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Flashcards in Principles of Neoplasia Deck (48):
1

Name for Cancers of Epithelium

B = Adenoma, papilloma
M = Adenocarcinoma, papillary carcinoma

2

Name for Cancers of Mesenchyme

B = Lipoma
M = Liposarcoma
Mesenchyme = connective tissue (fat, bone, blood vessels, cartilage)

3

Lymphocyte

M = Lymphoma/Leukemia

4

Melanocyte

B = Nevus (mole)
M = Melanoma

5

Aflatoxins causes

Hepatocellular carcinoma. Find this chemical in Aspergillus which can contaminate rice and grains so see commonly in Africa

6

Alkylating Agents cause

Leukemia/lymphoma. Side effect of chemotherapy

7

Arsenic causes

Squamous cell carcinoma of oropharynx and upper esophagus. Also hepatocellular carcinoma. Find in cigarette smoke

8

Asbestos Causes

Primarily lung carcinoma but also mesothelioma.

9

Cigarette Smoke Causes

Carcinoma of oropharynx, esophagus, lung, kidney, bladder, and pancreas. The polycyclic hydrocarbons are the most carcinogenic

10

Nitrosamines Cause

stomach carcinoma. See in smoked foods so common in Japan

11

Napthylamine Casues

Urothelial carcinoma of bladder. Find in cigarette smoke

12

Vinyl Chloride Casues

Angiosarcoma of liver. See in workers that make PVC pipes

13

Nickel, chromium, beryllium, or silica Casues

Lung carcinoma

14

Epstein Barr Virus Causes (EBV) Causes

Nasopharyngeal carcinoma in chinese males or Africans. Usually present with a neck mass
Burkitt lumphoma
CNS lymphoma in AIDS

15

Herpes Virus (HHV8) Causes

Kaposi Sarcoma. Find in Eastern European males, AIDS patients, or organ transplant (immunocompromised)

16

Hepatitis B (HBV) and C (HCV) causes

Hepatocellular Carcinoma

17

Human T-lymphotropic Virus 1 Causes

Adult T-Cell leukemia/lymphoma

18

HPV Causes

Squamous cell carcinoma of vulva, vagina, anus, and cervix. Also get adencarcinoma of cervix

19

Ionizing Radiation (nuclear accidents and radiotherapy) Causes

AML, CML, and papillary carcinoma of the thyroid

20

Nonionizing (UV sun rays)

Basal cell carcinoma, squamous cell carcinoma, and melanoma of the skin

21

Platelet Derived Frowth Factor B Associated w/

Astrocytoma (brain cancer). Overexpression so astrocyte is bombarded with PDGFB and grows and divides rapidly.

22

ERBB2 (HER2/neu) Associated w/

Subsets of breast carcinomas. Amplification of these growth factor receptors causes the cell to be hyperresponsive to growth factors and grow and divide

23

RET is associated w/

Neural Growth factor receptor. A point mutation can cause MEN2A or B and medullary carcinoma of thyroid

24

KIT assoicated w/

Stem cell growth factor receptor. Point mutation can cause GI stromal tumor

25

RAS gene family associated w/

Signal transducer that is a GTP binding protein. Point mutation results in a prolonged activated state and it sends too much message and get cancers of all kinds

26

ABLassociated with

Signal transducer that is a tyrosine kinase.
Get Philladelphia chromosome t(9:22) with BCR leading to overactivation of the tyrosine kinase and lots of cell growth. See in CML and some types of ALL. Philadelphia chromosome is poor prognosis

27

C, N, and L MYC

All are nuclear regulators that cause upregulation of genes needed for cell growth.

C- see a t(8:14) involving IgH. IgH is on chromosome 14 and usually on so translocation of c-MYC from 8 to Cr 14, get chronicall on c-MYC and get Burkitt Lymphoma

N - neuroblastoma
L = lung carcinoma

28

CCND1 (Cyclin D1)

t(11:14) involving IgH. Overexpression of Cyclin D1 so cell moves from G1 to S phase rapidly. Get Mantle Cell lymphoma

29

CDK4

Cell cycle regulator whose amplification leads to melanoma

30

Tumor Suppressor Genes

Regulate cell growth and check to make sure cell is ok to move from G1 to S. When working properly they reduce risk of cancer formation.

p53 and Rb are classic examples

Need both copies of gene to be mutated to get cancer (as compared to proto-oncogenes where only need 1 mutation)

31

p53

regulates progression from G1 to S. When DNA is damaged it upregulates repair enzymes

If DNA damage is so bad it induces apoptosis by upregulating BAX which dirupts Bcl2 allowing ytochrome C to leak out of mitochondria and apoptose.

Need both genes to be knocked out to get cancer.
Germline mutation results in Li-Fraumeni Syndrome.

32

Rb

Rb "holds" E2F transcription factor, which is needed to move to S phase. Rb mutation results in constitutively free E2F, allowing progression through cell cycle.

Sporadic mutation (both hits are somatic) get unilateral retinoblastoma but it is very rare

Germline mutation results familial retinoblastoma and can frequently see it bilaterally. Also more prone to osteosarcoma

33

Bcl2

Normally stabilizes mitochondiral membrane and prevents release of cytochrome c and apoptosis.

Overexpressed in follicular lymphoma. Get t(14:18) Bcl2 on 14 and Ig heavy chain on 18. See increased Bcl2 so get a bunch of B cells that would normally undergo apoptosis during somatic hypermutation in the lymph node germinal center are now living and circulate as useless B cells.

34

Telomerase

Cancers upregulate telomerase so can live longer

35

FGF and VEGF

Tumor cells express these a lot for angiogenesis so they can get nutrients to thrive

36

MHC1

Cancers avoid immune surveilance by downregulating MHC1. (Also reason you see cancers in immunocompromised)

37

Tumor Progression

1) Downregulation of E-cadherin so dissociate from neighboring cells
2)Cells attach to laminin and destroy basement membrane via colleganse
3)Attach to fibronectin in ECM and spread locally
4) Entry into blood or lymphatics allows them to spread all over

38

Cancers that spread via Lymphatics

Carcinomas

39

Cancers that spread hematogenously

Sarcomas + the following carcinomas
Renal cell, hepatocellular, follicular, and chorio

40

Clinical Features of Benign Tumors

slow growing
well circumscribed
distinct
mobile

41

Clinical features of Malignant Tumors

Rapid growing
poorly circumscribed
Infiltrative
Fixed to surrounding tissues and structures

42

Histologic Features of Benign Tumors

Organized growth
Uniform Nuclei
low nuclear:cytoplasmic
minimal mitotic activity
lack invasion
no metastatic potential

43

Hitologic Features of Malignant Tumors

Disorganized growth
Nuclear pleomorphism and hyperchromasia
High nuclear:cytoplasmic
High mitotic activity
Invasion

44

Immunohistochemical Stains indicate tumor of what origin:
Keratin, Vimentin, Desmin, GFAP, Neurofilament

Keratin = Epithelium
Vimentin = Mesenchyme
Desmin = Muscle
GFAP = neuroglia
Neurofilament = neurons

45

Immunohistochemical Stains indicate tumor of what origin:
PSA, Estrogen Receptor, Thyroglobulin, Chromogranin, S-100

PSA= Prostatic epithelium
Estrogen Receptor = breast epithelium
Thyroglobulin= thyroid follicular cells
Chromogranin = neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)
S-100 = Melanoma, Schwannoma, and Langerhans Cell Histiocytosis

46

Grading of cancer Low vs High

Low = well differentiated (resembles normal parent tissue)
High = poorly differentiated (does not resemble parent tissue)

47

Serum Tumor Markers

Useful for screening, monitoring response to treatment, and monitoring reccurence.
CANNOT be used to diagnose someone with cancer. Only a biopsy can diagnose. If serum levels are high the next step is biopsy not surgery or treatment.

48

Staging of Cancer : TNM

T- tumor size and depth of invasion
N = spread to regional lymph NODES
M = Metastasis