Term
| What does neoplasia mean and is it due to? |
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Definition
Neoplasia = New growth
Loss of responsiveness to normal growth controls |
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Term
| What is swelling, clinically used interchangeably with “neoplasm” |
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Definition
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Term
| What is the study of tumors? |
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Definition
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Term
| A cancer is a malignant or benign neoplasm? |
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Definition
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Term
| How do we characterize tumors? |
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Definition
| Clinical aggressiveness of neoplasm |
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Term
| What are tumors composed of? |
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Definition
-parenchyma (the neoplastic cells which determines biologic behavior)
-stroma (supporting connective tissue, blood supply) |
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Term
| What are tumor names derived from? |
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Definition
| the parenchymal component (the type of neoplastic cell that makes up the tumor) |
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Term
| If something ends with the suffix "-oma" it is a ______ neoplasm |
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Definition
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Term
| What is a benign mesenchymal neoplasia composed of fibrous connective tissue called? |
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Definition
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Term
| What is a benign mesenchymal neoplasia composed of cartilage called? |
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Definition
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Term
| What is a benign epithelialvneoplasm with glandular tissue called? |
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Definition
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Term
| What is a benign epithelial neoplasm with papillary (finger-like projections with fibrovascular core covered by epithelial cells) growth pattern called? |
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Definition
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Term
| What is a benign glandular neoplasm with a cystic growth pattern called? |
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Definition
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Term
| In a breast biopsy, you see a lesion of papillary architecture with a fibrovascular core covered by epithelium within an expanded duct. What type of neoplasia is this? |
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Definition
| intraductal papilloma neoplasia |
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Term
What are mesenchymal cancers called?
a malignant neoplasm from fibrous origin is?
a malignant neoplasm arising from cartilage is? |
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Definition
sarcomas
fibrosarcoma
chondrosarcoma |
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Term
What are epithelial cancers called?
a malignant neoplasm of squamous origin?
a malignant neoplasm of glandular epithelial origin?
a carcinoma that arose from the basal cell epithelial layer of the skin? |
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Definition
carcinomas
Squamous cell carcinoma
Adenocarcinoma
Basal cell carcinoma |
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Term
| If you had an ovary with a cyst in the middle with nodules and fine papillations. It is an epithelial tumor of the ovary. What would you call it? |
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Definition
| papillary cystadenocarcinoma |
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Term
Neoplasms are ________ (arise form a single cell which has undergone neoplastic transformation)
Stem cells may undergo divergent differentiation leading to __________. |
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Definition
Neoplasms are monoclonal (arise from a single cell which has undergone neoplastic transformation)
Stem cells may undergo divergent differentiation leading to heterogeneity |
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Term
| What are the mixed tumors? |
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Definition
Pleomorphic adenoma (benign neoplasm in the parotid gland)
Teratoma (an ovarian tumor)
Fibroadenoma (appearance only-breast tumor with fibrous [neoplastic] and epithelial component) |
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Term
What is the most common mixed tumor of the parotid gland?
What are the 2 components of the tumor? |
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Definition
pleomorphic adenoma
a mesenchymal component of cartilage and a glandular epithelial component |
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Term
Are the following benign or malignant tumors?
Lymphoma
Mesothelioma
Melanoma
Seminoma
Hepatoma
Choristoma |
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Definition
All malignant (names that break the rules)
b. Lymphoma is the malignancy of lymphocytes.
c. Mesothelioma is the malignancy of the mesothelia of the pleural cavity associated with asbestos exposure. (encases the lung)
d. Melanoma-malignancy of melanocytes usually on the skin but can also occur on mucosal sites like within the eye.
e. Seminoma-a malignant germ cell tumor that arises in the testes.
f. hepatoma- an old name for a hepatocellular carcinoma |
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Term
| If a benign nevus becomes malignant, it is known as a ______ characterized by (grossly and histologically)? |
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Definition
melanoma
melanoma which has irregular borders and variation in pigmentation (grossly)
Large melanocytes with variability in nuclear size with some moving up into epidermis (pagetoid spread) |
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Term
| What is the first feature we look at to determine if it is benign or malignant and how do we do this? |
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Definition
Degree of differentiation with a microscope
-How closely do the parenchymal cells resemble normal cells of this type
-Benign neoplasms are usually “well-differentiated” (look closely like the normal cell)
-Anaplasia = lack of differentiation (bizarre nuclei, atypical mitoses, loss of cell polarity) |
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Term
So if we have a benign tumor arising from the epithelial cells of the thyroid (glandular neoplasm) what are we going to call it?
This arises from the follicular cells so we call this? |
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Definition
Adenoma
follicular thyroid adenoma |
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Term
| If you saw squamous cells in a disorganized growth pattern and not forming layers/not maturing, what would you call this? |
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Definition
| squamous cell carcinoma (cells diverging from the normal) |
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Term
| If we have a bizarre pleomorphic nuclei and some multi nucleation within the cell (atypical mitosis within neoplasm), what would this be? |
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Definition
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Term
In general, function correlates with ________
What kind of unanticipated functions can emerge? |
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Definition
differentiation
Ectopic hormones
Fetal proteins |
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Term
| What are all the factors that we consider when trying to decide whether it is benign or malignant? |
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Definition
1. Degree of differentiation
2. Rate of growth
3. Local Invasion
4. Metastasis |
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Term
All benign tumors grow slowly while all cancers grow fast.
True or false? |
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Definition
False
Most benign tumors grow slowly while most cancers grow fast (there are many exceptions) - takes years to become clinically apparent |
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Term
| Rate of growth for malignant tumors correlates (inversely or directly) with degree of differentiation? |
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Definition
Rate of growth for malignant tumors correlates inversely with degree of differentiation
(well-differentiated cancer tends to grow slower than anaplastic cancer) |
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Term
| Rapid growth of tumors may lead to ______ |
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Definition
| Rapid growth may lead to necrosis = malignant |
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Term
Local invasion is a characteristic of (benign or malignant)?
Benign neoplasms often develop a ______ capsule. |
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Definition
malignant (invasion=surrounding tissue)
Benign neoplasms often develop a fibrous capsule (slow growth pushes/compresses tissue to form capsule at edge of lesion) |
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Term
| What are secondary, remote implants of tumor? |
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Definition
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Term
| What is the most important hallmark of malignancy? |
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Definition
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Term
| What are the methods of metastasis? |
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Definition
Seeding (ovarian tumors seed the abdominal cavity)
Lymphatic spread (lymph nodes)
Hematogenous spread (goes different organs or bones) |
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Term
| If you see multiple nodules/lesion within an organ, what does that give you a clue of? |
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Definition
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Term
A benign neoplasm of smooth muscle is known as _______
A malignant neoplasm of smooth muscle is known as _____ |
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Definition
leiomyoma
leiomyosarcoma (sarcoma bc it's a malignant mesenchymal neoplasm) |
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Term
Label the following characteristics as benign or malignant
Noninvasive
Large
Nonmetastatic
Poorly differentiated
Poorly demarcated
Rapid growth with hemorrhage and necrosis |
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Definition
Noninvasive-benign
Large-malignant
Nonmetastatic-benign
Poorly differentiated-malignant
Poorly demarcated-malignant
Rapid growth with hemorrhage and necrosis-malignant |
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Term
| If a patient has decreased body fat, weakness, anorexia, anemia, increased infections, abnormalities of taste, increased metabolic rate then you would say they have ______ |
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Definition
| Cachexia (clinical feature of malignancy) |
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Term
| Cachexia correlates with __________ |
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Definition
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Term
If a patient has symptoms that can’t be explained by spread of the tumor or by indigenous hormones
(Endocrinopathies, Nerve and muscle disorders, Vascular and hematologic changes (thrombosis)), you would say they have ____________ |
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Definition
| Paraneoplastic syndromes (clinical feature of malignancy) |
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Term
What is NOT a method to diagnose cancer?
Biopsy
Fine-Needle aspiration
Exfoliative cytology
Protein electrophoresis
Biochemical markers |
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Definition
Protein electrophoresis
Correct ones:
Biopsy – tissue diagnoisis
Fine-Needle aspiration (FNA)-cytologic
Exfoliative cytology (pap smear)
Biochemical markers (PSA, CEA, Alpha-fetoprotein) |
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Term
What can you NOT identify from cytology?
Cell type
Invasion
Degree of differentiation
Nuclear pleomorphism |
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Definition
| Invasion ( can't make that assessment without intact organ) |
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Term
Which is a stronger predictor of prognosis than grade
? Grade or Stage? |
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Definition
| Stage (Pathologic and clinical findings describing the extend of disease) |
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Term
| What is the determination of the degree of differentiation- it's well differentiated, moderately differentiated, or poorly differentiated. This correlates with? |
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Definition
| Grade correlates with aggressiveness (poorly differentiated tumors=more aggressive/grow faster) |
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Term
| What is the pathologic and clinical findings describing the extend of disease? |
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Definition
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Term
What does you use to stage all malignancies?
Size and invasiveness of tumor?
presence or absence of nodal metastases?
presence or absence of distant metastases? |
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Definition
AJCC Stage – I-IV
T – size and invasiveness of tumor
N – presence or absence of nodal metastases
M – presence or absence of distant metastases |
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Term
What is a pre neoplastic change usually in epithelia (cervix, oral mucosa)
What is a pre neoplastic change in the GI tract? |
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Definition
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Term
| If a patient has a dysplasia or adenoma does it mean that they will have cancer? |
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Definition
| Patients at increased risk of developing cancer, but lesion may not progress |
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Term
If we saw atypia thickness of lesion in squamous epithelium going to the midpoint we call it?
If it goes to full thickness?
If there is invasion through the basement membrane? |
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Definition
moderate dysplasia
in situ
invasive cancer |
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Term
| a benign (encapsulated) tumor fat is called? |
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Definition
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Term
| What would you call a lip lesion with infiltration? |
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Definition
| squamous cell carcinoma (malignant) |
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Term
| Tumors are _________, resulting from accumulation of nonlethal genetic damage. |
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Definition
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Term
| What are the targets of genetic damage in carcinogenesis? |
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Definition
Protooncogenes (growth promoting)
Tumor suppressor genes (growth inhibiting)
Apoptosis regulating genes
Genes regulating repair |
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Term
| Carcinogenesis is ___________ process |
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Definition
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Term
| What are genes which function to promote normal growth and differentiation. |
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Definition
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Term
| What are derived from protooncogenes with activation and loss of normal regulatory control. |
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Definition
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Term
| Oncogene transcription and production of oncoproteins is (dependent or independent) of growth factors or other external signals. |
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Definition
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Term
| What are the 2 changes that causes activation of oncogenes? |
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Definition
Changes in the structure of the gene
Changes in regulation of gene expression (increased production of a normal growth-promoting protein. |
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Term
| What encodes proteins that inhibit cell proliferation? |
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Definition
| Cancer suppressor genes (antioncogenes, tumor suppressor genes) |
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Term
What is Knudsen's two-hit hypothesis?
What is a classic example of this? |
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Definition
Both alleles of a tumor suppressor gene must be mutated for loss of inhibitory function
Retinoblastoma protein (RB) |
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Term
What is the rare ocular tumor of childhood that is is caused by loss of tumor suppressor gene function (both alleles mutated)?
60% ______ (sporadice or familial)? |
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Definition
Retinoblastoma
60% sporadic, 40% familial |
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Term
Retinoblastoma protein plays a central role as a gatekeeper in progression into the ___ phase of the cell cycle.
Which state (hypophosphorylated or hyperphosphorylated) activates transcription and which state prevents transcription? |
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Definition
S phase
hypophosphorylated state- prevents transcription
hyperphosphorylated/activated state-drives transcription |
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Term
| Wht is the single most common target (gene arrests cell cycle to allow for DNA repair) for genetic alteration in human tumors |
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Definition
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Term
| If an individual is born with one defective p53 gene, they have _________ syndrome (results in tumors growing in multiple organ sites-epithelial and mesenchymal tumors) |
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Definition
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Term
| What is the clinical development and progression of Colorectal Carcinoma? |
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Definition
1. Normal mucosal surface and crypt epithelium
2. Aberrant crypt foci (histologic, no clinical correlate)
3. Adenomatous polyp
4. Invasive carcinoma
5 Metastatic carcinoma |
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Term
In the progression of colon cancer, when there is a loss of the APC gene (adenomatous polyposis coli gene) that is seen in ___________ (cells look normal).
When there is a mutation/activation of the oncogene ras, that forms an _______.
As that progresses and grows larger, we may see a loss of the DCC gene (a tumor suppressor gene).
finally when there is a loss of p53 (a tumor suppressor gene), we have an _______. |
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Definition
aberrant crypt foci
adenoma
invasive carcinoma |
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