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mechanism of disease > Neoplasm > Flashcards

Neoplasm Flashcards

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1
Q

Hypoplasia

A

Incomplete or underdevelopment of an organ with decreased number of cells

Organ fail to reach normal size

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2
Q

Di george syndrome

A

Thymic hypoplasia causing T cell deficiency

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3
Q

Aplasia

A

Absence of an organ due to primordium failure , organ could just be a fibrous cord

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4
Q

Agenesis

A

Complete absence of an organ and it’s primordium

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5
Q

Is Corpus callosum agenesis compatible with life ?

A

Yes , but chil may be mentally retarded with normal mental function

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6
Q

Is Kidney agenesis compatible with life ?

A

Not when bilateral. Compatible when unilateral

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7
Q

What happens to normal kidney when there unilateral kidney agenesis

A

The normal kidney hypertrophies and chronically fails (CRF)

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8
Q

Harmatoma

A

Excessive and focal growth of cell forming mass of mature and specialized cells indigenous to site of mass

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9
Q

Is harmatoma benign or malignant

A

Benign

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10
Q

Ectopia

A

Congenital displacement of any organs or tissues

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11
Q

Ectopia Cordis

A

Absence of sternum and pericardium causing heart to be exposed

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12
Q

Ectopia lentis

A

Lens up outward displacement in Marfans syndrome

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13
Q

Choristoma/ heterotopia

A

Ectopic collection of normal tissue

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14
Q

Dysplasia

A

Disordered cells with reversible proliferation , loss of uniformity in respect to size, shape and orientation

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15
Q

Neoplasia

A

Persistent abnormal growth of tissue forming neoplasm

Purposeless and autonomic mass

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16
Q

Classification of tumors

A

Histogenetic (epithelial or connective tissue origin)

Behavioural (benign and malignant)

Histological (anaplastic, follicular, papillary)

Naked eye appearance - ( annular, fungating, schirrous, medullary)

Functional- insulinoma, glucagonoma

Aetiological- radiation, chemical, carcinogen, microbial

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17
Q

Main classification of neoplasm

A

Histogenesis

Behavior

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18
Q

Benign neoplasm

A

Neoplasm with good prognosis

do not spread , do not invade , and generally do not kill

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19
Q

Malignant neoplasm

A

Neoplasm with bad prognosis

Can spread and kill

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20
Q

Secondary malignant tumor

A

Metastatic tumor from another site

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21
Q

Primary malignant tumor

A

Tumor from original site

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22
Q

Basic component of tumor cells

A

Parenchyma - can proliferate

Supporting connective tissue - helps in tumor growth and contain blood vessels

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23
Q

Messenchymal benign tumor

A 
Lipoma 
Fibrous 
Chondrome 
Osteoma
Leiomyoma
Rhabdomyoma
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24
Q

Epithelial benign tumor types

A

Adenomas- glandular cells origin

Papillomas- surface epithelium origin with fingerlike or warty projections

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25
Cystadenomas
Large cysts benign tumors
26
Follicular adenomas
Form follicles benign tumors
27
Papillary cystadenoma
Fingerlike projection in epithelium of cyst - benign tumor
28
Suffix for malignant tumor of mesenchyme
Sarcoma
29
Suffix for malignant cancer of the epithelium
Carcinoma
30
Mixed tumors
Tumors arising from multiple cells types
31
Example of mixed tumors
Salivary glands tumors | Fibroadenoma of breast
32
Teratomas
Cancer cells that arise from totipotent cells | Can be malignant or benign
33
Eponymous cancers example
Burkitt lymphoma Wills tumors Hodgkin’s disease Krukenberg tumor
34
Cancer
Any malignant neoplasm
35
Benign tumor of adipose tissue
Lipoma
36
Benign tumor of fibrous tissue
Fibroma
37
Benign tumor of bone
Ostéoma
38
Benign tumor of cartilage
Chondroma
39
Benign tumor of smooth muscle
Leiomyoma
40
Benign tumor of skeletal muscle
Rhabdomyoma
41
Benign tumor of blood vessel
Hemangioma
42
Malignant tumor of adipose cells
Liposarcoma
43
Malignant tumor of fibrous tissue
Fibrosarcoma
44
Malignant tumor of bone
Osteosarcoma
45
Malignant tumor of cartilage
Chondrosarcoma
46
Malignant tumor of smooth muscle
Leiomyosarcoma
47
Malignant tumor of skeletal muscle
Rhabdomyosarcoma
48
Malignant tumor of blood vessel
Angiosarcoma
49
Malignant tumor of nerve
Malignant schwanomma
50
Malignant tumor of squamous cellsl
Squamous cell carcinoma
51
Malignant tumor of transitional cell
Transitional cell carcinoma
52
Malignant tumor of placenta
Choriocarcinoma
53
Benign tumor of nerve cell
Neurofibromas
54
Benign tumor of squamous cells
Squamous cell papilloma
55
Benign tumor of transitional cell
Transitional cell papilloma
56
Benign tumor of placenta
Hydatidiform mole
57
Benign tumor of breast nodule
Fibroadenoma
58
Benign tumor of salivary glands
Pleiomorphic adenoma
59
Benign tumor of melanocytes
Melanocytic nevus
60
Malignant tumor of breast lobule
Ductal or lobular carcinoma
61
Malignant tumor salivary glands
Malignant mixed tumors
62
Malignant tumor of melanocytes
Melanoma
63
Malignant tumor of hematopoietic cells ( always malignant)
Leukaemia
64
Malignant tumor of lymphoid tissue ( always malignant)
Lymphoma
65
Benign tumor growth rate
Slow
66
Malignant tumor growth rate
relatively rapid
67
Benign tumor mototic activity
Low
68
Malignant tumor mitotic activity
High
69
Benign tumor histological resemblance to normal tissue
Good
70
Malignant tumor histological resemblance to normal tissue
Variable often poor
71
Benign tumor nuclear morphology
Often normal
72
Malignant tumor nuclear morphology
Usually hyper chromatic, irregular outline , multiple nucleoli and pleomorphic
73
Benign tumor invasion?
Non
74
Malignant tumor invasion ?
Yes
75
Necrosis in benign tumor
Rare
76
Necrosis in malignant tumor
Common
77
Differentiation definition
Extent to which parenchymal cell ressemble normal cells morphologically and functionally
78
Well differentiated tumors
Ressemble normal tissue of origin
79
Undifferentiated
Primitive appearance, resemble in specialized cells
80
Generally , are benign tumor well differentiated of undifferentiated
Well differentiated
81
How do characterize a malignant tumor with undifferentiated cells
Anaplastic
82
Features of anaplasia
Pleomorphism (Variation in size and shape of the cells) Hyperchromasia High nuclear cytoplasmic ratio Enlarged and multiple nucleoli Angulated nuclear shapes Possible mitotic figures Tumor giant sells Loss of polarity Dysplasia
83
Carcinoma in situ
Dysplasia involves the entire thickness
84
Type of tumor that can produce hormones of the cell of origin
Benign tumor and well differentiated malignant tumor of endocrine glands
85
Why is there necrosis in some tumors
Rapid growth which outstrip blood supply
86
Why is there hemorrhage in some tumors
Necrosis or disruption of a blood vessel
87
Why do you Leiomyomas increase rapidly during pregnancy
Estrogen and progesterone Production increase rate of growth
88
Mode of growth of benign tumors
Cohesive expensile masses Fibrous capsule presents Benign tumors are discretes well circumscribed ,readily palpable ,movable masses
89
Malignant tumors mode of growth
Progressive infiltration with invasion and destruction
90
Epithelial malignant tumor normally starts as in situ carcinoma right or wrong ?
Right
91
Metastasis
Tomorrow implants in a zone discontinuous s from the primary tumor
92
Three pathways for distance metastasis
Heamatogenous Lymphatic Through Body cavities
93
Type of cell that do not metastasize widely
Glial tumor of the central nervous system Basal cell carcinoma of the skin
94
Sarcoma main type of metastasis pathway
Haematogenous spread throtgh mainly veins
95
Main metastasis pathway for carcinoma’s
Lymphatic spread
96
Macro features to note of cancers
``` Size Color Shape Necrosis Haemorrhage Capsule Ulceration of surface Edges of ulcer ```
97
Polyp
Benign tumor projecting above mucosal surface
98
Sessile papilloma
Broad based stalk
99
Pedunculated papilloma
Narrow base | Elongated stalk and
100
Billows papilloma
Thin fronds
101
Grade of tumors
Level of differentiation of the tumor
102
Stage of tumor
Extent of spread of tumor
103
Basis of different tumors grades
Nuclear size Pleomorphism Mitosis
104
The different grades of tumors
I , II , III | Done from least differentiated area
105
Limits of grade system of tumors
Heterogeneity of tumors Change of tumor over time Poor correlation with histological appearance and biological behavior
106
Basis of stage of tumors
Size of primary tumor Extent of spread Presence and extent of metastasis
107
TNM classification
T - size of primary tumor N - number of regional lymph node involved M- metastasis
108
T criteria of TNM
Tis- in situ lesion T0- no primary tumor detected T1-T4- increasing size of tumor Tx- size of primary tumor not known
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N stage of TNM
N0- no regional node involved N1-n3- increasing group of node present Nx - cannot be assessed
110
M criteria of TNM
M0- no metastasis blood M1- present metastasis in blood Mx- cannot be assessed
111
AJCC classification of cancers
``` Stage 0 Stage I Stage II Stage III Stage IV Incorporate TNM at each stage ```
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4 phases of malignant tumor
Transformation Clonal expansion Local invasion Distant metastasis
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Doubling time of cancer
Detectable tumor at 1gm - takes 30 population doubling
114
Maximum size of cancer compatible with life
1kg tumor (40 population doublings)
115
Growth fraction
Proliférating cells ratios
116
Type of cancer with high growth fraction
Leukemia Lymphomas Small cell carcinoma Nasopharyngeal carcinoma
117
Low growth carcinoma fraction
Carcinoma colon Carcinoma breast Salivary glands carcinoma
118
Is chemotherapy more effective in high of low growth fraction cancers ?
High
119
2 ways to acquire neovascularization
Tumor associated angiogenesis factors Inflammatory cell derived angiogenic factors
120
Hallmarks of malignancy
Invasion | Metastasis
121
Step from single epithelial cell to metastatic growth
Transformed cell Clonal expansion with growth and angiogenesis and heterogeneity Development of invasive subclone Adhésion and degradation of basal membrane Invasion of extra cellular matrix Intravasation Interaction with host lymphocytes Tumor cells embolises Adhere to another basal membrane and extravasation Metastatic deposit Angiogenesis Growth of metastasis
122
Metastatic subclone down regulate ...
E cadherin
123
Incidence of cancer around the world
Higher in advanced countries
124
Most common cancer in male
Prostate Lymphomas Stomach
125
Most common cancer in Female
Breast cancer Cervix cancer Lymphomas
126
Commonest cause of cancer death in male
Hepatoma Lymphoma Prostate
127
Commonest cause of cancer death in female
Breast Lymphoma Heaptoma Brain tumors
128
Most common cancer in Japan
Stomach cancers
129
Most common cancer in China and sub saharan Africa
Nasopharyngeal cancer
130
Environmental factors of cancer
``` UV rays Chemicals Asbestos (lung ca) Vinyl chloride (liver angiosarcoma) Benzene (leukemia, hodgkins) Alcohol ( ca mouth, larynx, pharynx, esophagus) Smoking ( ca mouth, pharynx, larynx, esophagus, pancreas , bladder, lung ) Viruses ( ca cervix , B cell lymphomas) ```
131
Most common age range of cancer
More than 55years
132
Most common cancer 0-15years
``` Congenital and embryonic tumors Retinoblastoma Neuroblastoma Nephroblastoma Leukemia Lymphomas Brain tumors ```
133
Main tumor 16-34yo
``` Breast Leukemia Lymphoma HCC Cervix Brain tumors ```
134
Type of tumors 35-54years old
``` Breast Lymphomas Ovary Cervix Lungs Stomach HCC Prostate ```
135
Common cancer +55years old
``` Prostate Breast Lymphomas Female Genital cancers ```
136
Cancer associated with defective DNA repair
Xeroderma pigmentosum Ataxia telangiectasia Bloom’s syndrome Fanconis anemia
137
Carcinogenic agents types
Chemical Radiation Oncogenic microbes
138
Initiation of chemical carcinogenicity
DNA damage by chemical | Proliferation to fix dna change as inherited change
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Promotion of chemical carcinogenicity
Promoters render cell susceptible to DNA damage by increasing proliferation
140
Direct acting initiator chemicals
``` Alkylating agents Acylations agents B propiolactone Dimethylsulfate Diepoxybutane ```
141
Indirect acting pro carcinogens
``` Aromatic hydrocarbons Aromatic amines amides azodyes Plant extract Nitrosamines Insecticides ```
142
Molecular targets of carcinogens
Tumor suppressor genes Proto oncogenes Genes for apoptosis
143
Natural carcinogens
Aflatoxins B1 seen in peanuts and dried grain. Causes hepatoma in africa
144
Radiation carcinogens
``` Uv light Alpha beta particles Protons Neutrons X ray Y ray ```
145
UV light damage causes ...
Squamous cell carcinoma Basal cell carcinoma Melanocarcinoma
146
What type of uv light is most associated with cutaneous carcinoma
UVB
147
Tumors produced by radiation ...
``` Leukemia’s Thyroid Breast Lungs Salivary glands ```
148
Human papilloma virus causes
Warts ( 1,2,4,7) Warts with low malignant potential ( 6,11) Squamous cell carcinoma (16,18,33,35,39,45,51,59,52)
149
Virus that causes burkitt lymphoma
EB virus
150
Virus associated with hepatocellular carcinoma
Hepatitis B and C virus
151
Helicobacter jejuni causes
Gastric lymphoma and carcinoma
152
Oncogenes
Cancer causing genes
153
Proto oncogenes
Genes that promote growth and differentiation
154
Activation of proto oncogenes
Change in structure which produce proteins with aberrant gene Changes in regulation of genre which produce excessive amount of protein
155
Types of proto oncogenes
Growth factors Gf receptors Signal transducers Cell cycle regulators
156
Ras oncogenes
Ras proteins with reduced gtpase activity , mutant GAP remains in active form
157
How can Translocation of chromosomes participate in cancer ceeation
Over expression of proto oncogenes by making it under regulatory gene influebcr Formation of hybrid genes that code for GF (C-abl-bcr)
158
Mantle cell lymphoma
Translocation occur t(11:14) , disregulate cyclin D1 allowing passage from g1 to s phase
159
Gêne amplification in oncogenesis
Protooncogene reduplicated to form multiple of its copy | L-myc in lung ca , n-Myc in neuroblastoma, cerb b2 in breast ca
160
Tumor suppressor genes
Regulate cell proliferation acting like brakes
161
Are tumor suppressor genes recessive or dominant
Recessive so require 2 copiers to be activated
162
What type of cancer do you see tumor suppressor gene 2 hit hypothesis
Retinoblastoma ( inherits one mutated allele and loses the normal allele after birth) familial type
163
P53
Tumor suppressor gene involved in more than 50 % of tumors
164
P53 action
``` Arrest cell cycle ( at g1) Promote apoptosis ( activates bax, bad, bak) ```
165
Genes that prevent apoptosis
Bcl1, bcl2, bcl xl
166
Genre that promotes apoptosis
Bax Bad Bak Bcl xs
167
Genomic instability syndrome
Disease occurring to damage to genes responsible of dna repair regulation
168
What enzyme wrongful activation can give immortality to tumor cells
Telomerase
169
Gatekeeper genes
Genes that directly affect cell growth and when mutated allow entry in carcinogenic
170
Types of gatekeeper genes
APC RB NF1 P53
171
Caretaker genes
Genes that do not directly control cell growth but affect genomic stability and DNA repair and protect entire genome
172
Tumor specific antigens
Unique tumor antigen Oncofetal antigens Differentiation antigens
173
Oncofetal antigens
Produced normally only by embryonic tissue but can appear in tumor ( alpha feto protein) No immune response but useful in diagnosis and follow up
174
Differentiated antigens
Peculiar to differentiation state of cancer cells CD10 for B CELL leukemia PSA for prostate cancer Viral antigens
175
Cellular arm of immune response against tumors
CytTCell in MHC I - direct cell to cell killing NK cells which kill without sensitization Macrophages which kill by cytotoxic products
176
Humoral mechanism against tumor
Some antibodies can play a role MAC complex can help lyse cells Opsonization of tumors
177
Immuno surveillance theory
Tumors cells constantly produced but being killed by immune system So more risk of cancers in immunodeficient (x200) Immunosuppressive therapy causes malignancy
178
Escape mechanism of tumors against immune system
Loss or reduced expression of MHC Lack of co stimulation moleculei Immunosupression by poorly defined factors
179
Local effects of tumors
Compression ( pressure atrophy) Invasion perforation Ulceration Distortion rupture of vessels Obstruction Replacement of specialized cells and function
180
Metabolic effects of tumors
Cachexia - lead to anorexia and anemia ( due to low appetite and taste abnormality, high calorie expenditure due to high BMR, Inappropriate elaboration of hormones ( insulin, thyroid adenomas , parathyroid adenomas) causes paranéoplastic syndrome
181
Paraneoplastic syndrome
Found in carcinoma but not related to spread of tumor nor hormone production May confound metastatic disease
182
Clinical information to take when suspecting a tumor
``` Name Age Sex Hospital Ward Physician Exact anatomical site Duration ```
183
Sampling technics of tumors
``` Biopsies excision Incision Needle aspiration Tru cut Whole specimen Exfoliative Smears ```
184
Preservatives of mass sample
Alcohol Formalin Gluteraldehyde
185
Tumor markers in lab findings
``` Hormones oncofetal proteins Enzymes Ig Antigens Cytoplasmic proteins ```

mechanism of disease (22 decks)

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