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Neoplasms Flashcards

(61 cards)

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1
Q

Small Cell Carcinoma

A 
poorly differentiated small cells
Kulchitsky (neuroendocrine)
Male smokers
Central
ADH/ACTH
Eaton-Lambert syndrome
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2
Q

Squamous Cell Carcinoma (Lung)

A

Keratin pearls, intracellular bridges
Most common tumor in male smokers
Central
PTHrP

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3
Q

Adenocarcinoma (Lung)

A

Glands or mucin
Most common tumor in nonsmokers and female smokers
Peripheral

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4
Q

Large Cell Carcinoma (Lung)

A

Poorly differentiated large cells
Smoking
Central or peripheral
Poor prognosis

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5
Q

Bronchioloalveolar Carcinoma

A

Columnar cells that grow along preexisting bronchioles and alveoli
Clara cells
No relation to smoking
Peripheral

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6
Q

Carcinoid Tumor

A

Well differentiated neuroendocrine cells, chromogranin positive
No relation to smoking
Low-grade malignancy, can cause carcinoid syndrome

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7
Q

Oral Squamous Cell Carcinoma

A

Floor of the mouth
leukoplakia and erythroplakia = precursors
Tobacco and alcohol are risk factors

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8
Q

Salivary pleomorphic adenoma

A

Most common tumor of salivary gland
Benign, parotid gland
mobile painless circumscribed mass at angle of jaw

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9
Q

Warthin Tumor

A

2nd most common salivary tumor (parotid)

Benighn, cystic, abundant lymphocytes

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10
Q

Mucoepidermoid carcinoma

A

Most common malignant tumor of salivary gland (parotid)
Mucinous and squamous cells
Commonly involves facial nerve

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11
Q

Esophageal carcinoma

A

Adeno = from Barrett’s (lower third), most common in west
Squamous = most common worldwide, upper or middle third, risks: ETOH, tobacco, very hot tea, achalasia, esophageal web
Presents late, progressive dysphagia
Nodes:
Upper 1/3 - cervical
Middle 1/3 - mediastinal/tracheobronchial
Lower 1/3 - celiac and gastric

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12
Q

Intestinal gastric carcinoma

A 
Large, irregular ulcer with heaped up borders
Risks: H. pylori, autoimmune gastritis, mitrosamines in smoked foods, blood type A
Periumbilical spread (Sister Mary Joseph nodule)
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13
Q

Diffuse type gastric carcinoma

A

Signet ring cells
Desmoplasia results in thickening of stomach wall
not associated with H pylori, intestinal metaplasia, nitrosamines
Spread to ovaries (Krukenberg)

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14
Q

Gastric Carcinomas

A

Present late, weight loss, abd pain, early satiety
Acanthosis nigricans or Leser-Trelat sign (explosive onset of seborrheic keratosis)
Spread can involve Virchow node

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15
Q

Familia Adenomatous Polyposis (FAP)

A

AD
APC mutation (Chr 5)
Gardner = FAP + soft tissue tumors and osteomas, hypertrophy of retinal pigment epithelium
Turcot = FAP + CNS (medulloblastoma and glial tumors)
Always involves rectum

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16
Q

HNPCC

A

Lynch syndrome
AD
DNA mismatch repair gene mutation
80% get CRC, always involves proximal colon

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17
Q

Colorectal Cancer

A

Includes FAP and HNPCC
Risks: IBD, tobacco, large villous adenomas, Peutz-Jeghers
Rectosigmoid>ascending>descending
“Apple core” lesion on barium enema x ray
CEA tumor marker for monitoring
2 molecular pathways:
>Microsatellite instability pathway (15%), DNA mismatch repair gene mutation: sporadic and HNPCC
>APC/B-catenin (85%):
Lose: APC, then K-RAS, then p53

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18
Q

Pancreatic Carcinoma

A

Adenocarcinoma
Risks: smoking and chronic pancreatitis, jewish and African american males
Painless jaundice
Migratory thrombophlebitis (trousseau’s sign)
Serum marker CA 19-9
Rw: whipple’s procedure

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19
Q

Gallbladder Carcinoma

A

Adenocarcinoma, glandular epithelium of bladder wall
Risks: gallstones, porcelain gallbladder
Cholecystitis in elderly woman

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20
Q

Hepatic adenoma

A

Benign tumor of hepatocytes
Assoc. oral contraceptives, regress with cessation
Risk of rupture/bleeding esp. with pregnancy (grow with Estrogens)

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21
Q

Hepatocellular carcinoma

A

Risks: Chronic hepatitis (HBV/HCV), cirrhosis (fatty liver, hemochromatosis, Wilson’s, Alpha1), Aflatoxins (from aspergillus)
Increases chance of Budd-Chiari
alpha fetoprotein is marker

HEMATOGENOUS spread

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22
Q

Renal Cell Carcinoma

A

hematuria, palpable mass, flank pain
Paraneoplastics: EPO, renin, PTHrP, ACTH
Abundant clear cytoplasm
Loss of VHL tumor suppressor, leads to increased IGF-1 and HIF transcription factor, increases VEGF and PDGF
Typically upper pole of kidney, risk factor is cigarette smok

HEMATOGENOUS spread to lungs and bone
retroperitoneal lymph nodes

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23
Q

Wilms Tumor

A

Most common malignant renal tumor if children (3 yo avg)
unilateral flank mass with hematuria and hypertension
blastema (immature kidney mesenchyme), glomeruli and tubules and stromal cells
WAGR, Denys-Drash & Beckwith-Widemann Syns

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24
Q

WAGR syndrome

A

Wilms tumor, Aniridia, Genital abnormalities, Retardation, assoc. with DELetion of WT1

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25
Denys-Drash syndrome
Wilms tumor, progressive renal (glomerular) disease, male pseudohermaphroditism, assoc. with MUTations of WT1
26
Beckwith-Wiedemann syndrome
Wilms tumor, neonatal hypoglycemia, muscular hemihypertrophy, organomegaly (including tongue), assoc. with MUTations of WT2
27
Transitional Cell Carcinoma
Urothelial cells, usually in bladder Risks: cigarette smoke > napthylamine, azo dies, cyclophosphamide Painless hematuria 2 pathways: >flat - high grade flat tumor, early invasion, early p53 mut >Papillary - low grade papillary tumor, late p53 mut
28
Squamous Cell Carcinoma of the Bladder
or other lower urinary tract (Pelvis, ureter, bladder, urethra) metaplasia -> dysplasia -> neoplasia Risks: chronic cystitis, Schistosoma hematobium, nephrolithiasis
29
Adenocarcinoma of the Bladder
``` or other lower urinary tract Urachal remnant (has glands), cystitis glandularis or extrophy (partial failure to form, exposed to outside) ```
30
Extramammary Paget Disease
erythematous, pruritic, ulcerated vulva Carcinoma in situ, no underlying carcinoma Distinguish from melanoma: Paget = PAS +, keratin +, S100 - Melanoma = PAS-, keratin -, S100+
31
Vaginal Clear Cell Adenocarcinoma
Complication of DES-associated vaginal adenosis | Glands with clear cytoplasm
32
Embryonal rhabdomyosarcoma
malignant mesenchymal proliferation of immature skeletal muscle bleeding, grape-like mass protruding from vagina or penis of child <5 cytoplasmic cross-striations desmin+, myogenin+
33
Vaginal carcinoma
Squamous epithelium assoc. High Risk HPV (16, 18, 31, 33) Lower 1/3 of vagina -> inguinal nodes Upper 2/3 of vagina -> regional iliac nodes
34
Cervical carcinoma
vaginal bleeding, post coital bleeding, cervical discharge in middle aged woman (40-50) High risk HPV Secondary risks: smoking, immunodeficiency 80% squamous, 15% adenocarcinoma Hydronephrosis with postrenal failure is common cause of death (invades bladder, blocks ureters)
35
Endometrial carcinoma
Postmenopausal bleeding most invasive carcinoma of female genital tract risks increase with estrogen exposure (early menarche/late menopause, nulliparity, infertility, anovulatory cycles, obesity) Sporadic (25%), age is 70+, aggressive, p53 mut, psammoma bodies and serous papillary structures
36
Leiomyoma
Most common tumor in females Often multiple, enlarge in pregnancy, shrink after menopause Well defined, white, whorled masses
37
Leiomyosarcoma
malignant prolif of smooth muscle of myometrium de novo in postmenopausal women areas of necrosis and hemorrhage
38
Dysgerminoma
markers: hCG, LDH | sheets of uniform cells, assoc with TURNER SYNDROME
39
Ovarian Choriocarcinoma
hCG Trophoblastic (placental) tissue, no chorionic villi Assoc with Theca Lutein cysts EARLY HEMATAGENOUS SPREAD (placental tissue, programed to invade blood)
40
Ovarian Yolk Sac tumor
AFP Aggressive, yellow friable mass 50% have Schiller-Duval bodies (resemble glomeruli) basically same for men, testicular yolk sac tumor
41
Teratoma
90% of ovarian germ line tumors Mature - dermoid cyst Immature - aggressively malignant Struma ovarii - functional thyroid tissue in teratoma can cause Hyperthyroidism
42
Ovarian Serous Cystadenoma
CA-125 Benign, Bilateral 45% of ovarian tumors fallopian tube epithelium
43
Ovarian Serous cystadenocarcinoma
BRCA-1,-2, HNPCC 45% of ovarian tumors Psammoma bodies
44
Brenner tumor
Benign, unilateral ovarian tumor Looks like Bladder Coffee Bean nuclei on HE Benign, Bladder, Bean, Brenner
45
Granulosa cell tumor
Secretes estrogen Precocious puberty in kids, endometrial hyperplasia/cariconoma in adults Call-Exner bodies - small follicles with eosinophilic secretions
46
Testicular seminoma
``` malignant, painless enlargement, most common Ages 15-35 Fried Egg cells PLAP + (placental alk phos) radiosensitive, excellent prognosis ```
47
Testicular Choriocarcinoma
hCG gynecomastia (hCG --> LH) hematogenous met to lungs
48
Testicular Embryonal Carcinoma
Malignant, painful, glandular/papillary, often mixed
49
Leydig Cell
Reinke crystals, androgen producing, gynecomastia in men, precocious puberty in boys
50
Testicular lymphoma
Most common in older men, metastasis from lymphoma, aggressive
51
Thyroid Papillary carcinoma
Most common Orphan annie eye nuclei psammoma bodies Good prognosis, spreads to cervical lymph nodes Exposure to ionizing radiation in childhood is risk
52
Thyroid follicular carcinoma
follicles in fibrous capsule with invasion THROUGH capsule | hematogenous spread
53
Thyroid medullary carcinoma
Parafollicular C cells, neuroendocrine cells, secrete calcitonin --> increased renal calcium excretion --> hypocalcemia Calcitonin deposits as amyloid locally
54
Glioblastoma multiporme
Malignant, high grade, astrocytes Most common primary mal of adults cerebral hemispheres, crosses corpus callosum regions of necrosis surrounded by pseudopallisading cancer cells GFAP+
55
Meningioma
``` Benign, arachnoid cells most common benign in adults (esp. women) round mass attached to dura whorled pattern on histology psammoma bodies ```
56
Schwannoma
benign, schwann cells S-100+ involves CN VIII
57
Oligodendroglioma
Malignant of oligodendrocytes calcified tumor in white matter of frontal lobe Fried egg cells
58
Pilocytic astrocytoma
benign tumor of astrocytes Most common CNS in Children, usually cerebellum Cystic lesion with mural nodule Rosenthall fibers (eosinophilic processes of astrocytes) GFAP+
59
Medulloblastoma
``` Malignant granular cells of cerebellum usually in children small, round blue cells Homer-wright rosettes Poor prognosis, spreads via CSF ('drop metastasis' to cauda equina) ```
60
Ependymoma
Malignant ependymal cells in ventricle children 4th ventricle, presents with hydrocephalus pseudorosettes
61
Craniopharyngioma
epithelial rathke's pouch supratentorial mass, compresses optic chiasm (bitemporal hemianopsia) Calcifications benign, may recurr

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