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Disease Exam 1: Neoplasias
Disease exam 1 neoplasias
216
Anatomy
Graduate
02/21/2011

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Term
carcinoma:
Definition
- malignant growth of squamous, glandular, or transitional epithelium
Term
sarcoma:
Definition
malignant tumor of connective tissue origin, arises from mesoderm
Term
fibroadenoma:
Definition
- benign tumor of connective tissue
Term
suffix "oma" generally means:
Definition
benign tumor
Term
malignant growth of squamous cells:
Definition
- squamous cell carcinoma
Term
mallignant growth of glandular cells:
Definition
adenocarcinoma
Term
carcinomas can be:
Definition
- flat
- ulcerated
- fungating
- polypoid
Term
malignant tumor of fat:
Definition
sarcoma
Term
Carcinomas are malignancy of epithelial-covering and linings: squamous, cuboidal, and columnar
Adenocarcinoma
Squamous Cell Carcinoma
Definition
Term
sarcomas:
Definition
Tumors of mesenchymal cells (connective tissue) include smooth muscle, skeletal muscle, adipose tissue, cartilage, bone, fibrous tissue, blood vessels, lymphatics, and nervous tissue.
Term
A Nevus is a ___, which is a __ tumor of ___.
Definition
- mole
- benign tumor of melanocytes
Term
All melanomas are:
Definition
malignant
Term
Melanoma is a malignancy of ____. Vertical and horizontal spread will be noted, as well as uneven pigmentation.
Definition
melanocytes
Term
A teratoma contains recognizable ___ or ___ cells or tissues representative of more than one ___ ___ ___ and sometimes all ___; has bone, epithelium, muscle, fat, and other tissues.
Definition
- mature or immature
- germ cell layer
- three
Term
teratoma:
Definition
is benign tumor composed of varying amounts of ectodermal, endodermal, and mesodermal tissue.
Term
Teratomas are made up of a variety of ___ cell types representative of more than one germ cell layer, usually all three. The arise from ____ cells that differentiate along various germ lines, producing tissues that can be identified like skin, fat, gut, tooth, hair, etc. A particulary common pattern is seen in the ovarian cystic teratoma aka ___ ____, which differentiates principally along ____ lines to create a cystic tumor lined by skin, hair, sebacious glands, and teeth.
Definition
- parenchymal
- totipotent
- dermoid cyst
- ectodermal
Term
A Seminoma is a ___ of ___ ____. The tumor replaces all ___ ___ with no evidence of normal testicular tissue.
Definition
- malignancy
- testicular epithelium
- testicular parenchyma
Term
seminoma:
Definition
- always malignant tumor of testies
Term
Lymphoma is a ____ of ____. It arises in ___ ___.
Definition
- malignancy of lymphocytes
- lymphoid tissues (lymph nodes, peyer's patches, tonsils, white pulp of spleen, etc.)
Term
Leukemia is in peripheral blood and bone marrow whereas lymphoma is a solid mass.
Definition
Term
54-year-old patient with weight loss, generalized rubbery adenopathy, and splenomegaly. What does he likely have?
Definition
lymphoma
Term
A biopsy of an enlarged, non-tender posterior cervical lymph node from a 66-year-old female reveals effacement of the nodal architecture by a monomorphous population of lymphocytes with large, dark blue nuclei and scant cytoplasm. The surface immunotyping confirm the cells are of a single clone of B-lymphocytes. What is significant about the cells being monoclonal?
Definition
- monoclonal= malignant

(this pt has lymphoma)
Term
Leukemia is a ___ of the __ ___ ___ that arises in the ___ ___.
Definition
- malignancy of the white blood cells
- arises in the bone marrow

Abnormal peripheral blood and bone marrow. This is bone marrow disease.
Term
50 year old with persistent lymphocytosis due to a chronic leukemia of monoclonal B lymphocytes. These mature lymphocytes are increased markedly in number. They are indicative of chronic lymphocytic leukemia, a disease most often seen in older adults.
Definition
Term
lymphocytosis is indicative of what malignancy?
Definition
- chronic lymphocytic leukemia
Term
benign tumor of fibrous connective tissue?
Definition
- fibroma
Term
malignant tumoor of fibrous connective tissue:
Definition
fibrosarcoma
Term
benign tumor of fat:
Definition
lipoma
Term
malignant tumor of fat:
Definition
liposarcoma
Term
benign tumor of cartilage:
Definition
chondroma
Term
malignant tumor of cartilage:
Definition
chondrosarcoma
Term
benign tumor of bone:
Definition
osteoma
Term
malignant tumor of bone:
Definition
osteosarcoma or osteogenic carcinoma
Term
benign tumor of the blood vessels:
Definition
hemangioma
Term
malignant tumor of blood vessels:
Definition
angiosarcoma
Term
benign tumor of lymph vessels:
Definition
lymphangioma
Term
malignant tumor of lymph vessels:
Definition
lymphangiosarcoma
Term
malignant tumor of mesothelium:
Definition
Mesothelioma
Term
benign tumor of brain coverings:
Definition
meningioma
Term
malignant tumor of brain coverings:
Definition
- invasive meningioma
Term
locations of endothelial related tumors:
Definition
- blood vessels
- lymph vessels
- mesothelium
- brain coverings
Term
tumor locations of mesenchymal origin:
Definition
- fibrous tissue
- fat
- cartilage
- bone
Term
a stratified squamous benign tumor:
Definition
squamous cell papilloma
Term
stratified squamous malignant tumor:
Definition
squamous cell carcinoma
Term
malignant (only malignant) tumor of basal cells of skin or adnexa:
Definition
- basal cell carcinoma
Term
epithelial lining of glands/ducts benign tumors:
Definition
- adenoma
- papilloma
- cystadenoma
Term
epithlial lining of glands/duct malignant tumors:
Definition
- adenocarcinoma
- papillary carcinomas
- cystadenocarcinomas
-
Term
is cystadenoma malignant?
Definition
no
Term
benign tumor of respiratory passages:
Definition
- bronchial adenoma
Term
malignant tumor of respiratory passages:
Definition
- bronchogenic carcinoma
Term
benign tumor of renal epithelium:
Definition
- renal tubular adenoma
Term
renal epithelium malignant tumor:
Definition
- renal cell carcinoma
Term
urinary tract epithlieum benign tumor:
Definition
transitional-cell papilloma
Term
urinary tract malignant tumor:
Definition
transitional cell carcinoma
Term
benign tumor of placental epithelium:
Definition
Hydatidiform mole
Term
malignant tumor of placental epithelium:
Definition
choriocarcinoma
Term
testicular epithelium tumors are always malignant, they may be ___ or ___ ____.
Definition
- seminomas
- embryonal carcinomas
Term
Leukemias come from _____ ____.
Definition
hematopoietic cells
Term
Lymphomas come from ___ ____.
Definition
lymphoid tissues
Term
benign smooth muscle tumors:
Definition
leiomyoma
Term
malignant tumors of smooth muscle:
Definition
leiomyosarcoma
Term
benign tumor of striated muscle:
Definition
rhabdomyoma
Term
malignant tumor of striated muscle:
Definition
rhabdomyosarcoma
Term
look at slides 27-29 of neoplasia lecture and know all types of tumors and their origin and whether benign or malignant
Definition
Term
uterine leiomyomas are commonly called ____. These are the most common tumors in humans. These present in 75% of females of reproductive age. Large tumors may develop areas of ____ to ___ ___ called ___ ___.
Definition
- fibroids
- yellow-brown to red
- red degeneration
Term
a non-malignant polyp is called:
Definition
- colon adenoma, if these are not removed they can become carcinoma
Term
a malignant polyp would be called:
Definition
adenocarcinoma
Term
____ is the term applied to a benign epithelial neoplasm that forms glandular patterns
Definition
Adenoma
Term
Malignant tumors arising in mesenchymal tissue are usually called ____.
Definition
sarcomas
Term
sarcomas:
Definition
malignant tumors that arise from mesenchymal tissue
Term
An ectopic rest of normal tissue is sometimes called a _____.
Definition
choriostoma

- rest of adrenal cells under the kidney capsules
Term
difference b/w choriostoma and choriocarcinoma:
Definition
- choriostoma: ectopic rest of normal tissue cells
- choriocarcinoma: malignant tumor of placental tissue
Term
Aberrant differentiation of cells may produce a mass of disorganized but mature cells or tissue indigenous to the particular site, referred to as a ____. give example:
Definition
- hamartoma

- hamartoma in the lung may contain islands of cartilage, blood vessels, brochial-type structures, and lymphoid tissues
Term
benign tumor of melanocytes:
Definition
nevus
Term
What is the precursor lesion to squamous cell carcinoma of the lungs?
Definition
- normal linging of the bronchus is glandular, thus the precursor lesion is bronchial epithelium metaplasia from glandular to squamous
Term
Leiomyosarcomas are ___ ___smooth muscle neoplasms that arise ___ __ directly from the ____. On histological examination they contain a wide range of ___, from those that are extremely well differentiated to anaplastic lesions.
Definition
- uncommon malignant
- de novo
- myometrium
- atypia
Term
The distinction of leiomyosarcomas from leiomyomas is based on a combination of ___ __ ____ such as ___ __, ___ __, and ___ ___. ___ is important to determine grade.
Definition
degree of differentiation
- nuclear atypia
- mitotic index
- zonal necrosis

Differentiation is important to determine grade.
Term
three factors of differentiation used to determine grade:
Definition
- nuclear atypia
- mitotic index
- zonal necrosis
Term
Leiomyosarcomas metastasize through the ___ to distant organs, like the lungs.
Definition
blood stream
Term
Sarcomas spread _____.
Definition
hematogenously
Term
In untreated malignant tumors, ischemic necrosis occurs. Why?
Definition
- the tumor outgrows its blood supply as it proliferates autonomously
Term
Tumors cannot enlarge beyond __ to __ mm in diameter or thickness without being vascularized. The ___ zone represents the maximal distance across which oxygen and nutrients can diffuse from blood vessels. Beyond this size the tumor fails to enlarge w/o vascularization b/c of ____ ___ ___ ___. This is how ischemic necrosis of malignant tumors occurs.
Definition
- 1-2 mm
- 1-2 mm
- hypoxia-induced cell death
Term
In the absense of inflammatory cells, what type of necrosis is expected in a tumor?
Definition
In the absence of infection, the expected type of necrosis in the tumor is coagulative due to ischemia
Term
Grade 1 of 3:
Definition
well differentiated,looks like normal tissue, you expect it to be less invasive but doesn't always mean noninvasive
Term
Grade 2 of 3:
Definition
- moderately differentiated
Term
Grade 3 of 3:
Definition
poorly differentiated
Term
Squamou cell carcinoma often looks normal and is graded as 1, but its ssquamous cell carcinoma
Definition
Term
grading schema are based on the ____ ___ of a neoplasm with ___ ___. A higher grade means there is ___ diffferentiation and the ___ the biological behavior a malignant neoplasm will be. Grading schema have been devised for many types of neoplasms, mainly carcinomas.
Definition
- microscopic appearance
- H&E staining
- less
- worse
Term
Grade 1 malignant tumors are ___ differentiated or ___ grade. They resemble ___ tissue. Give example:
Definition
- well differentiated
- parent
- example: produce keratin pearls or glandular lumen secretions
Term
Poorly differentiated malignant tumors are ___ grade or grade __ of 3. They have __ differentiating features.
Definition
- high
- grade 3 of 3
- no
Term
Intermediate grade tumors would be grade __ with moderate differentiation.
Definition
2
Term
what is grade IV:
Definition
- anaplastic
Term
Tumor grade should not be confused with the stage of a cancer. Cancer stage refers to the extent or severity of the cancer, based on factors such as the location of the primary tumor, tumor size, number of tumors, and lymph node involvement (spread of cancer into lymph nodes).
Definition
Term
Based on the microscopic appearance of cancer cells, pathologists commonly describe tumor grade by three degrees of severity: Grades 1, 2, and 3. The cells of Grade 1 tumors resemble normal cells, and tend to grow and multiply slowly. Grade 1 tumors are generally considered the least aggressive and the most well differentiated in behavior.
Conversely, the cells of Grade 3 tumors do not look like normal cells of the same type. Grade 3 are poorly differentiated and tend to grow rapidly and spread faster than tumors with a lower grade.
Definition
Term
Malignant tumors are monoclonal This left diagram represents plasma cells secreting immunoglobins. If Immunoglobins have either kappa or lambda light chains, so this is a mixed plasma cell population (or polyclonal derive from multiple cells). The diagram on the right is derived from a single precursor cell, monoclonal.
Definition
Term
breast and lung cancer tend to spread ____.
Definition
lymphatically
Term
Hematogenous Spread: Tumor embolus in esophageal blood vessel A cluster of cancer cells is seen within a small blood vessel in the muscularis. when this occurs it will spread from primary site to secondary site instead of lymph nodes.
Definition
Term
where does colon metastasize to first?
Definition
liver
Term
seeding:
Definition
- droppings from tumor falls onto other surfaces
- ovarian carcinoma tends to do this
Term
most common site for seeding is ___ seeding.
Definition
peritoneal
can also go to liver and lymph nodes
Term
Kidney adenocarcinoma spreads ___ via the ____ ____ to the ___ ___ and then the ___. This is why you have to get a chest xray with kidney cancer.
Definition
hematogenously
renal vein
inferior vena cava
lungs
Term
Prostate, lung, and breast cancers tend to metastasize to ___ via the blood. This forms lytic lesions (destroyed bone) or blastic lesions (builds bone).
Definition
bone
Term
Prostate, lung, and breast cancers tend to metastasize to ___ via the blood. This forms lytic lesions (destroyed bone) or blastic lesions (builds bone).
Definition
bone
Term
Imaging studies demonstrate an irregular ulcerating mass in the middle third of the esophagus with partial obstruction as it protrudes into the lumen. The infiltrating margins extend beyond the esophagus into the mediastinum.
Numerous para-aortic lymph nodes are enlarged. The correct route of this tumor spread is
Definition
local invasion and lymphatic spread
Term
how does esophageal cancer spread?
Definition
local invasion with lymphatic spread
Term
sentinel lymph nodes are especially used in ___ ___ and ____.
Definition
- breast carcinoma
- melanoma
Term
Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a cancer has been detected, often the next step is to find the lymph node closest to the tumor site and retrieve it for analysis. The procedure involves the injection of a dye (sometimes mildly radioactive) to pinpoint the lymph node which is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, including lung and skin (melanoma).
Definition
Term
The concept of the "sentinel" node, or the first node to drain the area of the cancer, allows a more accurate staging of the cancer, and leaves unaffected nodes behind, less likely to get Lymphedema
Definition
Term
A ___ ___ is the first node to which cancer cells likely spread from the primary tumor.
Definition
sentinel node (SLN)
Term
A ___ ___ is the first node to which cancer cells likely spread from the primary tumor.
Definition
sentinel node (SLN)
Term
what type of cancer causes most deaths in males and females?
Definition
bronchogenic (lung) cancer
Term
What is the second most likely cancer to result in death in men?
Definition
prostate and colon and rectum are tied
Term
What is the second and third most likely cancer to kill women?
Definition
- breast cancer
- colon and rectal cancer
Term
Familial adenomatous polyposis is development of sheets of ___ in colon in the teens and twenties, with devlopment of __ ____ from malignant transformation of the ___ by age 50. This is due to the inactivation of the ___ __ ___. Just if one polyp undergoes malignant transformation, colon cancer develops.
Definition
- polyps
- colorectal cancer
- polyps
- inactivation of the APC suppressor gene
Term
___ ___ ___ is an important precursor lesion to colon adenocarcinoma.
Definition
Familial adenomatous polyposis (FAP)
Term
what is the treatment for familial adenomatous polyposis?
Definition
colon resectoin
Term
Familial adenomatous polyposis: development of colorectal cancer from malignant transformation of polyps by age 50; inactivation of APC suppressor gene. Polyps identified at colonoscopy
Definition
Term
___ is a selected inherited cancer syndrome that is a malignancy of the eye. 40% of these cases are inherited. A ___ mutation inactivates the ___ ___ gene on chromosome ___. So one gene gets inactivated in germ cells, and the other gets inactivated after birth (2 hit theory).
Definition
- Retinoblastoma
- point mutation
- RB suppressor gene
- chromosome 13
Term
Name two Selected Inherited Cancer Syndromes:
Definition
- Familial Adenomatous Polyposis
- Retinoblastoma
Term
figure out and define terms BRCA1 and BRCA2 genes.
Definition
Term
list the pre-neoplastic conditons that may progress to carcinoma:
Definition
- endometrial hyperplasia
- cirrhosis
- chronic gastritis
- ulcerative colitis
- colon adenoma
- dysplastic bronchial mucosa
Term
Pre-neoplastic dysplasia is ___ ___ of cells with loss of ___ ___. This is a precursor to ___.
Definition
- disorderly proliferation
- loss of cell maturation
- precursor to cancer
Term
what are two signs of preneoplastic dysplasia?
Definition
- increased nuclear and chromatin size
- increased mitotic activity
Term
PAP smears screen for dysplasia.
Definition
Term
Preneoplastic cervical dysplasia is classifed as ___ ____, ___ ___, or ___ ____ ___, which means there is ___ ___ ___.
Definition
- mild CIN I
- moderate CIN II
- severe CIN III, means there is carcinoma in situ
Term
Preneoplastic cervical dysplasia rarely has symptoms and just detected with an abnormal PAP smear. A PAP smear is a screening test, meaning it is ____.
Definition
sensitive
Term
After an abnormal PAP smear screen, the definitive diagnosis is made by biopsies taken during a _____. This would be ___ test that is ___.
Definition
- colposcopy
- diagnostic
- specific
Term
Dysplasia graded mild, mod. Severe:
mild- 1/3 involved cervix
Moderate- half of cervix
Severe- all of cervix thickness
Definition
Term
invasive carcinoma has gone beyond the basement membrane of the cervix.
Definition
Term
cervical dysplasia is also known as:
Definition
cervical intraepithelial neoplasia (CIN)
Term
dysplasia is ___ cancer, but can develop into cancer.
Definition
NOT
Term
Endometrial hyperplasia is preneoplastic lesion that increases risk for ___ ____. Endometrial hyperplasia usually results from prolonged ___ ___ and can lead to ____, irregular bleeding, ____, excessive bleeding, or _____.
Definition
- endometrial adenocarcinoma
- excess estrogen
- metorrhagia
- menorrhagia
- menometorrhagia
Term
GERD causes ____, which can lead to ___, which can lead to ____.
Definition
metaplasia
dysplasia
adenocarcinoma
Term
___ ____, aka as ___ ___, is a premalignant condition of thick,scaly, or crusty growth of skin. This is where collagen of the skin has broken down. Some of these progress to ___ ___ ___. Common in fair people where sun exposure occurs: face, ears, neck, scalp, chest, back of hands, forearms, or lips.
Definition
Actinic Keratosis, aka solar kerotosis
squamous cell carcinoma
Term
All colon polyps=adenomas arise as the result of epithelial proliferative dysplasia, which may range from low-grade to high-grade dysplasia (carcinoma in situ
Definition
Term
Colonic polyps (adenomas) are slow-growing overgrowths of the colonic mucosa that carry a small risk (<1%) of becoming malignant.
However, because colonic adenomas (polyps) are highly prevalent in the general population (especially with increasing age), they confer an important predisposition to colon cancer and are therefore removed when detected.
Remove the entire polyp to search for adenocarcinoma.
). All colon adenomas arise as the result of epithelial proliferative dysplasia, which may range from low-grade to high-grade dysplasia (carcinoma in situ
There is strong evidence that adenomas are a precursor lesion for invasive colorectal adenocarcinomas
Definition
Term
A change in bowel habits prompted a 53-year-old female to see her physician, who found that she has a positive stool guaiac. This was her first colonoscopy (she avoided the screening colonoscopy ate age 50yearsA colonoscopy revealed a 3-cm sessile mass in the cecum. A polypectomy (complete resection) of this mass demonstrated t adenocarcinoma with adjacent tubular adenoma. How should a surgeon deal with this information?
Definition
resect the cecum and right colon to prevent metastasis
Term
Cervical Papanicolaou (Pap) smears
Colonoscopy
Mammography
Prostate-specific antigen (PSA)

These are all screening tests, meaning they are ___.
Definition
sensitive
Term
Which of the following diagnostic screening techniques used in health care has had the greatest impact reduction in cancer deaths in developed nations?
Definition
Pap smear of the cervix
Cervical Pap smear: most responsible for ↓ incidence/mortality rate for cervical cancer
Term
PAP smear:
Definition
Decreases risk for cervical cancer
Cervical cancer is the least common gynecologic cancer in the United States.
Pap smear detects cervical dysplasia, which can be surgically removed.
Detection of low-grade dysplasia-sensitivity ∼70%, specificity 75%
Detection of high-grade dysplasia-sensitivity 75%, specificity 95%
Term
A 39-year-old female has an abnormal Pap smear. Cervical biopsy of 1.0-cm, red, slightly raised lesion on the anterior ectocervix shows viral and dysplastic changes. Which of the following statements best characterizes her condition?
These are premalignant changes identified on cancer screen.
Definition
Term
Cervix carcinoma in situ (CIS) can be identified via ___ __ and ___ ___. This condition involves the __ ___ of epithelium.
Definition
- pap smear
- cervix biopsy
- entire thickness
Term
Xeroderma pigmentosum is a __ ___involving defective __ ___ __. These patients have a greater risk of developing ___ of the ___ when exposed to UV rays b/c UV light causes damage to DNA that is not repaired by the nucleotide excision repair pathway.
Definition
- inherited disorder
- defective DNA repair genes
- cancers of the skin
Term
what is the translocation of chronic myelogenous leukemia:
Definition
- 9,22
- chromosome 22 is Philadelphia's chromosome
- this is a balanced translocation
Term
What is the translocation in Burkitt's lymphoma?
Definition
- 8, 14
- balanced translocation
Term
what is the Philadelphia chromosome?
Definition
chromosome 22, responsible for chronic myelogenous leukemia
Term
With chronic myelogenous luekemia, the t9;22 translocation of the ___ ____ occurs. Then the __ ___ fuses with with the ___ ___ __ on chromosome ___ forming the ___ ___ ___ ___. Chromosome __with this translocation is called the ___ ___.
Definition
- ABL proto-oncogene
- ABL proto-oncogene
- break cluster region (BCR)
- 22
- BCR-ABL fusion gene
- 22
- Philadelphia chromosome
Term
What are the four oncogenic DNA viruses implicated in the causation of human cancers ?
Definition
- Papillomavirus (HPV)
- Epstein-Barr virus (EBV)
- Hepatitis B virus (HBV)
- Hepatitis C virus (HCV)
Term
Hepatitis B causes ___ cancer, thus the hep B vaccine was the first vaccine against a cancer.
Definition
hepatocellular
Term
Epstein barr causes what type of cancer?
Definition
epstein barr> lymphoma, nasopharyngeal carcinoma
Term
HIV can cause?
Definition
lymphoma and other types of cancers
Term
cytomegalovirus and herpes simplex virus are not linked to any cancer.
Definition
Term
HPV can cause:
Definition
squamous cell carcinoma of vulva, vagina, cervix, anus (associated with anal intercourse), larynx, oropharynx
Term
Human T-cell leukemia virus type 1 is linked to what cancer?
Definition
leukemia
lymphoma
Term
Recognize there is much evidence linking gastric infection with the bacterium Helicobacter pylori (H. pylori) to the causation of gastric carcinomas and gastric lymphomas.
Definition
Term
Those with 3rd degree burn scars and/or chronically draining sinus orifices aka chronic osteomyelitis are at risk for?
Definition
- squamous cell carcinoma
Term
greatest risk for development of melanoma-Ultraviolet Radiation 
Definition
Term
TEST: TNM: TUMOR NODAL METASTASIS: KNOW THIS
Definition
Term
when penetrating wall of colon first will hit mucosa, then muscerlaris, then subserosal fat
Definition
Term
polypoid moderately differentiated adenocarcinoma extending from the mucosal surface through the wall into the muscular propia into the subserosal fat. The three of the twelve regional lymph nodes are enlarged with areas of necrosis.
What is the best explanation for the enlarged lymph nodes?
Definition
lymphatic spread and/or local invasion and lymphatic spread

local spread into the wall, then lymphatic spread to regional lymph nodes, later hematogenous spread to liver.
Term
The TNM system stands for ___ ___ ___. The T refers to __ ___, greater than or equal to __ ___ correlates with ___ ____. N refers to whether ___ ___ are involved. M refers to ___ ___ (liver, lung, etc.)
Definition
- Tumor Nodal Metastasis
- tumor size
- 2 cm
- metastatic ability
- lymph nodes
- extranodal metastasis
Term
56 –year-old smoker has a lung lesion that extends from an ulcerated bronchial wall into the lung parenchyma as clusters of atypical squamous cells. The squamous cells differentiation consistent of nuclear pleomorphism, anaplasia, increased mitotic activity, and nuclear hyperchromatism. The cells infiltrate and destroy the surrounding local structures. Hilar lymph nodes show metastasis with a similar proliferation of squamous cells. Sections of the vertebral bone show metastasis with similar cells.
What is most likely the diagnosis?
Definition
Squamous cell carcinoma with vascular and lymphatic metastasis
Squamous cell carcinoma of the lung may invade by a variety of paths.
Extension may occur to the pleural surface and then within the pleural cavity or into the pericardium…
Term
Distant spread of lung carcinoma occurs through ___ and ___ spread. It spreads to ___, ___, and ___ nodes in most cases. Main sites of metastasis inlcude the ____, ___, ___, and ___.
Definition
- hematogenous and lymphatic
- tracheal, bronchial, and mediastinal
- adrenals, liver, brain, bone
Term
With lung cancer, why are squamous cells in the bronchial epithelium,
rather than the respiratory glandular epithelium?
Definition
metaplasia due to chronic irritation
Term
The most common epithelial metaplasia is ___ to ___ as occurs in the respiratory tract in response to chronic irritation. In the habitual smoker, normal ___ ___ epithelial cells of the trachea get replaced by ____ ___ cells. Thus, the most common form of cancer in the respiratory tract is ___ ___ ___.
Definition
- columnar to squamous
- normal ciliated columnar
- stratified squamous
- squamous cell carcinoma
Term
Squamous cell carcinoma of the lung begins as an area of in situ cytologic squamous dysplasia that, over an unknown interval of time, yields a small area of thickening or piling up of bronchial mucosa. With progression, this small focus elevates or erodes the lining epithelium. The tumor may then invade by a variety of paths
Definition
Term
Osteosarcoma is defined as a ___ ___ tumor in which the cancerous cells produce ___ ___, try to behave like normal osteoblasts.
Definition
- malignant mesenchymal
- bone matrix
Term
what is the expected route of spread of an osteosarcoma?
Definition
- vascular spread to the lung/other distant sites
Term
Osteosarcoma frequently breaks through the ___ and ____ the surrounding structures. These aggressive neoplasms spread through the ____ and at the time of diagnosis, 10-20% of patients have ___ metastasis. In those who die of metastasis, 90% have spread to the brain, lung, bones, and elsewhere all via bloodstream spread.
Definition
- cortex
- invades
- blood stream
- pulmonary
Term
Osteosarcoma first spreads via the blood to the ___.
Definition
lungs
Term
Chondrosarcoma (malignant cartilage) with vascular (hematogenous) to lung.
Definition
Term
What type of cancers cause hypercalcemia due to ectopic production of parathyroid hormone related protein? This hypercalcemia is a paraneoplastic syndrome.
Definition
- renal cell carcinoma
- primary sqaumous cell carcinoma of the lung
- breast carcinoma
Term
What type of cancers cause secondary polycythemia (too many red blood cells) due to erythropoietin production? This type of elevated RBCs is a paraneoplastic syndrome.
Definition
- renal cell carcinoma
- hepatocellular carcinoma
Term
What type of cancer causes superficial migratory thrombophlebitis due to release of procoagulants, and what is this sign called?
Definition
- pancreatic cancer
- Trousseau's sign- another paraneoplastic syndrome
Term
what paraneoplastic syndrome does pancreatic cancer cause?
Definition
pancreatic cancer > release of procoagulants> superficial migratory thrombophlebitis (Trousseau's sign)
Term
what type of paraneoplastic syndromes does renal cell carcinoma cause?
Definition
renal cell carcinoma> ectopic release of parathyroid hormone like protein> hypercalcemia

renal cell carcinoma> produce eryhtropoeitin> polycythemia
Term
what cancers cause hypercalcemia and by what method?
Definition
- renal cell carcinoma, primary squamous cell carcinoma of lung, breast cancer> ectopic production of parathyroid like hormone> hypercalcemia
Term
what cancers cause polycythemia and by what method?
Definition
- renal cell carcinoma and hepatocellular carcinoma> erythropoeitin production> polycythemia
Term
what cancer causes thrombophlebitis and by what method?
Definition
- pancreatic carcinoma> releases procoagulants> thrombophlebitis
Term
What is an associated reaction to bronchogenic carcinoma?
Definition
- hypertrophic osteoarthropathy
Term
what type of cancers cause Cushing Syndrome as a secondary paraneoplastic syndrome and how do they do this?
Definition
small cell lung carcinoma and thyroid carcinoma> ectopic production of ACTH> Cushing Syndrome (paraneoplastic syndromes)
Term
List common paraneoplastic syndromes endocrinopatheis and what they are caused by:
Definition
- Cushing syndrome: small cell carcinoma of lung and thyroid cancer> ectopic production of ACTH> Cushiings syndrome

- Hypercalcemia: Renal cell carcinoma, Primary squamous cell carinoma of lung, breast carcinoma> ectopic production of parathyroid like hormone> hypercalcemia

- Polycythemia. Renal cell carcinoma and hepatocellular carcinoma> eryhtropoietin production> polycythemia

- Thrombophlebitis. Pancreatic cancer> procoagulants (Trousseau's sign)> migratory thrombophlebitis
Term
Carcinoembryonic antigen (CEA):
Definition
- glycoprotein involved with cell adhesion
- It is normally produced during fetal development, but the production of CEA stops before birth. Therefore, it is not usually present in the blood of healthy adults
- ASSOCIATED WITH COLORECTAL AND PANCREATIC CARCINOMAS
Term
Alpha fetoprotein (AFP):
Definition
- a major plasma protein produced by the yolk sac and the liver during fetal life.
- These AFP levels gradually decrease after birth down to the low
- associated with HEPATOCELLULAR CARCINOMA and YOLK SAC TUMOR/ENDOMETRIAL SINUS TUMOR OF OVARY OR TESTIES
Term
Prostate Specific Antigen:
Definition
- protein produced by cells of the prostate gland
- ASSOCIATED WITH PROSTATE CARCINOMA AND PROSTATE HYPERPLASIA
Term
cancer cachexia:
Definition
- wasting disease
- generalized catabolic reaction: anorexia, muscle wasting, loss of subcutaneous fat, fatigue
- Mechanism: macrophages and cancer cell secrete high levels of tumor necrosis factor a (cachectin)> suppresse appetite center in hypothalamus and stimulates apoptosis of cells
Term
define term paraneoplastic syndrome:
Definition
- distant effects of a tumor that are unrelated to metastasis
- occur in 10-15% of patients
- involve multiple organ systems and mimic metastatic disease
- may involve ectopic secretion of hormone
Term
Acanthosis nigricans is a paraneoplastic syndrome associated with ___ ___.
Definition
stomach carcinoma
Term
Eaton-Lambert syndrome is a paraneoplastic syndrome associated with __ __ ___ _ ___. This causes ___ __ like with Myasthenia gravis. There is an antibody directed agains calcium channels.
Definition
- small cell carcinoma of the lungs
- muscle weakness
Term
Hypertrophic osteoarthropathy is associated with ___ ___, this is a reaction of the distal phalanx, often involving clubbing.
Definition
Bronchogenic carcinoma
Term
Nonbacterial thrombotic endocarditis is a paraneoplastic syndrome associated with __ ___ ____ ___ and ____ ___. This causes sterile vegetations on the mitral valve.
Definition
- mucus secreting pancreatic carcinoma
- colorectal carcinoma
Term
Seborrheic keratosis is a paraneoplastic syndrome associated with ___ ___.
Definition
stomach carcinoma
Term
Nephrotic syndrome is paraneoplastic syndrome associated with __, __, and ___ carcinomas. This causes diffuse membrane glomerulopathy.
Definition
- lung, breast, stomach
Term
Grading is about degree of differentiation with 1 being well differentiation and 3 being poorly differentiated. Staging is about TNM (tumor size, N where or not lymph nodes are involved, M refers to extranodal metastasis). Staging is most important prognostic factor.
Definition
Term
WELL DIFFERENTIATED = ___ GRADE.
Definition
LOW (1)
Term
what are some tumor like conditions:
Definition
- Hamartoma: non-neoplastic overgrowth of disorganized tissue indigenous to particular site

- Choristoma= heterotropic rest: non-neoplastic normal tissue in a foreign location (pancreatic tissue in the stomach wall or parietal cells in Meckel diverticulum)
Term
components of tumors are the parenchyma and the stroma. Describe each.
Definition
Parenchyma: neoplastic component that determines the tumors biological behavior

Stroma: non-neoplastic supportive tissues, most infiltrating carcinomas induce production of dense, fibrous stroma
Term
poorly differentiated = ___ grade aka ____
Definition
high grade
anaplastic
Term
mixed tumor :
Definition
usually benign
neoplastic cells have 2 differnt morphologic patters but derive from same germ cell layer

example: pleiomorphic adenoma of parotid gland
Term
pleomorphism:
Definition
variability in the size and shape of cells and/or their nuclei. It is a feature characteristic of malignant neoplasms.
Term
breast carcinoma metastasizes to :
Definition
bone
Term
mutations of the proto-oncogenes can lead to ___ activity of the gene, the mutant alleles are known as ____.
Definition
- sustained
- oncogenes
Term
Mutations of suppressor genes ___ and ___ result in unregulated cell proliferation.
Definition
- RB and p53
Term
Proto-oncogenes are involved in normal growht and repair. These genes make growth factors, growth factor recptors, signal transducers, nuclear transcribers. Mutations cause sustainted activity of these genes.
Definition
Term
Suppressor genes aka ____ protect against ___ cell growth. They control _ and _ phase of the cell cycle and nuclear transcription. Mutations cause ___ ___ ____.
Definition
- anti-oncogenes
- unregulated
- G1 and S
- unregulated cell proliferation
Term
Antiapoptosis genes are the ____ family of genes. The protein products from the genes prevent ___ ___ from leaving ___. __ __ in the cytosol activates ___ initiating apoptosis. Mutation causes increased gene activity which ____ apoptosis resulting in ___ ___ ____.
Definition
- BCL2
- cytochrome C
- mitochondria
- cytochrome C
- apoptosis
- prevents
- B cell follicular lymphoma
Term
Normally the BCL2 gene family on chromosome 18 makes gene products that prevent mitochondrial leakage of cytochrome c. A translocation t(14,18) causes overexpression of BCL2 protein product which ___ apoptosis of B lymphoctyes and causes B cell follicular lymphoma.
Definition
prevent
Term
Apoptosis genes regulate programmed cell death. The ___ apoptosis gene is activated by a ___ ___ ___ product if DNA damage is excessive. The __ protein inactivates ___ ___ ___.
Definition
- BAX apoptosis
- TP53
- BAX
- BCLW antiapotosis gene
Term
normal:

excessive DNA damage> TP53 gene product>(activates)> BAX gene> BAX protein inactivates BCL2 genes> apoptosis occurs
Definition
Term
A mutation that inactives TP53 suppressor gene makes the BAX gene ____, which prevents ____ .
Definition
- inoperative
- apoptosis
Term
4 genes involved in cancer:
Definition
- proto-oncogene
- suppressor/anti-oncogenes
- antiapoptosis genes (BLR-2)
- apoptosis genes (BAX)
Term
mutation in the RB suppressor gene results in:
Definition
- retinoblastoma
- breast carcinoma
- osteogenic carcinoma
Term
mutation in TP53 suppressor gene results in:
Definition
- lung carcinoma
- breast carcinoma
- colon carcinoma
- Li-Fraumeni syndrome
Term
H.pylori infections cause gastric carcinomas and gastric lymphomas
Definition
Term
ionizing radiation causes ___ ___ __. most common cancer caused by this is ___.
Definition
hydroxyl free radicals
leukemia
Term
UV light causes ___ ___. most common cancer caused by uv light is __ ___ ___.
Definition
pyrimidine dimers
basal cell carcinoma
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