Neoplasm Flashcards
(91 cards)
1
Q
what are 3 important characteristics of neoplasm
A
unregulated, irreversible, and monoclonal
2
Q
define the monoclonal nature of neoplasm
A
neoplastic cells are derived from a single mother cell
3
Q
what can be used to determine clonality of a neoplasm
A
G6PD isoforms or androgen receptor isoforms
4
Q
what is desmoplasia
A
the presence of abundant collagen fiber in connective tissue, giving it a firmness
5
Q
what are the 2 basic components of tumors
A
- tumor parenchyma (neoplastic cells(
* reactive stroma (CT, fibrous tissue, blood vessels, and inflammatory cells; may be desmoplastic)
6
Q
what is a fibroma
A
a benign tumor originating from fibrous tissue
7
Q
what is a lipoma
A
a benign tumor originating from adipose tissue (lipid)
8
Q
what is a chondroma
A
a benign tumor originating from cartilage
9
Q
what is a osteoma
A
a benign tumor originating from bone
10
Q
what is a hemangioma
A
a benign tumor originating from blood vessels
11
Q
what is a lymphangioma
A
a benign tumor originating from lymph vessels
12
Q
what is leiomyoma
A
a benign tumor originating from smooth muscle
13
Q
what is a rhabdomyoma
A
a benign tumor originating from striated muscle
14
Q
what is a fibrosarcoma
A
a malignant tumor originating from fibrous tissue
15
Q
what is a liposarcoma
A
a malignant tumor originating from adipose tissue
16
Q
what is a chondrosarcoma
A
a malignant tumor originating from cartilage
17
Q
what is an osteosarcoma
A
a malignant tumor originating from bone
18
Q
what is an angiosarcoma
A
a malignant tumor originating from blood vessels
19
Q
what is a lymphangiosarcoma
A
a malignant tumor originating from lymph vessels
20
Q
what is a leiomyosarcoma
A
a malignant tumor originating from smooth muscle
21
Q
what is a rhabdomyosarcoma
A
a malignant tumor originating from striated muscle
22
Q
what is the nomenclature for a benign neoplasm derived from glands
A
adenoma
23
Q
what is the nomenclature for a benign neoplasm that produces fingerlike or warty projections
A
papilloma
24
Q
what is the nomenclature for a benign neoplasm that forms large cystic masses
A
cystadenoma
25
what is the nomenclature for a benign neoplasm that forms a visible projection above mucosal surface
polyp
26
what is the nomenclature for a malignant tumor derived from glands
adenocarcinoma
27
what is the nomenclature for a malignant tumor derived from squamous epithelium
squamous cell carcinoma
28
what is the nomenclature for a malignant tumor derived from kidney cells
renal cell carcinoma
29
what is the nomenclature for a malignant tumor derived from liver cells
hepatocellular carcinoma (hepatoma is an old term, and it somewhat of a misnomer)
30
what is a biphasic neoplasm
one that is derived from both fibroblasts and glandular epithelium
31
what is a fibroadenoma
a benign neoplasm of breast
32
having well circumscribed borders is a common characteristic of what kind of tumor
benign
33
what is a teratoma
a germ cell tumor arising from totipotent cells in testis or ovary
34
ovarian teratomas are almost always benign this can be contrasted with...
testicular teratomas in adults are never benign
35
melanoma is an exception to general nomenclature because
they are malignant by definition
36
what is an anaplastic tumor
one that has no resemblance (histologically) to the tissue of origin
37
a tumor that is well differentiated...
closely resembles the normal cells of the tissue of origin
38
tumor necrosis is a feature of malignant tumors. what happens here?
rapidly growing cancers can outgrow their blood supply -> ischemia -> tumor necrosis
39
what are the 6 hallmarks of cancer?
* sustain proliferative signaling
* evade growth suppressors
* resist cell death
* enable replicative immortality
* induce angiogenesis
* activate invasion and metastasis
40
how to malignant cells sustain proliferative signaling?
* can proliferate without external stimuli
| * usually consequence of oncogene activation
41
what is an oncogene
* originates from mutated proto-oncogene
| * promotes autonomous cell growth in cancer cells
42
how do malignant cells evade growth suppressors
* mutated tumor suppressor genes
| * 2 hit origin of cancer
43
why is P53 considered the guardian of the genome?
* encoded by tumor suppressor gene
| * when mutated, unable to arrest cell cycle for DNA damage repair
44
which protein is often called the "governor of cell proliferation" and why?
* retinoblastoma protein
* encoded by tumor suppressor gene
* regulated G1/S checkpoint
45
what are some ways that malignant cells resist cell death
* mutations in TP53
* mutations in other genes that regulate apoptosis
* overexpression of anti-apoptotic signaling molecules (ie Bcl-2)
46
how do malignant cells enable replicative immortality?
* all cancer cells contain stem cells -> immortality
| * also high telomerase activity
47
what is an important regulator of angiogenesis, which is an important hallmark of cancer
VEGF
48
how can malignant cells activate invasion and metastasis
* loosen cell-cell adhesion mediated by cadherins
* secrete proteases to degrade ECM
* use adhesion molecules to migrate through ECM
49
what type of gene accounts for the vast majority of familial cancer syndromes?
tumor suppressor genes (ie TP53, RB, P16)
50
mutations leading to oncogenes (less common than tumor suppressor) lead to
constitutive activation (gain of function)
51
what are the basic steps of polymerase chain reaction (PCR)
1. denaturation of DNA
2. anneal with primer
3. elongation; doubled DNA with each cycle
52
a carcinoma is a malignancy of
epithelial cells
53
a sarcoma is a malignancy of
mesenchyme/soft tissues
54
What is the TNM staging system for cancer? and which is the most important for predicting patient outcome?
T: tumor
N: lymph nodes
M: metastasis
*metastasis most important for determining outcome
55
what test is recommended in all patients with colorectal cancer?
testing for lynch syndrome (and endometrial cancers in females, at least in NM)
56
what is lynch syndrome
a hereditary cancer cause by mutation in 1 of 4 DNA mismatch repair proteins (form of tumor suppressor gene)
57
what are the 4 mismatch repair proteins, and which one most commonly mutated in lynch syndrome?
MLH1 (most common)
MSH2
MSH6
PMS2
58
which mutations are almost never seen in lynch syndrome?
BRAF, meaning a BRAF test could be done to rule out HNPCC
59
what is the underlying mechanism of HNPCC or lynch syndrome
microsatellite instability
60
EGFR is a proto-oncogene, and mutations can cause
non-small cell lung cancer
61
non-small cell lung cancer is a unique lung cancer in that it is commonly seen in
never smokers, females, asians
62
what is the idea behind a "liquid biopsy"
tumor fragments can enter the blood stream and can be found in serum test rather than invasive biopsy
63
what is liquid biopsy commonly used for
* lung cancers
* resistance mutations
* patients who can't do another biopsy
64
syndromic colorectal carcinoma are caused by germline mutations. examples include
* HNPCC -> mismatch repair genes including MLH1
| * familial adenomatous polyposis -> APC gene
65
what are the signs and symptoms that usually lead to detection of cancer
* physical pressure
* organ(s) dysfunction
* systemic effects (ie fever, peri-neoplastic effects)
66
what is metastatic tropism?
tumors originating from a given organ preferentially seed in particular tissues
67
angiogenesis in tumor formation most closely resembles what type of capillary
sinusoid capillaries, which have wide spaces between endothelial cells
68
angiogenesis is a process seen anatomically and pathologically including
* embryonic development
* implantation of placenta
* wound healing
* many disease processes
* tumorigenesis
69
Receptor tyrosine kinases located on the surfaces of endothelial cells respond mainly to ___ and ___ to stimulate angiogenesis
* VEGF = vascular endothelial growth factor
| * bFGF = basic fibroblast growth factor
70
what is the role of HIF-1α in angiogenesis?
| hint: what happens to is in oxygen rich and poor states
* in oxygen rich states, proline residues on HIF-1α are hydroxylated -> ubiquitination -> proteasome degradation
* in oxygen poor states, it binds to HIF-1β, which acts as a transcription factor to stimulate VEGF production
71
what do tumors resemble?
* wound healing sites
| * macrophages secrete many growth factors, including VEGF
72
what do matrix metalloproteinases (MMPs) do?
they are a family of proteases involved in the degradation of capillary basal lamina that is needed for angiogenesis
73
what is an important protein involved in new vessel maturation in angiogenesis?
angiopoietin 1 (Ang 1)
74
many tumor cell populations initially lack what ability, which is necessary for tumor expansion?
ability to track blood vessels; the "angiogenic switch" must be turned on before tumor expansion can occur
75
what does it mean to say that tumors have a heterogeneity of angiogenic activity?
a mix between angiogenic and non-angiogenic cells
76
what transition is necessary for a neoplasm to become invasive? and what does this transition involve?
* epithelial-mesenchymal transition (EMT)
| * involves a transition of type of cell adhesion molecules
77
what factors affect where a metastasis will seed?
* blood and lymph flow from the organ of origin
| * chemokines
78
what factors affect the efficiency of a metastasis?
differentiation, developmental and growth conditions (mitogens and growth factors)
79
what are the additional hallmarks of cancer that were added after the original 6?
* deregulating cellular energetics
* avoiding immune destruction
* tumor-promoting inflammation
* genome instability and mutation
80
infection by what organism causes 90% of stomach cancers?
H. pylori
81
infection by what causes nearly 100% of cervical cancers?
HPV
82
what infections can account for ~77% of liver cancers?
HBV and HCV
83
what are 3 important steps that microbes use to induce uncontrolled cellular proliferation?
1. uncoupling of normal regulatory mechanisms
2. prevention of host cells from undergoing apoptosis
3. avoid host's immune system
84
what are the 2 major phyla normally found in the gut?
bacteriodetes and firmicutes
85
what is the only known neoplasm that can be eliminated with abx?
MALT lymphoma; 80% associated with H. pylori
86
what locations can develop cancer due to infection with HPV?
cervix, vagina/vulva, anus, penis, and oropharynx
87
which HPV variants cause the most cervical cancers
HPV 16 and 18 cause 70% of cervical cancers and precancerous cervical lesions
88
E6 and E7 are 2 important genes on the HPV genome. What do they bind to in humans?
E6->p53
| E7->pRB
89
what is the most important factor in worldwide occurrence of hepatocellular carcinoma?
HBV
90
how is HBV transmitted?
perinatal, sexual, blood transfusions, IV drug use
91
how is HCV transmitted?
blood transfusions, IV drug use
