Step 1 First Aid - Pathology Flashcards
USMLE Step 1 First Aid - Pathology notes (190 cards)
0
Q
Apoptosis is characterized by…?
A
Cell shrinkage, nuclear shrinkage and basophilia (pyknosis), membrane blebbing, pyknotic nuclear fragmentation (karyorrhexis), nuclear fading (karyolysis), and formation of apoptotic bodies, which are then phagocytosed. No significant inflammation.
1
Q
Apoptosis (definition)
A
Programmed cell death; ATP required. Mediated by caspases.
2
Q
When does apoptosis occur?
A
Occurs during embryogenesis, hormone induction (menstruation), immune cell-mediated death, injurious stimuli (e.g., radiation, hypoxia), atrophy (e.g., endometrial lining during menopause)
3
Q
Necrosis (definition)
A
Enzymatic degradation of a cell resulting from exogenous injury.
4
Q
Necrosis is characterized by…?
A
Enzymatic digestion and protein denaturation, with release of intracellular components. Inflammatory.
5
Q
Necrosis morphologies
A
Coagulative (heart, liver, kidney) Liquefactive (brain) Caseous (tuberculosis) Fat (pancreas) Fibrinoid (blood vessels) Gangrenous (limbs, GI tract)
6
Q
Characteristics of reversible cell injury
A
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change
7
Q
Characteristics of irreversible cell injury
A
Plasma membrane damage Lysosomal rupture Ca2+ influx –< oxidative phosphorylation Nuclear pyknosis, karyolysis, karyorrhexis Mitochondrial permeability
8
Q
5 Characteristic signs of inflammation
A
Rubor (redness) Dolor (pain) Calor (heat) Tumor (swelling) Functio laesa (loss of fxn)
9
Q
Fluid exudation in inflammation
A
Incr vascular permeability, vasodilation, endothelial injury.
10
Q
Leukocyte activation in inflammation
A
Emigration (rolling, tight binding, diapedesis); chemotaxis (bacterial products, complement, cytokines); phagocytosis and killing.
11
Q
Substances that are chemotactic for neutrophils
A
IL-8 C5a Leukotriene B4 Kallikrein
12
Q
Fibrosis in inflammation
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Fibroblast emigration and proliferation; deposition of ECM.
13
Q
Acute inflammation
A
Neutrophil, eosinophil, and Ab-mediated. Rapid onset (seconds-minutes), lasts minutes-days.
14
Q
Chronic inflammation
A
Mononuclear cell mediated: Characterized by persistent destruction and repair. Associated w/ blood vessel proliferation, fibrosis. Granuloma – nodular collections of epithelioid macrophages and giant cells.
15
Q
Granulomatous dz’s
A
TB (caseating) Syphilis Listeria monocytogenes Wegener’s granulomatosis Leprosy Bartonella Some fungal pneumonias Sarcoidosis Crohn’s dz *Granuloma formation is IL-2, interferon-gamma mediated.
16
Q
Resolution of inflammation
A
Restoration of normal structure. Granulation tissue – highly vascularized, fibrotic. Abscess – fibrosis surrounding pus. Fistula – abnormal communication. Scarring – collagen deposition resulting in altered structure and fxn.
17
Q
Characteristics of trans udate
A
Hypocellular Protein-poor Specific gravity > 1.012 Due to: Incr hydrostatic pressure Decr oncotic pressure Na+ retention
18
Q
Characteristics of ex udate
A
Cellular Protein-rich Specific gravity < 1.020 Due to: Lymphatic obstruction Inflammation
19
Q
Leukocyte extravasation
A
Neutrophils exit from blood vessels at sites of injury and inflammation in 4 steps: 1.) Rolling 2.) Tight binding 3.) Diapedesis 4.) Migration <img></img>
20
Q
Rolling (step 1 in leukocyte extravasation)
A
Mediated by E-selectin and P-selectin on vascular endothelium binding to sialyl Lewis^x on the leukocyte. <img></img>
21
Q
Tight binding (step 2 of leukocyte extravasation)
A
Mediated by ICAM -1 on vascular endothelium binding to LFA-1 (integrin) on the leukocyte (“Hold on tight to your CAM era”) <img></img>
22
Q
Diapedesis (step 3 in leukocyte extravasation)
A
Leukocyte travels btw endothelial cells and exits blood vessel; PECAM-1 is involved. <img></img>
23
Q
Migration (step 4 in leukocyte extravasation)
A
Leukocyte travels thru the interstitium to the site of injury or infxn guided by chemotactic signals (e.g., cytokines) <img></img>
24
Things that initiate Free radical injury
Radiation exposure Metabolism of drugs (phase I) Redox rxtn Nitric oxide Transition metals Leukocyte oxidative burst *Reperfusion after anoxia induces free radical production (e.g., superoxide) and is a major cause of injury after thrombolytic therapy
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Free radical injury induces cell injury thru...?
Membrane lipid peroxidation Protein modification DNA Breakage
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Free radical degradation
Produced thru enzymes (catalase, superoxide dismutase, glutathioe peroxidase), spontaneous decay, antioxidants (Vitamins A, C, E).
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Amyloid structure
Beta-pleated sheet demonstrable by apple-green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.
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Type of amyloid protein: Primary Protein? Derived from...?
AL protein Derived from Ig L ight chains (multiple myeloma) (AL = L ight chains)
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Type of amyloid protein: Secondary Protein? Derived from...?
AA protein Derived from serum amyloid-associated (SAA) protein (chronic inflammatory dz) (AA = A cute-phase reactant)
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Type of amyloid protein: Senile cardiac Protein? Derived from...?
Protein = transthyretin Derived from AF (AF = old F ogies)
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Type of amyloid protein: DM2 Protein? Derived from...?
Amylin protein Derived from AE (AE = E ndocrine)
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Type of amyloid protein: Medullary carcinoma of thyroid Protein? Derived from...?
A-CAL protein Derived from calcitonin (A-CAL = CAL citonin)
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Type of amyloid protein: Alzheimer's dz Protein? Derived from...?
Beta-amyloid Derived from amyloid precursor protein (APP)
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Type of amyloid protein: Dialysis-associated Protein? Derived from...?
Beta-2 microglobulin Derived from MHC class I proteins.
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Hypovolemic/cardiogenic shock
Low-output failure. Findings: cold, clammy pt; low cardiac output; Incr TPR.
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Septic shock
High-output failure; high mixed venous pressure. Findings: hot pt, dilated arterioles, decr TPR.
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Neoplastic progression: normal state, before anything goes wrong
Normal cells w/ basal --< apical differentiation 
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Neoplastic progression: step 1 Hyperplasia/dysplasia
Cells have increased in # (hyperplasia ) Abnormal proliferation of cells w/ loss of size, shape, and orientation (dysplasia ) 
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Neoplastic progression: step 2 In situ carcinoma
Neoplastic cells hae not invaded basement membrane. High nuclear/cytoplasmic ratio and clumped chromatin Neoplastic cells encompass entire thickness Tumor cells are monoclonal 
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Neoplastic progression: step 3 Invasive carcinoma
Cells have invaded basement membrane using collagenases and hydrolases Can metastasize if they reach a blood or lymphatic vessel 
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Neoplastic progression: step 4 Metastasis
Metastasis = Spread to distant organ Must survive immune attack. "Seed and soil" theory of metastasis: Seed = tumor embolus Soil = target organ -- liver, lungs, bone, brain... Angiogenesis allows for tumor survival Decr cadherin, incr laminin, integrin receptors 
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Hyperplasia
Incr in # of cells. Reversible.
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Metaplasia
1 adult cell type is replaced by another. Often 2' to irritation and/or environmental exposure (e.g., squamous metaplasia in trachea and bronchi of smokers) Reversible.
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Dysplasia
Abnormal growth w/ loss of cellular orientation, shape, and size in comparizon to normal tissue maturation; commonly preneoplastic. Reversible.
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Anaplasia
Abnormal cells lacking differentiation; like primitive cells of the same tissue, often equated w/ undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin. Irreversible.
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Neoplasia
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.
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Desmoplasia
Fibrous tissue formation in response to a neoplasm. Irreversible.
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Tumor grade
Degree of cellular differentiation based on histologic appearance of tumor. Usually graded I-IV based on degree of differentiation and number of mitoses per high-power field; character of tumor itself.
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Tumor stage
Degree of localization/spread based on site and size of 1' lesion, spread to regional LNs, presence of metastases; spread of tumor in a specific pt. S tage = S pread
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TNM staging system
T = size of T umor N = N ode involvement M = M etastases
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Which usually has more prognostic value, tumor stage or grade?
Usually stage < grade
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Tumor nomenclature: Epithelium What do you call a benign tumor of this tissue? .. a malignant one?
Benign: Adenoma, papilloma Malignant: Adenocarcinoma, papillary carcinoma
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Tumor nomenclature: Blood cells What do you call a benign tumor of this tissue? .. a malignant one?
Benign: -- Malignant: Leukemia, lymphoma
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Tumor nomenclature: Blood vessels What do you call a benign tumor of this tissue? .. a malignant one?
Benign: hemangioma Malignant: Angiosarcoma
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Tumor nomenclature: Smooth muscle What do you call a benign tumor of this tissue? .. a malignant one?
Benign: Leiomyoma Malignant: Leiomyosarcoma
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Tumor nomenclature: Skeletal muscle What do you call a benign tumor of this tissue? .. a malignant one?
Benign: Rhabdomyoma Malignant: Rhabdomyosarcoma
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Tumor nomenclature: Bone What do you call a benign tumor of this tissue? .. a malignant one?
Benign: Osteoma Malignant: osteosarcoma
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Tumor nomenclature: Fat What do you call a benign tumor of this tissue? .. a malignant one?
Benign: lipoma Malignant: liposarcoma
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Tumor nomenclature: < 1 cell type What do you call a benign tumor of this tissue? .. a malignant one?
Benign: mature teratoma (women) Malignant: immature teratoma and mature teratoma (men)
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Carcinoma vs. sarcoma
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels, muscle, bone, fat, etc.) Both imply malignancy
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Benign
Usually well-differentiated, slow growing, well-demarcated, no metastasis.
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Malignant
May be poorlly differentiated, erratic growth, locally invasive/diffuse, may metastasize.
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Dz: Down syndrome What is the associated neoplasm?
ALL (we ALL fall Down ) AML
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Neoplasm: ALL (we ALL fall Down ) AML With what dz is this associated?
Down syndrome
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Dz: Xeroderma pigmentosum, albinism What is the associated neoplasm?
Melanoma, basal cell carcinoma, and esp. squamous cell carcinomas of the skin
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Neoplasm: Melanoma, basal cell carcinoma, and esp. squamous cell carcinomas of the skin With what dz is this associated?
Xeroderma pigmentosum, albinism
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Dz: Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants What is the associated neoplasm?
Gastric adenocarcinoma
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Neoplasm: Gastric adenocarcinoma With what dz is this associated?
Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants
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Dz: Tuberous sclerosis (facial angiofibroma, seizures, mental retardation) What is the associated neoplasm?
Astrocytoma, angiomyolipoma, and cardiac rhabdomyoma
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Neoplasm: Astrocytoma, angiomyolipoma, and cardiac rhabdomyoma With what dz is this associated?
Tuberous sclerosis (facial angiofibroma, seizures, mental retardation)
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Dz: Actinic keratosis What is the associated neoplasm?
Squamous cell carcinoma of the skin
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Neoplasm: Squamous cell carcinoma of the skin With what dz is this associated?
Actinic keratosis
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Dz: Barrett's esophagus (chronic GI reflux) What is the associated neoplasm?
Esophageal adenocarcinoma
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Neoplasm: Esophageal adenocarcinoma With what dz is this associated?
Barrett's esophagus (chronic GI reflux)
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Dz: Plummer-Vinson syndrome (atrophic gastritis, esophageal webs, anemia; all due to iron deficiency) What is the associated neoplasm?
Squamous cell carcinoma of esophagus
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Neoplasm: Squamous cell carcinoma of esophagus With what dz is this associated?
Plummer-Vinson syndrome (atrophic gastritis, esophageal webs, anemia; all due to iron deficiency)
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Dz: Cirrhosis (alcoholic, hepatitis B or C) What is the associated neoplasm?
Hepatocellular carcinoma
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Neoplasm: Hepatocellular carcinoma With what dz is this associated?
Cirrhosis (alcoholic, hepatitis B or C)
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Dz: Ulcerative colitis What is the associated neoplasm?
Colonic adenocarcinoma
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Neoplasm: Colonic adenocarcinoma With what dz is this associated?
Ulcerative colitis
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Dz: Paget's dz of bone What is the associated neoplasm?
Secondary osteosarcoma and fibrosarcoma
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Neoplasm: Secondary osteosarcoma and fibrosarcoma With what dz is this associated?
Paget's dz of bone
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Dz: Immunodeficiency states What is the associated neoplasm?
Malignant lymphomas
84
Neoplasm: Malignant lymphomas With what dz is this associated?
Immunodeficiency states
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Dz: AIDS What is the associated neoplasm?
Aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma
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Neoplasm: Aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma With what dz is this associated?
AIDS
87
Dz: Autoimmune dz's (e.g., Hashimoto's thyroiditis, myasthenia gravis) What is the associated neoplasm?
Benign and malignant lymphomas
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Neoplasm: Benign and malignant lymphomas With what dz is this associated?
Autoimmune dz's (e.g., Hashimoto's thyroiditis, myasthenia gravis)
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Dz: Acanthosis nigricans (hyperpigmentation and epidermal thickening) What is the associated neoplasm?
Visceral malignancy (stomach, lung, breast, uterus)
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Neoplasm: Visceral malignancy (stomach, lung, breast, uterus) With what dz is this associated?
Acanthosis nigricans (hyperpigmentation and epidermal thickening)
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Dz: Dysplastic nevus What is the associated neoplasm?
Malignant melanoma
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Neoplasm: Malignant melanoma With what dz is this associated?
Dysplastic nevus
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Dz: Radiation exposure What is the associated neoplasm?
Sarcoma
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Neoplasm: Sarcoma With what dz is this associated?
Radiation exposure
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Oncogenes
Gain of fxn --< cancer. Need damage to only 1 allele.
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Oncogene: abl Associated tumor?
CML
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tumor: CML What is the associated oncogene?
abl
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Oncogene: c-myc Associated tumor?
Burkitt's lymphoma
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tumor: Burkitt's lymphoma What is the associated oncogene?
c-myc
100
Oncogene: bcl-2 Associated tumor?
Follicular and undifferentiated lymphomas (inhibits apoptosis)
101
tumor: Follicular and undifferentiated lymphomas (inhibits apoptosis) What is the associated oncogene?
bcl-2
102
Oncogene: erb-B2 Associated tumor?
Breast, ovarian, and gastric carcinomas
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tumor: Breast, ovarian, and gastric carcinomas What is the associated oncogene?
erb-B2
104
Oncogene: ras Associated tumor?
Colon carcinoma
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tumor: Colon carcinoma What is the associated oncogene?
ras
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Oncogene: L -myc Associated tumor?
L ung tumor
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tumor: L ung tumor What is the associated oncogene?
L -myc
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Oncogene: N -myc Associated tumor?
N euroblastoma
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tumor: N euroblastoma What is the associated oncogene?
N -myc
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Oncogene: ret Associated tumor?
Multiple endocrine neoplasia (MEN) types II and III
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tumor: Multiple endocrine neoplasia (MEN) types II and III What is the associated oncogene?
ret
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Oncogene: c-kit Associated tumor?
Gastrointestinal stromal tumor (GIST)
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tumor: Gastrointestinal stromal tumor (GIST) What is the associated oncogene?
c-kit
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Tumor suppressor genes
Loss of fxn --< cancer; both allels must be lost for expression of dz.
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Tumor suppressor gene: Rb chromosome? Associated tumor?
Chr. 13q Assoc.: Retinoblastoma, osteosarcoma
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Chr. 13q Assoc.: Retinoblastoma, osteosarcoma What is the tumor suppressor gene?
Rb
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Tumor suppressor gene: BRCA1 chromosome? Associated tumor?
Chr. 17q Assoc.: Breast and ovarian cancer
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Chr. 17q Assoc.: Breast and ovarian cancer What is the tumor suppressor gene?
BRCA1
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Tumor suppressor gene: BRCA2 chromosome? Associated tumor?
Chr. 13q Assoc: breast cancer
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Chr. 13q Assoc: breast cancer What is the tumor suppressor gene?
BRCA2
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Tumor suppressor gene: p 53 chromosome? Associated tumor?
Chr. 17p Assoc: most human cancers (crap!), Li-Fraumeni syndrome
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Chr. 17p Assoc: most human cancers (crap!), Li-Fraumeni syndrome What is the tumor suppressor gene?
p 53
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Tumor suppressor gene: p 16 chromosome? Associated tumor?
Chr. 9p Assoc: Melanoma ("MelaN oma is N ine")
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Chr. 9p Assoc: Melanoma ("MelaN oma is N ine") What is the tumor suppressor gene?
p 16
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Tumor suppressor gene: APC chromosome? Associated tumor?
Chr. 5q Assoc: Colorectal cancer (assoc w/ FAP)
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Chr. 5q Assoc: Colorectal cancer (assoc w/ FAP) What is the tumor suppressor gene?
APC
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Tumor suppressor gene: WT1 chromosome? Associated tumor?
Chr. 11p Assoc: Wilms' tumor
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Chr. 11p Assoc: Wilms' tumor What is the tumor suppressor gene?
WT1
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Tumor suppressor gene: NF1 chromosome? Associated tumor?
Chr. 17q Assoc: Neurofibromatosis type 1
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Chr. 17q Assoc: Neurofibromatosis type 1 What is the tumor suppressor gene?
NF1
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Tumor suppressor gene: NF2 chromosome? Associated tumor?
Chr. 22q Assoc: Neurofibromatosis 2 ("Type 2 = 22")
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Chr. 22q Assoc: Neurofibromatosis 2 ("Type 2 = 22") What is the tumor suppressor gene?
NF2
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Tumor suppressor gene: DPC chromosome? Associated tumor?
Chr. 18q Assoc: Pancreatic cancer [DPC = D eleted in P ancreatic C ancer"]
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Chr. 18q Assoc: Pancreatic cancer
[DPC = D eleted in P ancreatic C ancer"] What is the tumor suppressor gene? DPC
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Tumor suppressor gene: DCC chromosome? Associated tumor?
Chr. 18q Assoc: Colon cancer [DCC = D eleted in C olon C ancer]
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Chr. 18q Assoc: Colon cancer
[DCC = D eleted in C olon C ancer] What is the tumor suppressor gene? DCC
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How should tumor markers be used clinically?
Tumor markers should not be used as the primary tool for cancer Dx. They may be used to confirm Dx, to monitor for tumor recurrence, and to monitor response to therapy.
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Tumor markers: PSA
Prostate-Specific Ag. Used to screen for prostate carcinoma. Can also be elevated in BPH and prostatitis.
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Tumor markers: Prostatic acid phospatase
Prostate carcinoma.
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Tumor markers: CEA
Carcinoembryonic Ag. Very nonspecific, but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric and breast carcinomas.
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Tumor markers: alpha-fetoprotein
Normally made by fetus. Hepatocellular carcinomas. Nonseminomatous germ cell tumors of the testis (e.g., yolk sac tumor)
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Tumor markers: Beta-hCG
"HCG" H ydatidiform moles C horiocarcinomas G estational trophoblastic tumors
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Tumor markers: CA-125
Ovarian, malignant epithelial tumors
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Tumor markers: S-100
Melanoma, neural tumors, astrocytomas.
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Tumor markers: Alkaline phosphatase
Metastases to bone, obstructive biliary dz, Paget's dz of bone.
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Tumor markers: Bombesin
Neuorblastoma, lung, and gastric cancer.
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Tumor markers: TRAP
Tartrate-resistant acid phosphatase. Hairy cell leukemia -- a B-cell neoplasm. "TRAP the hairy animal."
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Tumor markers: CA-19-9
Pancreatic adenocarcinoma
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Oncogenic viruses: HTLV-1 What is the associated cancer?
Adult T-cell leukemia
150
Adult T-cell leukemia What is the assocciated oncogenic virus?
HTLV-1
151
Oncogenic viruses: HBV, HCV What is the associated cancer?
Hepatocellular carcinoma
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Hepatocellular carcinoma What is the assocciated oncogenic virus?
HBV, HCV
153
Oncogenic viruses: EBV What is the associated cancer?
Burkitt's lymphoma nasopharyngeal carcinoma
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Burkitt's lymphoma nasopharyngeal carcinoma What is the assocciated oncogenic virus?
EBV
155
Oncogenic viruses: HPV What is the associated cancer?
Cervical carcinoma (types 16, 18) Penile/anal carcinoma
156
Cervical carcinoma (types 16, 18) Penile/anal carcinoma What is the assocciated oncogenic virus?
HPV
157
Oncogenic viruses: HHV-8 What is the associated cancer?
[aka Kaposi's sarcoma-associated herpesvirus] Kaposi's sarcoma Body cavity fluid B-cell lymphoma
158
[aka Kaposi's sarcoma-associated herpesvirus] Kaposi's sarcoma Body cavity fluid B-cell lymphoma What is the assocciated oncogenic virus?
HHV-8
159
Chemical carcinogens: Aflatoxins (produced by Aspergillus) What is the affected organ?
Liver (hepatocellular carcinoma)
160
Chemical carcinogens: Vinyl chloride What is the affected organ?
Liver (angiosarcoma)
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Chemical carcinogens: CCl4 What is the affected organ?
Liver (centrilobular necrosis, fatty change)
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Chemical carcinogens: Nitrosamines (e.g., in smoked foods) What is the affected organ?
Esophagus, stomach
163
Chemical carcinogens: Cigarette smoke What is the affected organ?
Larynx (squamous cell carcinoma) Lung (squamous cell and small cell carcinomas) Kidney (renal cell carcinoma) Bladder (transitional cell carcinoma)
164
Chemical carcinogens: Asbestos What is the affected organ?
Lung (mesothelioma and bronchogenic carcinoma)
165
Chemical carcinogens: Arsenic What is the affected organ?
Skin (squamous cell carcinoma) Liver (angiosarcoma)
166
Chemical carcinogens: Naphthalene (aniline) dyes What is the affected organ?
Bladder (transitional cell carcinoma)
167
Chemical carcinogens: Alkylating agents What is the affected organ?
Blood (leukemia)
168
Paraneoplastic effects of tumors: Small cell lung carcinoma Causes...? Effect?
Causes: ACTH or ACTH-like peptide Effect: Cushing's syndrome
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Causes: ACTH or ACTH-like peptide Effect: Cushing's syndrome What neoplasm would create this paraneoplastic effect?
Small cell lung carcinoma
170
Paraneoplastic effects of tumors: Small cell lung carcinoma and intracranial neoplasms Causes...? Effect?
Causes: ADH Effect: SIADH
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Causes: ADH Effect: SIADH What neoplasm would create this paraneoplastic effect?
Small cell lung carcinoma and intracranial neoplasms
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Paraneoplastic effects of tumors: Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma Causes...? Effect?
Causes: PTH-related peptide, TGF-beat, TNF, IL-1 Effect: Hypercalcemia
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Causes: PTH-related peptide, TGF-beat, TNF, IL-1 Effect: Hypercalcemia What neoplasm would create this paraneoplastic effect?
Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma
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Paraneoplastic effects of tumors: Renal cell carcinoma, hemangioblastoma Causes...? Effect?
Causes: Erythropoietin Effect: Polycythemia
175
Causes: Erythropoietin Effect: Polycythemia What neoplasm would create this paraneoplastic effect?
Renal cell carcinoma, hemangioblastoma
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Paraneoplastic effects of tumors: Thymoma, small cell lung carcinoma Causes...? Effect?
Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert-Eaton syndrome (muscle weakness)
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Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert-Eaton syndrome (muscle weakness) What neoplasm would create this paraneoplastic effect?
Thymoma, small cell lung carcinoma
178
Paraneoplastic effects of tumors: Leukemias and lymphomas Causes...? Effect?
Causes: Hyperuricemia due to excess nucleic acid (e.g., cytotoxic therapy) Effect: Gout, urate nephropathy
179
Causes: Hyperuricemia due to excess nucleic acid (e.g., cytotoxic therapy) Effect: Gout, urate nephropathy What neoplasm would create this paraneoplastic effect?
Leukemias and lymphomas
180
Psammoma bodies
Laminated, concentric, calcific spherules seen in: 1.) Papillary adenocarcinoma of thyroid 2.) Serous papillary cystadenocarcinoma of ovary 3.) Meningioma 4.) Malignant mesothelioma PS aMM oma: P apillary (thyroid) S erous (ovary) M eningioma M esothelioma
181
Metastasis to brain
Typically multiple well-circumscribed tumors at grety-white border. Overall, approximately 50% of brain tumors are from metastases.
182
Primary tumors that metastasize to brain
L ung B reast S kin (melanoma) K idney (renal cell carcinoma) G I L ots of B ad S tuff K ills G lia.
183
Metastasis to liver
The liver and lung are the most common sites of metastasis after regional LN's. Metastasis << primary liver tumors.
184
Primary tumors that metastasize to liver
C olon < S tomach < P ancreas < B reast < L ung "C ancer S ometimes P enetrates B enign L iver."
185
Metastasis to bone
Metastatic bone tumors are far more common than primary bone tumors. L ung = lytic Prostate = blastic B reast = B oth lytic and blastic.
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Primary tumors that metasize to bone
P rostate, T hyroid, T estes, B reast, L ung, K idney "P.T. B arnum L oves K ids" Metastases from breast and prostate are mosot common.
187
Cancer epidemiology: Lung cancer? As a cause of death overall?
Lung cancer deaths have plateaued in males, but continue to incr in females. Cancer is the 2nd leading cause of death in the USA (heart dz is 1st).
188
Male cancer epidemiology (incidence, mortality)
Incidence: Prostate (32%) Lung (16%) Colon and rectum (12%) Mortality: Lung (33%) Prostate (13%)
189
Female cancer epidemiology (incidence, mortality)
Incidence: Breast (32%) Lung (13%) Colon and rectum (13%) Mortality: Lung (23%) Breast (18%)
