Neoplasia

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Author:
thezidane
ID:
40929
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Neoplasia
Updated:
2010-10-10 10:43:14
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pathology
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Description:
Overview of Neoplasia I, II, III
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  1. define neoplasia
    "new growth"; lack of responsiveness to normal growth controls
  2. define benign neoplasm
    remains localized, amenable to surgical removal and patient survival
  3. define malignant neoplasm
    "cancer"; potential to invade and destroy adjacent normal tissue and spread to distant anatomic sites (metastisis). may cause death.
  4. Define parenchyma
    transformed or neoplastic cells; determines biologic behavior of the particular neoplasm
  5. define stroma
    supporting tissue of the tumor: non-neoplastic blood vessels and CT
  6. what suffix is used for benign tumors?
    "-oma", ex. Chondroma: benign tumor of cartilaginous origin.
  7. what suffix is used for malignant mesenchymal neoplasms?
    "-sarcoma"; ex. Osteosarcoma: malignancy of osseous tissue.
  8. what suffix is used for malignancies of epithelial origin?
    "carcinoma"; ex. Squamous cell carcinoma or adenocarcinoma (malignancy of glandular epithelial origin)
  9. What are two exceptions to the malignancy suffix rule?
    Lymphoma and Melanoma (both are malignant instead of benign)
  10. Define anaplasia
    degree parenchmyal tissue of a neoplasm resembles the parent tissue, functionally and morphologically
  11. malignancies composed of poorly differentiated cells are described as being this.
    What is anaplastic---correct for $200!!
  12. define dysplasia
    altered growth pattern that may become cancerous eventually
  13. what is the most severe form of dysplasia?
    carcinoma-in-situ. contains microscopic features of cancer but the atypical cells have not invaded the host yet
  14. describe the growth rates for benign and malignant neoplasms
    • benign: grow slowly
    • malignant: most grow rapidly
  15. most benign tumors have this band of fibrous connective tissue on the periphery
    what is a "capsule"
  16. what are 2 common exceptions to benign tumors with capsules?
    hemangioma and neurofibroma
  17. define metastisis
    process of portions of a malignancy breaking free and traveling to distant sites to form new tumor masses
  18. what two malignancies readily metastasize?
    osteosarcoma and melanoma
  19. what malignancy rarely metastasizes?
    basal cell carcinoma
  20. what percent of newly diagnosed patients with solid tumors will present with metastases?
    30%
  21. how are anaplasia and metastasis related?
    greater anaplasia = greater tendency to metastasize
  22. what are 3 ways in which malignancies spread?
    • 1. seeding within body cavities
    • 2. lymphatic spread
    • 3. hematogenous spread (by blood)
  23. which method of metastasis is favored by sarcomas?
    hematogenous
  24. what are the two most frequent sites for metastatic deposits via hematogenous spread and why?
    lung and liver. the lungs act to filter the blood above the diaphram while the liver filters blood below the diaphram
  25. what are the 3 categories for genetically influenced cancers?
    • 1. inherited cancer syndromes (autosomal dominant like retinoblastoma)
    • 2. familial cancers (breast, ovarian, colon)
    • 3. defective DNA repair syndromes (xeroderma pigmentosum)
  26. define Aquired Preneoplastic Disorder
    cancer arising from disorder within the life of the patient (not inherited or environmental necessarily)
  27. list 4 acquired preneoplastic disorders
    • 1. persistent regenerative cell replication
    • 2. hyperplastic and dysplastic proliferations
    • 3. leukoplakia of oral mucosa/vulva/penis
    • 4. villous adenomas of the colon
  28. what is the predominant reason of carcinogenesis?
    nonlethal genetic damage. most cancers are clonal proliferations that arise from one genetically altered cell.
  29. list the 3 classes of normal regulatory genes that are principle targets of genetic damage
    • 1. protooncogenes (growth promoting)
    • 2. cancer suppressor genes (growth inhibiting)
    • 3. apoptosis regulatory genes
  30. how do DNA repair genes affect carcinogenesis?
    if DNA repair genes are disabled, increased frequency of mutations and increased rate of neoplastic transformation
  31. oncoproteins are products of oncogenes. list 5 examples of oncoproteins.
    • 1. growth factors
    • 2. growth factor receptors
    • 3. signal-transducing proteins
    • 4. nuclear transcription factors
    • 5. CDKs (cyclin-dependent kinases)
  32. give 2 examples of growth factors involved with carcinogenesis
    • 1. platelet-derived growth factor (glioblastoma)
    • 2. TGF-a (sarcomas)
  33. give 2 examples of growth factor receptors involved with carcinogenesis
    • 1. ERBB-1: overexpressed in 80% of squamous cell carcinomas of the lungs
    • 2. ERBB-2: amplified in some breast cancers leading to poorer prognosis
  34. give an example of a signal-transducing protein involved with carcinogenesis
    RAS. Mutated RAS binds to GAPs but GTPase activity is not accentuated. cell continues to receive signals to divide as a result.
  35. give an example of a nuclear transcription factor involved in carcinogenesis
    MYC: overexpression causes continuous cell proliferation
  36. give an example of CDKs involved with carcinogenesis
    CDKs are responsible for determining if a cell will start the cell cycle or not. Dysregulation/overexpression favors cell proliferation.
  37. give an example of a tumor suppressor gene
    Retinoblastoma gene
  38. explain the "two-hit" hypothesis
    in order for retinoblastoma to develop, both Rb alleles must be disabled or mutated ("hit"). Children inherit one defective Rb gene and the second "hit" is very likely to occur as a somatic mutation resulting in tumor formation
  39. which tumor suppressor gene is the single most common target for genetic alteration in human tumors?
    TP53
  40. describe the normal function of TP53
    • 1. slows down DNA replication when mutations have affected the DNA
    • 2. activates the transcription of DNA repair enzymes. if DNA cannot be repaired TP53 activates apoptosis
  41. What is the prototypical anti-apoptosis gene?
    BCL2
  42. define Xeroderma pigmentosum
    defective nucleotide excision repair system. risk for skin cancer from UV light
  43. define Bloom Syndrome
    hypersensitivity to DNA damage
  44. What 2 genes are involved with familial breast cancer?
    BRCA1 and 2
  45. List 3 karyotypic changes in tumors
    • 1. balanced translocations
    • 2. deletions
    • 3. gene amplifications
  46. Philadelphia chromosome is an example of balanced translocation. define what a philadelphia chromosome is.
    occurs in chronic myelogenous leukemia: it is a translocation between chromosome 22 and 9. as a result 22 is shortened.
  47. what deletions are common to colon cancer?
    17p, 5q, 18q
  48. what deletions are common in oral cancers?
    3p, 9p, 17p
  49. are all carcinogens electrophiles or nucleophiles?
    electrophiles
  50. radiation has a latent period for the development of cancer. how long is it?
    8-12 years from exposure
  51. what two types of viruses can cause cancer?
    RNA and DNA oncogenic viruses
  52. give an example of an RNA oncogenic virus
    Human T-cell leukemia virus Type 1 (HTLV-I)
  53. give 3 examples of DNA oncogenic viruses
    HPV, EBV, HBV
  54. give an example of a tumor-specific antigen
    MAGE-1 (melanoma-associated antigen)
  55. give an example of a tumor-associated antigen
    prostate-specific antigen. expressed in a normal state but levels are elevated in a neoplastic state
  56. list 4 antitumor effector mechanisms
    • 1. CD8 T cells
    • 2. NK cells
    • 3. Macrophages
    • 4. Humoral mechanisms
  57. list 4 ways in which cancer can initiate from immune competent patients
    • 1. selective outgrowth of antigen-negative subclones (antigenic subclones are attacked and killed by immune system leaving tumor cells that are essential invisible to the immune system)
    • 2. lost or reduced expression of MHC antigens
    • 3. lack of co-stimulation for t-cell response
    • 4. immunosuppression from a carcinogenic agent
  58. list 5 ways in which benign tumors can cause complications in a patient
    • 1. location: a benign tumor next to the pituitary can compress it and cause damage
    • 2. hormone production: common in well-differentiated benign tumors. adenomas and carcinomas from beta cells in the pancreas can produce hyperinsulinism
    • 3. ulceration (breaking through epithelial surface)
    • 4. cachexia (progressive loss of body fat and lean body mass)
    • 5. paraneoplastic syndrome (A set of symptoms that is associated with cancer but is not directly caused by the cancer)
  59. define Grading
    attempt to assess the aggressiveness of a malignancy based on degree of differentiation of the tumor cells and number of mitoses
  60. define Staging
    assessment of the size of the primary lesion, presence or absence of lymph node involvement and presence or absence of metastatic lesions involving other distant tissues. Stage I: most localized, Stage IV: most disseminated. Staging is more valuble than grading for determining prognosis
  61. explain the TNM method to classify squamous cell carcinomas
    • T: primary tumor diameter
    • N: lymph node involvement
    • M: metastases

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