Neoplasms/Pathology

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Anonymous
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7910
Filename:
Neoplasms/Pathology
Updated:
2010-02-23 21:22:21
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neoplasm
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Neoplasms
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  1. What is the most common malignant tumor of childhood and infancy?

    Signs and symptoms?
    Neuroblastoma

    • - originates in adrenal medulla--> secretes NE and epi (catecholamines)
    • - invades abdominal organs

    • Signs and Symptoms
    • 1) large abdomen
    • 2) sensation of fullness
    • 3) hypertension
    • 4) later: abdominal mass

    - sometimes converts into a ganglioneuroma
  2. Pheochromocytoma

    What diseases is pheochromocytoma involved with?
    • - adrenal medulla tumor secretes catecholamines
    • - uncommon, benign


    • 1) hypertension
    • 2) cardiac arrhythmias
    • 3) increased catacholamines in urine, hyperglycemia

    • - MEN II (parathyroids and pheochromocytoma)
    • - von Recklinghausen's disease (neurofibromatosis)
    • - von-Hippel Lindau disease- multiple hemangiomas
  3. Most common Cutaneous T-cell lymphoma?

    rare form?
    • Cutaneous T-cell Lymphoma
    • - T-lymphocytes become malignant and affect skin
    • - slow-growing cancer

    • 1. Mycosis fungoides
    • - men> women
    • - black people> white
    • - unknown cause

    • 2. Sezary syndrome
    • - skin lesions
    • - circulating neoplastic cells w/ cerebriform nuclei
  4. Most common cancers in men?

    Most common cancers in women?
    • 1. lung (both sexes)
    • 2. colon cancer (95% adenocarcinomas from preexisting adenomatous polyp)

    • 1. Lung
    • 2.
    • 3. colon cancer
  5. Colorectal cancer

    1. Predisposing factors

    2. Signs and symptoms

    3. most common site
    • 1.
    • - adenomatous polyps
    • - diet high in fat, low in fiber
    • - inherited polyposis syndromes (Turcot's, Gardner's, Peutz-Jegher, Familial)
    • - ULCERATIVE COLITIS
    • - genetics

    • 2.
    • a. rectal bleeding
    • b. abdominal pain
    • c. weight loss
    • d. *** increased serum carinomaembryonic antigen (CEA)

    • 3. sigmoid colon
    • - left colon cancers diagnosed before right bc they cause constipation and obstruction earlier
  6. 1. Most common malignant skin cancer?
    2. most severe skin cancer?
    3. most common cancer found in oral cavity?
    • 1. BCC; also most common cancer form in US
    • - head and neck; upper parts of sun-exposed face
    • - NEVER metastacizes
    • - tumor is indurated, invasive, painless
    • - Tx- excision


    • 2. malignant melanoma
    • - metastacizes

    • - SCC can metastacize
    • - more aggressive than BCC, but still slow growing
    • - arises from keratinocytes in epidermis
    • - painless--> painful ulcer
    • - sun exposed areas, esp lower face (actinic keratosis- lower lip)
    • - 90% of all malignant cancers of ORAL CAVITY (lateral dorsum of tongue, palate mostly)
  7. Which forms of Hodgkin's lymphoma are associated w/ EBV?

    Most common and least common forms of Hodgkin's?

    All are more common in men except?
    - all 3 associated w/ EBV except lymphocytic predominance

    • 1. mixed
    • 2. lymphocyte depleted (least common type and associated w/ HIV; poorest prognosis)
    • 3. nodular sclerosing type- most common; women> men
    • 4. lymphocyte predominance
  8. 1. Most common benign bone tumor

    2. Most common malignant bone tumor
    • 1. Osteochondroma
    • - mature bone w/ cartilage cap
    • - men < 25 yrs old
    • - long metaphysis
    • - malignant transformation to chondrosarcoma rare
    • - chondrosarcoma- malignant cartilaginous tumor
    • - men 30-60
    • - can metastasize (primary when arise w/out underlying benign tumor)

    • 2. Osteosarcoma
    • - less common than multiple myeloma
    • - males 10-20 yrs
    • - metaphysis of long bones (femur, tibia, humerus)
    • - tendency to spread to LUNGS

    - sunburst pattern on x-ray
  9. 1/2. Choristoma vs. Hamartoma

    3. Desmoplasia
    • 1. Choristoma
    • - benign mass of normal tissue is misplaced w/in another organ

    • 2. Hamartoma
    • - benign overgrowth of normal cell types in an affected organ

    • 3. when neoplasm forms fibrous stroma that gives tumor a firm/hard feel on palpation
    • - can fix tumor to surrounding structures
  10. Multiple myeloma
    • - most common primary tumor arising in bone
    • - malignant plasma cell tumor (plasma cells look like fried eggs)
    • - BENCE JONES proteins
    • - punched out bone lesions
    • - men over 40


    • hyperCalcemia
    • Renal failure bc hypercalcemia
    • Anemia/ AMYLOIDOSIS
    • Bone pain/Bence jones proteins
    • - earliest sign; back and rib pain


    • - Bence-Jones protein- increased Ig light chains; shows in urine
    • Pancytopenia- increase infections, bleeding, anemia
  11. Teratoma

    1. Most common site for a Teratoma?
    - tumor composed of all 3 layers of germ layer

    • 1. most frequent in ovary
    • - benign and forms dermoid cysts

    - occurs in testes where it is usually malignant
  12. 2nd most common malignant bone tumor in children (after osteosarcoma)?
    • - Ewing's Sarcoma- nonosseous tumor
    • - boys<15 yrs old
    • - "small blue cell malignant tumor"
    • - a peripheral neuro-ectodermal tumor (PNET)- started in embryonic tissue and developed into nerve tissue
    • - caused by chromosome rearrangement (11,22)
    • 11+ 22= patrick EWING's jersey number

    • - AGGRESSIVE/MALIGNANT w/ very EARLY METASTASIS
    • - "onion skin appearance" (going out for eWINGS and ONION rings)
    • - diaphysis (shaft) of long bones- femur, tibia, humerus, vertebra, fibula
    • - can spread to LUNGS
    • - pt presents w/ severe bone pain (nonspecific)
    • - ***responds to chemotherapy****


    - mostly occurs in bone or soft tissue
  13. Chordoma
    • - nonosseous tumor derived from notochord remnants
    • - slow progression
    • - men 50-60 yrs old
    • - occurs at end of vertebral column, spheno-occipital, sacrococcygeal, vertebral areas
    • 1) constipation
    • 2) visual problems
  14. Keratoacanthoma
    • 1. common skin tumor
    • - treated now as a malignant growth (some transform to SCC)
    • - originates in pilosebaceous glands
    • - resembles SCC pathologically
    • - Factors: sunlight, chemical carcinogens, trauma, HPV, genetic, immunocompromised
    • - men > women (70s)

    • Clinical:
    • Very rapid growth (inch mass in week)--> spontaneous resolution 2-6 months (slow regression)
  15. Acanthosis Nigricans
    • - cutaneous disorder w/ hyperkeratosis and pigmentation of axilla, neck, flexures, anogenital region
    • - hyperplasia of stratum spinosum
    • - associated with:
    • 1. hyperlipidemia
    • 2. malignancy/cancer of GI tract (esp stomach)
  16. Most common tumor of women?

    Complications?

    Cause?
    • Leiomyoma aka fibroid
    • - benign tumor of smooth muscle
    • - most often in UTERUS (can occur in stomach, esophagus, small intestine)
    • - good prognosis
    • - cause:

    • Complications:
    • 1. painful menses
    • 2. infertility

    • Cause
    • - unknown
    • - estrogen therapy and pregnancy may cause fibroids to enlarge

    - all muscle neoplasms rare; when encountered they are usually malignant
  17. Leading cause of death from cancer in men and women?

    Where does it like to metastasize to?

    Subtypes of this type of carcinoma? Most and least common types?
    • Bronchogenic carcinoma
    • (squamous cell and small cell)

    • - caused by smoking (proportional to # of cigarettes per day and # of yrs of smoking)
    • - Benzpyene= carcinogen in ciagrette; cigarettes worse than pipes and cigars
    • - 5 yr survival less than 1-%
    • - males>females 4:1

    • - lungs like to metastacize to (BLAB):
    • 1. BRAIN*** (1st signs of lung cancer related to metastatic spread via lymphatics)
    • 2. liver
    • 3. adrenal medulla
    • 4. bone

    • 1. squamous cell- PTH-like hormone 30%
    • 2. Adenocarcinoma- MOST COMMON in peripheral lung 40%
    • - Bronchial
    • - Bronchioloalveolar
    • - most common in WOMEN and NONSMOKERS
    • 3. small cell (oat)- undifferentiated and aggressive 20%
    • - ACTH of ADH ectopic production
    • - can lead to Lambert-eatin syndrome
    • - responds to chemotherapy
    • 4. Large cell- LEAST COMMON 10%
    • -undifferentiated and anaplastic
    • - poor prognosis
  18. Most common cancer in women?

    Predisposing factors?

    Most important prognostic predictor?

    Most important risk factor for developing endometrial cancer?
    • Breast cancer
    • #2 killer after lung cancer of women 35-54
    • - always an ADENOCARCINOMA
    • - rare before 25 yrs old; most common in reproductive yrs

    - painless mass on breast with pitted surface

    • 1. *** strongest is family history in 1st degree relatives
    • 2. history of breast cancer
    • 3. early menarche, late menopause
    • 4. fibrocystic disease w/ atypical epithelial hyperplasia
    • 5. obesity
    • 6. 1st pregnancy after 30 yrs (basically anything that exposes a women to more estrogen)
    • 7. diet high in animal fat

    - LYMPH NODE involvement most important for prognosis

    - HYPERESTROGENISM
  19. Most common malignant melanoma?

    Least common?

    Poorest prognosis?
    • - related to sun exposure
    • - ABCs of melanoma
    • A
    • Borders irregular
    • Color abnormal
    • satellite lesion

    • 2 growth phases of melanoma for determining prognosis:
    • 1. radial- spread laterally in epidermis and dermal papilla
    • - no metastasis
    • - lymphocyte prominent
    • 2. vertical- growth is deeper
    • - metastasis can occur via lymph and blood

    • A. Most common: Superficial spreading- trunk and extremities
    • - radial growth dominant

    • B. Least common: Nodular melanoma
    • - begins w/ vertical growth phase
    • - POOREST PROGNOSIS

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