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Flashcards in Neoplastic Growth Deck (77):
1

How do we assess monoclonality in tumors?

G6PD iso-enzyme studies

HUMARA- human androgen receptor gene

Ig Light Chain studies- only kappa or only lambda= monoclonal

T-cell Receptor Gene analysis

2

What type of breast tumor is slow growing, freely mobile/not attached to skin or chest wall, firm mass, well-circumscribed, with fibrous capsule

Fibroadenoma

3

What type of breast tumor is rapid growing, poorly circumscribed with infiltrating margins, fixed to underlying tissues causing dimpling

Infiltrating Ductal Carcinoma

4

What kind of tumor will show atypical mitotic figures?

Malignant tumor

5

The following features are characteristic of ____?
Pleomorphism
Hyperchromasia
Increased N/C ratio
Irregular nuclear membrane
Tumor giant cells

Cellular Atypia

6

What type of malignant tumor shows intracellular and extracellular KERATIN PEARLS?

WELL-DIFFERENTIATED squamous cell carcinoma

7

What type of malignant tumor shows intracellular keratin only?

Moderately-differentiated squamous cell carcinoma

8

What type of malignant tumor shows numerous mitoses but no keratin?

Poorly-differentiated squamous cell carcinoma

9

IHC stains ordered for a Carcinoma?

Keratin, cytokeratin
Epithelial Membrane Antigen (EMA)

10

IHC stain ordered for a Sarcoma?

Vimentin

11

IHC stains ordered for a Rhabdomyoma, Rhabdomyosarcoma?

Desmin
Muscle-specific Actin

12

IHC stain ordered for Leukemia, Lymphoma?

Leukocyte Common Antigen (LCA)

13

IHC stains ordered for Neuroblastoma, Carcinoid tumor, Small cell carcinoma?

Neuron-specific Enolase (NSE)
Chromogranin
Bombesin
Synaptophysin
S-100

14

IHC stains ordered for Melanoma?

S-100
Melanin
HMB-45

15

IHC stain ordered for a Glioma?

Glial Fibrillary Acidic protein (GFAP)

16

IHC stain ordered for suspected Thyroid cancer?

Thyroglobulin

17

IHC stain ordered for suspected Acute Lymphoblastic Leukemia

B-cell-CD10 (CALLA)

18

IHC stains ordered for suspected Seminoma?

Placental Alkaline Phosphatase (PLAP)
beta-HCG

19

IHC stain ordered for suspected Yolk Sac tumor?

Alpha-fetoprotein (AFP)

20

IHC stains ordered for suspected Vascular neoplasms?

vWF
CD31

21

EM studies of Squamous cell carcinomas will show what?

Tonofilaments

22

EM studies of an Angiosarcoma will show what type of structures?

Weibel Palade bodies

23

EM studies of a Small cell carcinoma will show what?

Neuro-secretory granules

24

EM studies of a Malignant melanoma will show what?

Melanosomes

25

EM studies of a Histiocytosis X tumor will show what?

Birbeck granules

26

Which factors/proteins induce angiogenesis in tumors?

VEGF, bFGF
Hypoxia inducible factor (HIF)- stimulates VEGF production

27

Name the two malignant tumors that DO NOT metastasize

Basal cell carcinoma (local invasion
Glioma (invasion and seeding)

28

During ECM invasion, loss of which molecule is required for detachment of tumor cells?

E-cadherin

29

During ECM invasion, which enzymes are released to degrade the basement membrane and connective tissue?

MMPs
Cathepsin D
Collagenase

30

During ECM invasion, increase of which proteins allow for attachment of tumor cells to the ECM?

Laminin
Fibronectin
Integrins

31

Which route of metastasis is more common in carcinomas?
Name the 3 exceptions

Lymphatic spread

Follicular carcinoma
Renal cell carcinoma
Hepato-cellular carcinoma

32

Which route of metastasis is more common in sarcomas?

Hematogenous spread

33

What is a common metastatic site for Stomach adenocarcinoma?

Virchow's left supraclavicular node

34

What is a common metastatic site in breast cancer?

Lung
Bone

35

Common metastatic site in prostate cancer?

Bone

36

Common metastatic site in testicular tumor?

Para-aortic nodes

37

What will an X-ray likely show in a patient with PROSTATE CANCER?

OSTEOBLASTIC metastases (appear as radio-dense loci)

serum alkaline phosphatase indicates reactive bone formation

38

What will an X-ray likely show in a patient with BREAST CANCER?

OSTEOLYTIC metastases (appear as radio-lucent loci)

PGE2 and IL1 produced by tumor

39

What cytokine is responsible for the effects of Cancer Cachexia?

TNF-alpha

40

Autoimmune response at neuromuscular junction resulting in muscle weakness and periorbital heliotrope rash?

Eaton-Lambert syndrome (dermatomyositis)

41

Hyponatremia, cerebral edema, and neuro dysfunction are characteristic of what paraneoplastic syndrome?

SIADH

42

What is the underlying cancer and mechanism of Cushing syndrome?

Small cell carcinoma OF LUNG
ACTH

43

What is the underlying cancer and mechanism of SIADH?

Small cell carcinoma OF LUNG
ADH

44

What is the underlying cancer and mechanism of Eaton-Lambert syndrome?

Small cell carcinoma OF LUNG
Immunological/autoimmune

45

What is the underlying cancer and mechanism of Hypercalcemia?

Squamous cell carcinoma of lung

MOA:
PTH-related protein (PTHRP)

46

What is the underlying cancer and mechanism of Polycythemia?

Renal cell carcinoma
Erythropoietin

47

What is the underlying mechanism of Carcinoid syndrome?

Serotonin

48

What is the underlying cancer of Acanthosis nigricans?

Visceral malignancy, Gastric carcinoma

49

What is the underlying cancer of Hypertrophic osteoarthropathy?

Bronchogenic carcinoma. (associated with clubbing of distal phalanx)!

50

What is the underlying cancer of Trousseau phenomenon?

Pancreatic carcinoma (tumor products activate clotting)

51

What is the underlying cancer and mechanism of Hypocalcemia?

Medullary carcinoma of thyroid
Calcitonin

52

For adenocarcinoma, "well formed glands" and "mucin production" indicate what?

Grade 1 tumor (well differentiated)

53

For adenocarcinoma, "poorly formed glands" and "occasional glands" indicate what?

Grade 3 tumor (poorly differentiated)

54

For adenocarcinoma, "bizarre multinucleate giant cells" indicate what?

Grade 4 tumor (anaplastic/undifferentiated)

55

For squamous cell carcinoma, "keratin pearls" indicates what?

Grade 1 tumor (well differentiated)

56

For squamous cell carcinoma, "poorly formed squamous cells" indicates what?

Grade 3 tumor (poorly differentiated)

57

For squamous cell carcinoma, "bizarre multinucleate giant cells" indicates what?

Grade 4 tumor (anaplastic/undifferentiated)

58

If cancer is still near the place it started and has not invaded nearby tissues, what stage is it?

Stage 0

59

If cancer has not spread either to LNs or other parts of the body but has grown deeply into nearby tissues, what stage is it?

Stage I

60

If cancer shows distant metastasis, what stage is it?

Stage IV

61

What tumor marker will be present in prostate cancer?

Prostate-specific antigen (PSA)

62

What tumor marker will be present in Trophoblastic tumors such as Hydatidiform moles?

beta-hCG

63

What tumor marker will be present in carcinoma of the colon, pancreas, stomach, or breast?

Carcino-embryonic antigen (CEA)

64

What tumor marker will be present in Ovarian carcinoma?

Cancer antigen-125 (CA-125)

65

What tumor marker will be present in Hepatocellular carcinoma and Germ cell tumor of testes or ovary?

alpha-fetoprotein (AFP)

66

what are the two malignant tumors that do not metastasize?

1) Basal Cell Carcinoma
2) Glioma

67

what tumor marker is present for small cell carcinoma? and what is the cell of origin?

Neuron specific enolase (NSE)

neuro-endocrine

68

what tumor marker is present for medullary carcinoma of thyroid?

calcitonin

69

what tumor marker is present for colon or pancreatic cancer?

cancer antigen 19-9 (CA 19-9)

70

what tumor marker is present for breast carcinoma?

cancer antigen 15-3 (CA 15-3)

71

where does colorectal cancer metastasize to?

liver

72

where does melanoma commonly metastasize to?

liver, lung

73

where does renal adenocarcinoma metastasize to?

lung

74

where does lung cancer metastasize to?

adrenal, liver

75

what is a lab test marker for hepatocellular carcinoma?

alpha-fetoprotein

DON'T YOU FORGET THIS!

76

what are 3 examples of cancers that spread via "seeding" of body cavity

1) peritoneum (tumors of ovary)
2) pleural cavity (primary lung tumor)
3) sub-arachnoid (glioma)

77

most common site of bone metastasis?

1) vertebral column
2) proximal femur