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Pathoma: Principles of Neoplasia Flashcards

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1
Q

definition of neoplasia

A

new tissue growth that is unregulated, irreversible, and monoclonal

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2
Q

definition of monoclonal

A

the neoplastic cells are derived from a single mother cell

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3
Q

How is clonality of B lymphocytes determine

A

Ig light chain phenotype
Immunoglobulin composed of heavy and light chains that is either kappa or lambda
normal kappa to lambda is 3:1
monoclonal is 6:1 or inverted 1:3

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4
Q

benign neoplastic tumors

A

remain localized and do not metastasize

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5
Q

malignant neoplastic tumors

A

invade locally and have the potential to metastasize

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6
Q

Epithelium tumors nomenclature - benign and malignant

A

Benign: adenoma, papilloma
Malignant: adenocarcinoma, Papillary carcinoma

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7
Q

Mesenchyme tumors nomenclature - benign and malignant

A

Benign: lipoma
Malignant: liposarcoma

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8
Q

lymphocyte tumors nomenclature - benign and malignant

A

Benign: does not exist
Malignant: lymphoma, leukemia

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9
Q

Melanocyte tumors nomenclature - benign and malignant

A

Benign: Nevus
Malignant: Melanoma

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10
Q

most common cancers by incidence in adults

A

1) breast/prostate
2) lung
3) colorectal

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11
Q

most common cause of cancer mortality

A

1) lung
2) breast/prostate
3) colorectal

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12
Q

definition of carcinogens

A

agents that damage DNA, increasing the risk for cancer

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13
Q

What is the associated cancer with this carcinogenic chemical:
Aflatoxins

A

Hepatocellular carcinoma

Derived from aspergillus, which can contaminate stored rice and grains

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14
Q

What is the associated cancer with this carcinogenic chemical:
Alkylating agents

A

leukemia/lymphoma

side effect of chemo

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15
Q

What is the associated cancer with this carcinogenic chemical:
alcohol

A

squamous cell carcinoma of oropharynx and upper esophagus,

hepatocellular carcinoma

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16
Q

What is the associated cancer with this carcinogenic chemical:
arsenic

A

squamous cell carcinoma of skin, lung cancer, and angiosarcoma of liver

arsenic is present in cigarette smoke

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17
Q

What is the associated cancer with this carcinogenic chemical:
nitrosamines

A

stomach carcinoma

found in smoked foods
responsible for high rate of stomach carcinoma in Japan

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18
Q

What is the associated cancer with this carcinogenic chemical:
naphthylamine

A

urothelial carcinoma of bladder

derived from cigarette smoke

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19
Q

What is the associated cancer with this carcinogenic chemical:
vinyl chloride

A

angiosarcoma of liver

occupational exposure
used to make PVC

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20
Q

What is the associated cancer with this carcinogenic chemical:
nickel, chromium, beryllium, or silica

A

lung carcinoma

occupational carcinoma

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21
Q

What is the associated cancer with this carcinogenic chemical:
asbestos

A

lung carcinoma and mesothelioma

exposure to asbestos is more likely to lead to lung cancer than mesothelioma

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22
Q

What is the associated cancer with this carcinogenic chemical:
cigaretter smoke

A

carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas

most common carcinogen worldwide, polycyclic hydrocarbons are particularly carcinogenic

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23
Q

What is the associated cancer with this carcinogenic oncogenic virus:
EBV

A

nasopharyngeal carcinoma, burkitt lymphoma, and CNS lymphoma in AIDS

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24
Q

What is the associated cancer with this carcinogenic oncogenic virus:
HHV-8

A

Kaposi Sarcoma

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25
What is the associated cancer with this carcinogenic oncogenic virus: HBV and HCV
Hepatocellular carcinoma
26
What is the associated cancer with this carcinogenic oncogenic virus: HTLV-1
Adult T-cell leukemia/lymphoma
27
What is the associated cancer with this carcinogenic oncogenic virus: High-risk HPV (16,18,31,33)
squamous cell carcinoma of vulva, vagina, anus, and cervix, adenocarcinoma of cervix
28
What is the associated cancer with radiation: | ionizing (nuclear reactor accidents and radiotherapy)
AML, CML, and papillary carcinoma of the thyroid generates hydroxyl free radicals
29
What is the associated cancer with radiation: | nonionizing (UVB sunlight is most common source)
basal cell carcinoma, squamous cell carcinoma, and melanoma of skin results in formation of pyrimidine dimers in DNA, which are normally excised by restriction endonuclease
30
Function Mechanism associated tumor of: PDGFB
platelet-derived growth factor overexpression, autocrine loop astrocytoma
31
Function Mechanism associated tumor of: ERBB2 (HER2/neu)
Epidermal growth factor receptor amplification subset of breast carcinomas
32
Function Mechanism associated tumor of: RET
neural growth factor receptor point mutation MEN2A, MEN 2B and sporadic medullary carcinoma of thyroid
33
Function Mechanism associated tumor of: KIT
stem cell growth factor receptor point mutation gastrointestinal stromal tumor
34
Function Mechanism associated tumor of: RAS gene family
GTP-binding protein point mutation carcinomas, melanoma, and lymphoma
35
Function Mechanism associated tumor of: ABL
tyrosine kinase t(9:22) with BCR CML and some types of ALL
36
Function Mechanism associated tumor of: c-Myc
transcription factor t(8:14) involving IgH burkitt lymphoma
37
Function Mechanism associated tumor of: N-Myc
transcription factor amplification neuroblastoma
38
Function Mechanism associated tumor of: L-myc
transcription factor amplification lung carcinoma (small cell)
39
Function Mechanism associated tumor of: CCND1 (cyclin D1)
cyclin t(11:14) involving IgH mantle cell lymphoma
40
Function Mechanism associated tumor of: CDK 4
cyclin dependent kinase amplification melanoma
41
p53
tumor suppressor regulates progression of the cell cycle from G1 to S phase slows cell cycle when damage is present if repair is not possible, upregulates BAX -> disrupts Bcl2 -> induces apoptosis
42
Knudson two hit hypothesis
both copies of p53 gene must be knocked out for tumor formation
43
Rb
tumor suppressor hold E2F transcription factor which is necessary for transition to S phase from G1
44
sporadic Rb mutation
both hits are somatic | characterized by unilateral retinoblastoma
45
germline Rb mutation
familial retinoblastoma - 2nd hit is somatic | bilateral retinoblastoma and osteosarcoma
46
Bcl2
prevents apoptosis in normal cells stabilizes mitochondrial membrane, blocking release of cytochrome c over expressed in follicular lymphoma
47
telomerase is necessary for
cell immortality | cancers often have upregulated telomerase, which preserves telomeres
48
angiogenesis
necessary for tumor survival and growth | FGF and VEGF often produced by tumor cells
49
how do tumor cells evade immune surveillance
downregulating expression of MHC I normally, the abnormal proteins would be displayed by MHC I and destroyed by CD8+
50
lymphatic spread is characteristic of
carcinomas
51
hematogenous spread is characteristic of
sarcomas and some carcinomas
52
seeding of body cavities is characteristic of
ovarian carcinoma | which often involves the peritoneum
53
Benign tumors histologic features
``` organized growth uniform nuclei low nuclear to cytoplasmic ratio minmal mitotic activity lack of invasion no met potential ```
54
malignant tumor histology
``` disorganized growth nuclear pleomorphism and hyperchromasia high nuclear cytoplasmic ratio high mitotic activity with atypical mitosis invasion ```
55
well differentiated
low grade | resembles normal parent tissue
56
poorly differentiated
high grade | does not resemble parent tissue
57
grading
determines prognosis
58
staging
more important than grade | assessment of size and spread of cancer
59
TNM staging of a tumor
T - tumor - size and/or depth of invasion N - spread to regional lymph nodes, 2nd most important prognostic factor M - metastasis - single most important prognostic factor
60
Immunohistochemical stain assoc. with which tissue: | keratin
epithelium
61
Immunohistochemical stain assoc. with which tissue: | vimentin
mesenchyme
62
Immunohistochemical stain assoc. with which tissue: | desmin
muscle
63
Immunohistochemical stain assoc. with which tissue: | GFAP
neuroglia | astrocytes
64
Immunohistochemical stain assoc. with which tissue: | neurofilament
neurons
65
Immunohistochemical stain assoc. with which tissue: | PSA
prostatic epithelium
66
Immunohistochemical stain assoc. with which tissue: | ER
breast epithelium
67
Immunohistochemical stain assoc. with which tissue: | thyroglobulin
thyroid follicular cells
68
Immunohistochemical stain assoc. with which tissue: | chromogranin
``` neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors) ```
69
Immunohistochemical stain assoc. with which tissue: | S-100
melanoma, Schwannoma, and Langerhans cell histiocytosis

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