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neoplasms
neoplasms
89
Pathology
Graduate
12/28/2010

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Term
cell types
Definition
1. epithelial
2. connective & muscle
3. nerve
4. lymphoid
5. hematopoietic
Term
neoplasm general info.
Definition
Neoplasms end with the suffix “oma” (not OMG!)
When benign & malignant tumors are classified by cell types, they are named by the tissue of origin. Remember
epithelial
connective and muscle
nerve
lymphoid
hematopoietic
Term
-oma
Definition
tumor
Term
metastasis
Definition
spreading
Term
occult
Definition
hidden
Term
benign
Definition
No metastasis
Encapsulated
Non-invasive
Slow-growing
Well differentiated
Little or no anaplasia

In benign tumors they grow independent of tissue and continue to grow but do NOT metastasize

A benign tumor may still kill you, for example, if a benign tumor starts in the brain, by growing, it will push against structures and disrupt those structures.
Term
malignant
Definition
Metastasis
Non-encapsulated
Invasive
Rapid growth
Poorly differentiated
Anaplasia to varying degrees
Term
insitu
Definition
It doesn’t break through the basement membrane

It is a tumor that is sitting there waiting!!
Term
caution cluster signs
Definition
Changes in B & B habits
A sore that does not heal in six weeks
Unusual bleeding or discharge (continues)
Thickening or lump (breast or elsewhere)
Indigestion or difficulty in swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

It is a cluster of these that should be considered
Term
encapsulation
Definition
is when a neoplasm grows w/in a connective tissue or capsule. Most encapsulated neoplasms are benign.
Whereas, most malignant neoplasms grow with no connective tissue capsule.
Term
invasion
Definition
is the process of being in one tissue and invading another tissue. Malignant neoplasms invade adjacent tissue. Patterns of metastasis differ from cancer to cancer.
Term
anaplasia
Definition
when there are differences w/in the actual cell types. For example, one CAncer cell doesn't look like the next cell & doesn't look like the next cell. So cellular atypii or anaplasia or "do the cells look like the other cells?” The clinical example here is a PAP smear
Term
local effects of tumors
Definition
1. Pain-acts as a warning sign
2. Obstruction-when a tumor compresses a passageway. May restrict bloodflow to an area.
3. Tissue necrosis & ulceration may lead to infection around the tumor. For example, in the infection occurring with CA in the mouth.
Term
cachexia
Definition
wasting away of the body-weight loss and wasting due to illness
Term
systemic effects of malignant tumors
Definition
1. weight loss & cachexia.
2. anemia-decreased hemoglobin. Results from poor intake, chronic bleeding w/iron loss & bone marrow destruction
3. fatigue-caused by inflammation, cachexia, anemia, stress & tx.
4. infections such as pneumonia
5. bleeding due to erosion of the blood vessels in the area of the tumor
6. paraneoplastic syndromes-caused by tumor cells releasing substances that effect neurological fx thereby causing hormonal change
Term
stage 0
Definition
carcinoma insitu
Term
stage I
Definition
early stage, local CA
Term
stage II
Definition
increased risk of spread because of tumor size
Term
stage III
Definition
local CA has spread but may not be disseminated to distant regions
Term
stage IV
Definition
CA has spread & disseminated to distant sites
Term
risk factors for developing CA
Definition
Geographical
Age
Nutritional
Cultural
Genetic factors
Term
median age for all cancers
Definition
70

Older people may be more susceptible to CA simply because they have been exposed to carcinogens longer than younger people.
 
Tobacco use remains the most important cause of CA.
Term
cancer treatment
Definition
Curative if tumor is small & localized
Palliative if CA is advanced


Chemotherapy & radiation therapy are administered in repeated doses to maximize tumor cell death but minimize normal tissue effects.

Total parenteral nutrition—nutrients administered directly through a vein
Term
functional and structural unit in the body
Definition
cell
Term
cause of cell function loss
Definition
disorganization or undifferentiated or growth becomes uncontrolled, their specialized functions are lost.
Term
ribosomes
Definition
granules that produce proteins
Term
mitochondria
Definition
provide energy
Term
lysosomes
Definition
contain digestive enzymes to break down unwanted materials
Term
golgi complex
Definition
process and release proteins
Term
mitosis
Definition
process of cell reproduction resulting in two daughter cells with the same DNA as the parent cell

regulator genes control mitosis for diff. types of cells
Growth factors, such as cytokines, signal proliferation while inhibitors inside cells prevent excessive growth
Term
mutation
Definition
a change in the genetic make up (DNA) of a cell, which will be inherited
Term
apoptosis
Definition
programmed cell death
Term
causes of DNA mutation
Definition
spontaneously during mitosis
result of exposure to chemicals, viruses, radiation and other environmental hazards
rapid rates of mitosis associated with tissue trauma may increase risk
Term
cell type with most rapid rate of mitosis
Definition
epithelial cells
Term
cells that never undergo mitosis
Definition
neurons
Term
chromosomes
Definition
s an organized structure of DNA and protein that is found in cells. It is a single piece of coiled DNA containing many genes, regulatory elements and other nucleotide sequences.
Term
neoplasm
Definition
(tumor) is a cellular growth that is no longer responding to normal body controls. The cells continue to reproduce when there is no need for them.

This excessive growth deprives other cells of nutrients
The expanding mass creates pressure on surrounding structures
Term
oncology
Definition
study of malignant tumors
Term
angiogenesis
Definition
the development of new capillaries in the tumor, thus promoting tumor development.
Term
tumor grading
Definition
based on the degree of differentiation
grade I tumor-well differentiated cells similar to the original cells
grad IV tumor is undifferentiated with cells varying in size and shape (anaplasia).-highly malignant
Term
why is infection likely to occur at the tumor site?
Definition
tissue necrosis and ulceration may lead to infection around the tumor, particularly in areas where normal flora can become opportunistic
Term
anemia
Definition
decreased hemoglobin
decreases the O2 available to cells, leading to fatigue and poor tissue regeneration
Term
paraneoplastic syndromes
Definition
associated with certain tumors
tumor cells release substances that affect neurologic function or blood clotting or have hormonal effects.
EX: bronchogenic carcinoma cause release of ACTH leading to manifestaions of cushings syndrome.
Term
naming tumors
Definition
-oma by itself means benign
carcinoma-malignant
sarcoma-malignant
Term
reasons for pain of tumors
Definition
pain-direct pressure of the mass on sensory nerves. Can be stretching of a visceral capsule. INflammation because of increased pressure on the nerves.
can be:
infection, ischemia and bleeding.. Blood can irritate tissues and if collection in an area can cause pressure on nerves
Term
reason for bleeding of tumors
Definition
tumor cells may erode the blood vessels or cause tissue ulceration. Bone marrow depression and hypoproteinemia may contribute to poor clotting
Term
reason for weight loss with tumors
Definition
and cachexia- anorexia, fatigue, pain, stress and increased demands placed on the body by reproducing tumor cells (nutrient trapping) altered carbohydrate and protein metabolism and cachectic factors produced by macrophages in response to tumor.
Term
reasons for fatigue with tumors
Definition
inflammatory changes, cachexia, anemia, stress and treatment schedules. Psychological factors involved in facing a life-threatening illness can also lead to depression.
Term
thrombocytopenia
Definition
abnormally low number of thrombocytes or platelets
Term
tumor markers
Definition
substances, enzymes, antigens or hormones produced by some malignant cells and circulating in the blood or other body fluid.
Term
radioisotopes
Definition
a radioactive form of an element, giving off radiation (beta or gamma) in the body, used in diagnosis and therapy
Term
cytology
Definition
study of cells
Term
histology
Definition
study of tissues
Term
three mechanisms for the spread of cancer
Definition
invasion-local spread, secrete lytic enzymes that break down tissue

metastasis-spread to distant sites by blood or lymph channels.

seeding-spread of cancer cells in body fluids or along membranes, usually in body cavities. cells break away and travel easily with the movement of fluid and tissue. EX: ovarian cancer
Term
micrometastases
Definition
small metastasis that are found traveling through lymph or blood on their way to form tumors at other sites.

-too small to be detected
Term
stages of cancer
Definition
based on the extent of the disease and therefore provides a basis for treatment and prognosis

based on :
size of primary tumor (T)
extent of involvement of regional lymph nodes(N)
spread (M) mestastasis

Only stage IV has metastasis showing up
Term
carcinogenesis
Definition
process by which normal cells are transformed into cancer cells
Term
stages of carcinogenesis
Definition
initiating factors-cause change in DNA-first mutation-does not mean active neoplasm

exposure to promoters- further changes to DNA and less differentiation and increased mitosis-dysplasia or anaplasia evident here

continued exposure and changes in DNA

changes in regulation of growth- metastasis-cells capable of detaching and moving on
Term
aggressive tumor
Definition
metastasize readily and exhibit cells that reproduce quickly
Term
peritoneal organs
Definition
cecum
liver
jejunum
stomach
ilium
transverse colon
sigmoid colon
Term
palliative
Definition
intended to reduce the manifestations and complications related to the cancer and to prolong life.
Term
radiofrequency ablation (RFA)
Definition
used for small tumors of the lungs and liver
radiologist uses CT scans and ultrasound to guide and needle and electrodes to tumor. Heat is supplied in the form of radio waves to destroy the malignant cells and tissue immediately surrounding the tumor.
Term
radiotherapy
Definition
may be used alone or with other treatments

causes mutations or alterations in the targeted DNA, thus preventing mitosis or causing immediate cell death. It also damages blood supply to the tumor.
Most effective on rapidly dividing cells
Term
hematemesis
Definition
blood in the stool or vomitus
Term
xerostomia
Definition
dry mouth
Term
chemotherapy adverse effects
Definition
bone marrow depression is the limiting factor
normal cells also damaged, most commonly skin, mucosa, bone marrow and gonads.
Term
nadir
Definition
point of lowest cell count
Term
antiemetic drugs
Definition
prevent nausea
Term
reason for hair loss
Definition
chemotherapy kills rapidly dividing cells and epithelial cells are rapidly ongoing mitosis.
Term
antineoplastic drugs
Definition
chemotherapy
Term
major risk with thrombocytopenia
Definition
hemorrhage
Term
common problems with neutropenia, septicemia, tumors of intestinal tract.
Definition
infection
Term
risk with lung cancer
Definition
pneumonia
Term
prednisone use with neoplasms
Definition
used to decrease mitosis and increase erythrocyte counts. Improve appetite and sense of well-being. Decrease inflammation and swelling around the tumor.
Term
tamoxifen
Definition
estrogen-blocking agent
most effective in post-menopausal women
Term
exemestane (aromasin)
Definition
fewer side effects than tamoxifen in advanced cases of post-menopausal, hormone dependent breast cancer in which tamoxifen is not effective.
this drug blocks the conversion, by the enzyme aromatase of androgens to estrogens
Term
biologic response modifiers (BRMs)
Definition
agents that augment the natural immune response in the body to improve the surveillance and removal of abnormal cells.

EX: natural product of interferon and bacillus Calmette-Guerin (BCG) vaccine (for TB) BCG stimulates the movement of macrophages and T-lymphs to the site where they may destroy the tumor cell.
Term
angiogenic inhibitor drugs (angiostatin, endostatin)
Definition
angiogenesis means new blood vessels and as a tumor grows and spreads, so must new blood vessels. Antiangiogenesis drugs block the stimulus for endothelial cell (blood vessel walls) growth by various mechanisms and therefore reduce local blood flow and starve the tumor cells. Also reduces the delivery of chemotherapy to the cells in the tumor.
Term
analgesics
Definition
pain control
doses are increased with tolerance
Term
reasons of malnourishment in cancer patients
Definition
change in taste, anorexia, vomiting, sore mouth, loss of teeth, pain and fatigue, malabsorption due to inflammation in the GI tract, altered metabolism and nutrient trapping by the tumor. Can be because of tumor or treatments.
Term
total parenteral nutrition (TPN)
Definition
administration of a nutrient mixture directly into a peripheral vein.
Term
alternative treatments for cancer
Definition
called "complementary" non-medical treatments.
Term
definition of a "cure" of cancer
Definition
5-year survival without recurrence after diagnosis and treatment.
Term
basal cell carcinoma
Definition
most common form of skin cancer
lack of pain, pruritis and persistence
lesion remains and grows slowly
invasive into the subcutaneous tissues
Term
skin cancers
Definition
highest rate of recurrence
occur mostly on head, neck and back
fair skin increases risk
over 40 increases risk
Term
ovarian cancer
Definition
poor prognosis
tumor is "silent" in peritoneal cavity
tumor spreads by lymph vessels and seeding
also invades uterus and pelvis
chemo, radiation and surgery
Term
brain tumors
Definition
may be benign or malignant
space-occupying mass that creates pressure
even small can cause death if on brainstem or cerebellum.
can be diff. to remove
can originate from neurons, neuroglial cells, blood vessels or connective tissue.
signs are seizures or signs of pressure such as a headache, drowsiness, vomiting, visual problems or impaired motor function.
don't metastasize beyond CNS but other types of cancers can metastasize here.
Term
pituitary tumors
Definition
cause neurologic dysfunction and hormonal abnormalities
Term
tumors in interior of brain
Definition
can shift ventricles and interfere with flow of cerebrospinal fluid
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