

Hard or soft for tumors?

A

Usually hard

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19
Q

TTP or not for tumors?

A

Usually no TTP

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20
Q

How does metastatic adenocarcinoma appear in lymph nodes microscopically?

A

Looks like glands, as opposed to normal lymph nodes

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21
Q

What are the three carcinomas that do not spread via the lymph nodes?

A
  1. Follicular carcinoma
  2. Renal cell carcinoma
  3. Hepatocellular carcinoma
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22
Q

Hematogenous spread is characteristic of what type of tumors?

A

Sarcomas

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23
Q

What is the one sarcoma that does not spread via the hematogenous route? How does it spread?

A

Rhabdomyosarcoma–spread via local invasion of the submucosal layer

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24
Q

What are the four sites that are frequently involved in hematogenous spread?

A

Liver
Lungs
Brain
Bone

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25
Multiple tumors are characteristic of local tumor or metastatic tumors?
Metastatic
26
What is umbilication?
Term to characterize the central area of necrosis in tumors
27
What are sentinal lymph nodes?
1st node in a regional lymphatic system that receives lymph flow from primary tumor
28
How are sentinel lymph node tumor detected?
Radio labels tracers
29
What is the most common site for bony metastases? Why?
Vertebral column, d/t direct connection with the vena cava
30
What is the primary symptom with bone metastases?
Pain
31
What are the two types of bone metastases?
Osteoblastic | Osteolytic
32
How do osteoblastic metastases appear on x-ray?
Radio-dense loci
33
What is the elevated lab seen in osteoblastic metastases?
Increased Serum alk phos
34
How do osteolytic metastases appear on x-ray?
Pathological fractures | Lucency of bones
35
What are the factors that are produced in osteolytic tumors?
PGE2 | IL-1
36
What is the complication with osteolytic metastases?
Hypercalcemia
37
What is the common site of metastases for: stomach adenocarcinoma
Left Supraclavicular node
38
What is the common site of metastases for: breast CA
Bone | lung
39
What is the common site of metastases for: colorectal CA
Liver
40
What is the common site of metastases for: renal adenocarcinoma
Lung
41
What is the common site of metastases for: lung
Adrenal/liver
42
What is the common site of metastases for: melanoma
liver | Lung
43
What is the common site of metastases for: the prostate
Bone
44
What is the common site of metastases for: testicular tumors
Para-aortic nodes
45
Which is more important, the grade or stage of a tumor?
Stage
46
What is grading of a tumor?
Looking histologically at a tumor by a pathologist
47
Higher grade tumor = ? prognosis
Worse
48
How many grades are there for a tumor
I-IV
49
Well differentiated tumors with a loss of polarity = what grade?
I
50
Moderately differentiated tumor = what polarity?
II
51
Poorly differentiated tumor = what grade?
III
52
Nearly anaplastic tumor = what grade?
IV
53
What are the three most common CA causes of death?
Lung CA Prostate/breast Colorectal
54
What are the three highest incidence causes of CA?
Breast/Prostate Lung Colorectal
55
Where, geographically, is gastric CA high?
Japan
56
What are the three CAs associated with arsenic?
Lung Skin Hemangiosarcoma
57
What are the three CAs associated with asbestos?
Lung Mesothelioma GIT
58
What are the two CAs associated with Nickel?
Nose | Lung
59
What is the CA associated with Radon?
Lung CA
60
What is the CA associated with vinyl chloride?
Angiosarcoma of liver
61
Aniline dyes are associated with what CA?
Bladder CA
62
Asbestos is associated with what CA?
Mesothelioma
63
Cigarette smoking is associated with what CA?
Oropharynx and lung
64
What type of CAs particularly increase with age?
Carcinomas
65
What are the four types of CA found in young adults?
1. Leukemia 2. Lymphoma 3. CNS/soft tissue CA
66
What are the three CAs found commonly in infancy?
Blastomas Leukemia Rhabdomyosarcoma
67
What are the four steps of tumor metastases?
1. Detachment of tumor cells from each other 2. Attachment to matrix component 3. Degrade ECM 4. Migration of tumor cell
68
What is the receptor that tumor cells use to attach to the BM?
Laminin receptor
69
Where do the enzymes that tumor utilize to pierce the ECM come from?
Fibroblasts and inflammatory cells induced by the tumor cell
70
What is the primary collagenase that tumor cells cause to release?
Type IV collagenase
71
What is the function of fibronectin in tumor cells?
Prevent the ECM from coming back
72
Where do the motility factors that tumor cells needs to migrate through a tissue come from?
The tumor
73
Intravasation = enter blood or leave blood? Extravasation?
Enter blood | Extravasation is leave blood
74
What are the two features of the conventional grading method performed by pathologists?
Degree of differentiation | Mitotic index
75
What molecule is used to grade tumors, and is uptaken by tumor cells?
BrdU (Bromodexy-uridine)
76
In what part of the cell cycle does BrudU uptake occur by tumor cells? Why?
S phase--is a Thymidine analogue
77
What is the TNM system of staging?
``` T = size of primary tumor N = nodal involvement M = distant metastases ```
78
What is the staging system used for colorectal CA?
Duke system
79
What is the staging system used for Hodgkin's and Non-hodgkin's lymphoma?
Ann Arbor
80
Where is skin CA found geographically?
New Zealand
81
What is the CA associated with beryllium?
lung CA
82
What is the CA associated with benezes?
Leukemia and Hodgkin's lymphoma
83
What is the CA associated with chromium?
Lung CA

Pathology (32 decks)

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