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Pathology I > Principles of Neoplasia > Flashcards

Principles of Neoplasia Flashcards

1
Q

what is cancer

A

genetic disorder caused by DNA mutations

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2
Q

what can cancer causing DNA mutations be caused by

A
  • hereditary
  • environmental exposure
  • aging
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3
Q

genetic alterations are _____

A

inheritable

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4
Q

describe neoplasia

A
  • independent of regulatory influences, increase in size
  • require host nutrients, blood supply, hormones
  • can be benign or malignant
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5
Q

what is a benign tumor

A

gross and microscopic characteristics are often innocuous; lesion is localized

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6
Q

what is a malignant tumor

A

ability to invade and destroy adjacent structures and metastasize

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7
Q

what is the nomenclature for benign tumors

A

attached suffix ending in -oma

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8
Q

what is the nomenclature for a malignant tumor

A

mesenchymal tissue: sarcoma
- blood: leukemia/lymphoma

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9
Q

what is the nomenclature for epithelial tissue

A
  • carcinoma
  • squamous: squamous cell carcinoma (SCC)
  • glandular: adenocarcinoma
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10
Q

what is the benign and malignant tumors of connective tissue and derivatives

A
  • benign: fibroma, lipoma, chondroma, osteoma
  • malignant: fibrosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma
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11
Q

what are the benign and malignant tumors for blood vessels

A
  • benign: hemangioma
  • malignant: angiosarcoma
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12
Q

what are the benign and malignant tumors of lymph vessles

A
  • benign: lymphangioma
  • malignant: lymphoangiosarcoma
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13
Q

what is the malignant tumor of mesothelium

A

mesothelioma

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14
Q

what is the benign and malignant tumor of brain coverings

A
  • benign: meningioma
  • malignant: invasive meningioma
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15
Q

what is the malignant tumor of hematopoietic cells

A

leukemias

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16
Q

what is the malignant tumor of lymphoid tussue

A

lymphomas

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17
Q

what is the benign and malignant tumor of smooth muscle

A
  • benign: leiomyoma
  • malignant: leiomyosarcoma
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18
Q

what is the benign and malignant tumor of striated muscle

A
  • benign: rhabdomyoma
  • malignant: rhabdomyosarcoma
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19
Q

what is the benign and malignant tumor of stratified squamous cells

A
  • benign: squamous cell papilloma
  • malignant: squamous cell or epidermoid carcinoma
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20
Q

what is the malignant tumor of basal cells of skin or adnexa

A

basal cell carcinoma

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21
Q

what is the benign and malignant tumor of tumors of melanocytes

A
  • benign: nevus
  • malignant: malignant melanoma
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22
Q

what is the benign and malignant tumors of epithelial lining of glands or ducts

A
  • benign: adenoma, papilloma, cystadenoma
  • malignant: adenocarcinoma, papillary carcinoma, cystadenocarcinoma
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23
Q

what is the benign and malignant tumor of lung

A
  • benign: bronchial adenoma
  • malignant: bronchogenic carcinoma
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24
Q

what is the benign and malignant tumor of the kidney

A
  • benign: renal tubular adenoma
  • malignant: renal cell carcinoma
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25
Q

what is the benign and malignant tumor of the liver

A

benign: liver cell adenoma
malignant: hepatocellular carcinoma

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26
Q

what is the benign and malignant tumor of the bladder

A
  • uroethelial papilloma
  • uroethelial carcinoma
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27
Q

what is the benign and malignant tumor of the placenta

A
  • hydatidiform mole
  • choriocarcinoma
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28
Q

what is the malignant tumor of the testicle

A
  • seminoma
  • embryonal carcinoma
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29
Q

what is the benign and malignant tumor of the salivary gland

A
  • pleomorphic adenoma
  • malignant mixed tumor of salivary gland
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30
Q

what is the malignant tumor of the renal anlage

A

Wilms tumor

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31
Q

what is differentiation

A

refers to the extend a tumor resemble their tissue of origin morphologically and functionally

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32
Q

what is anaplasia

A

lack of differentiation

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33
Q

what are benign tumors

A

usually well differentiated cells that resemble normal parent tissue

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34
Q

what are malignant tumors

A

wide range of parenchymal cell differentiation
- well- differentiated tumors to poorly differentiated tumors

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35
Q

what is local invasion

A

progressive infiltration, invasion, and destruction of surrounding tissue

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36
Q

what do benign tumors grow as

A

cohesive expansile masses and remain localized to site of origin

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37
Q

where do malignant tumors grow

A

locally invasive and destructive

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38
Q

what is metastasis

A

spread of tumor with sites that are physically discontinuous with the primary tumor

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39
Q

do benign tumors metastasize

A

no

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40
Q

what do malignant tumors invade

A

blood vessels, lymphatics, body cavities to spread to distant sites

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41
Q

what are the types of metatastic spread

A
  • seeding within body cavities
  • lymphatic spread/hematogenous
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42
Q

describe seeding within body cavities and give example

A
  • invasion of natural body cavity
  • ovarian tumors commonly invade peritoneum
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43
Q

what is lymphatic spread/hematogenous

A
  • invasion through lymph nodes/lymphatic system or vascular system
  • involvement depends on tumor’s primary location and access to lymphatics/vascular
  • sentinel lymph node: first regional lymph node that receives lymph flow from a primary tumor
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44
Q

what is the leading cause of death worldwide

A

cancer

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45
Q

cancer accounts for _____ deaths

A

10 million

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46
Q

between ______ of cancers can be prevented by avoiding risk factors

A

30-50%

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47
Q

what are the most common cancers

A

breast, lung, colon, rectum and prostate cancers

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48
Q

incidence of cancer in men are _____ as women

A

twice as high

49
Q

where do cancers associated with HPV occur

A

oropharynx

50
Q

what are the risk factors for cancer of oral cavity and pharynx

A
  • tobacco use
  • alcohol consumption
  • HPV infection
51
Q

frequency of cancer ____ with age

A

increases

52
Q

most cancer deaths occur between ____ years of age

A

55-75

53
Q

in children, most common tumors are:

A

leukemias, CNS cancer, lymphoma, soft tissue, and bone sarcoma

54
Q

what environmental factors can be controlled to prevent cancer

A
  • diet
  • smoking
  • alcohol
  • sun exposure
  • infectious agents
55
Q

what cancer is arsenic responsible for

A

lung carcinoma, skin carcinoma

56
Q

what cancer is asbestos responsible for

A

lung, esophageal, gastric, and colon carcinoma; mesothelioma

57
Q

what cancer is benzene responsible for

A

acute myeloid leukemia

58
Q

what cancer is beryllium responsible for

A

lung carcinoma

59
Q

what cancer is cadmium responsible for

A

prostate carcinoma

60
Q

what cancer is chromium compounds responsible for

A

lung carcinoma

61
Q

what cancer is nickel compounds responsible for

A

lung and oropharyngeal carcinoma

62
Q

what cancer is radon responsible for

A

lung carcinoma

63
Q

what cancer is vinyl chloride responsible for

A

hepatic angiosarcoma

64
Q

what types of radiation are established carcinogens

A
  • UV light
  • radiographs
  • nuclear fission
  • radionuclides
65
Q

what are exposure examples of radiation carcinogenesis

A
  • unprotected mineworkers of radioactive elements- 10x risk
  • survivors of hiroshima and nagasaki bomb, increased risk of leukemia, increased mortality rates of thyroid, breast, lung carcinomas
  • chernobyl accident- increased risk of thyroid cancer
  • therapeutic radiation to head and neck
  • UV light
66
Q

what can radiation to the head and neck area cause

A
  • mutagenic effects
  • may give rise to papillary thyroid carcinoma
67
Q

what can UV light cause

A
  • may form pyrimidine dimers in DNA
  • nucleotide excision repair pathway may be overwhelmed
  • SCC, melanoma
68
Q

many chronic inflammatory conditions create a supportive environment for:

A

the development of malignant tumors

69
Q

immunodeficiency states predispose:

A

to viral- induced cancer, including specific types of lymphoma

70
Q

what are precursor lesions

A

localized disturbances of epithelial differentiation, elevated risk of developing carcinoma

71
Q

what is an example of precursor lesions in the oral cavity

A

leukoplakia

72
Q

what are oncogenes

A

genes that promote independent cell growth in cancer cells

73
Q

what are proto-oncogenes

A

unmutated precursor cellular counterpart of an oncogene

74
Q

what are oncoproteins

A

products of oncogenes which usually lack regulatory elements and do not need external signals to function

75
Q

what are growth factors

A

substances that link to growth factor receptors on cells and signal internal cell signaling pathways to stimulate growth

76
Q

what are tumor suppressor genes

A

genes which produce products which limit cell proliferation, often transcription factors

77
Q

what are the stages of carcinogenesis and what are they

A
  • initiation: genetic damage occurs due to a carcinogen
  • promotion: exposure to a factor which allows for clonal expansion
  • transformation: point at which a cell does not respond to normal controls for growth
  • progression: growth of the tumor
78
Q

what are the hallmarks of cancer

A
  • self- sufficiency in growth signals
  • insensitivity to growth- inhibitory signals
  • altered cellular metabolism
  • evasion of apoptosis
  • limitless replicative potential
  • sustained angiogenesis
  • invasion and metastasis
  • evasion of immune surveillance
79
Q

what does self- sufficiency in growth stem from

A

gain of function mutations that convert protooncogenes to oncogenes

80
Q

what are the normal cell proliferation steps

A
  • growth factor binding to its receptor on cell membrane
  • limited activation of growth factor receptor -> activates several transducing proteins
  • transmission of transduced signal across cytosol into nucleus by second messengers
  • activation of nuclear regulatory factors -> initiate DNA transcription, other cellular components necessary for cell division
  • cell cycle progression -> ultimately results in cell division
81
Q

what do cell cycle checkpoints do

A

ensure there is not progress if there is damage or unfavorable cell condition

82
Q

what are the cell cycle checkpoints

A
  • G1/S checkpoint
  • G2/M checkpoint
83
Q

cancer may acquire the ability to secrete their own _____

A

growth factors

84
Q

what cells does cancer induce to make growth factors

A

stromal cells

85
Q

in cancer RAS is kept in ____ state

A

active

86
Q

oncogenes allow for ______, whereas tumor suppressor genes dont

A

cell growth and progression

87
Q

in cancer, oncogenes are turned____ and tumor suppressor genes are turned _____

A

on; off

88
Q

what is RB

A
  • retinoblastoma gene
  • tumor suppressor gene inactivated in many cancers
  • regulates G1/S checkpoint
89
Q

what is TP53

A

tumor suppressor gene
- most commonly mutated gene in cancer
- important for DNA repair

90
Q

what is Warburg effect

A
  • cancer cells demonstrate a distinctive form of cellular metabolism through the glycolytic pathway- high levels of glucose uptake and conversion to lactose
  • less efficient: produced 2 ATP/glucose vs 35 ATP/glucose in oxidative phosphorylation
  • the glycolytic pathway produced metabolic intermediates necessary for synthesis of cellular components
91
Q

tumor cells contain mutations in genes that regulate _____

A

apoptosis

92
Q

what is the result of tumor cells regulating apoptosis

A

cell survival during times of intrinsic stress

93
Q

what can p53 do

A

stop cell cycle if theres damage

94
Q

most normal cells have a capacity of ____ divisions

A

70

95
Q

how do cells get a capacity to replicate

A
  • telomeres shorten, the cells enter replicative senescence
96
Q

what makes cancer cells immortal and have limitless replicative potential

A

telomere maintenance
- telomerase is upregulated

97
Q

what is neoangiogenesis

A

vessel formation from existing capillaries

98
Q

what does neoangiogenesis do

A
  • supplies nutrients and oxygen
  • newly formed endothelial cells stimulate growth of adjacent tumor cells
  • secrete growth factors
  • vessels form haphazard connections,may leak
99
Q

what does invasion and metastasis result from

A
  • interactions between cancer cells, stromal cells, and the ECM
100
Q

what are the steps in invasion and metastasis

A
  • invasion of ECM
  • vascular dissemination and homing of tumor cells
101
Q

what happens in the invasion of ECM

A
  • loosening of tumor cell- cell interactions
  • degradation of ECM
  • migration of tumor cells
102
Q

what is immune surveillance

A

immune system scans the body for emerging malignant cells and destroys them

103
Q

immune response to established tumors is______

A

ineffective

104
Q

what are neoantigens

A

mutations may generate new protein sequences that the immune system is unfamiliar with

105
Q

what is immunoediting

A

the ability of the immune system to promote darwinian selection of the tumor subtypes that are most able to avoid host immunity

106
Q

what are immune checkpoints

A

inhibitory pathways that are crucial for maintaining self-tolerance

107
Q

cancer cells reduce expression of ___ and minimize _____ response

A

MHC; CD8 T cell

108
Q

what are some of the incidence and mortality changes in cancer detection and which cancers in each

A
  • screening and early detection: colon cancer, cervical cancer
  • identification of risk factors: lung cancer, breast cancer
  • treatment improvements: childhood leukemia and lymphoma
109
Q

what is immunohistochemistry

A
  • the use of monoclonal antibodies via special stains on tissue samples from biopsy or aspirational biopsy to subclassify types of tissue based on the expression of cell products or surface markers
110
Q

what does immunohistochemistry help determine

A
  • tissue of origin
  • site of origin of metastatic tumors
  • markers may indicate behavior of lesion or response to treatment
111
Q

what is IHC: S100 staining used for

A

neurofibroma

112
Q

describe H pylori

A
  • first bacterium classified as a carcinogen
  • implicated in gastric carcinomas and gastric mucosal lymphomas
  • pathway to adenocarcinoma through chronic gastritis, atrophy, metaplasia, dysplasia and carcinoma
113
Q

h pylori infection leads to a monoclonal B cell tumor over time ->

A

MALT lymphoma

114
Q

gastric lymphomas may regress with:

A

antibiotic treatment

115
Q

what are the oncogenic DNA viruses

A
  • human papilloma
  • Epstein Barr virus
  • Hep B virus
  • Hep C virus
116
Q

describe human papilloma virus

A
  • most commonly transmitted STI
  • strains most often associated with cancer are 16 and 18
  • low risk types cause squamous papillomas
  • high risk types cause SCC of the cervix, anogenital region, oropharyngeal region
  • HPV viral genes: E6 and E7- prooncogenic
117
Q

describe epstein barr virus

A
  • herpesvirus
  • infects mostly B lymphocytes
  • implicated in Burkitt lymphoma, nasopharygneal cancer, T cell lymphomas, gastric carcinoma
  • enters B cells via CD21 molecule and may remain latent in the nucleus
  • abnormally regulates proliferative and survival signals of the cells
118
Q

describe hepatitis B and C viruses

A
  • 70-85% of hepatocellular carcinoma is associated with HBV or HCV
  • HBV: DNA virus
  • HCV: RNA virus
  • chronic inflammation results in hepatocyte death, leading to regeneration with genomic damage -> tumor formation
  • HBV - HBx protein and HCV- core protein can activate signal transduction pathways that may contribute to carcinogenesis
119
Q
A

Pathology I (24 decks)

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