tumor progression & metastasis Flashcard

what is characteristic of melanoma?
asymmetrical, always malignant, and strong association with UV light
where are squamous cell carcinomas usually seen?
the skin, lung. lung cancer is *rapidly increasing* and currently has the lowest survival rate of all cancers
what cancers has estrogen been linked to?
breast and endometrial
what hormone are colon polyps linked to?
somatotropin (growth hormone)
what is hepatocellular carcinoma linked to?
aflatoxin (found in foods w/mold)
what is bladder cancer related to?
aromatic amines
what is mesothelioma linked to?
asbestos
what is acute leukemia linked to?
benzene and cancer chemotherapy (alkylating agens)
what is lung cancer related to?
beryllium and radon (not always smoking)
what is skin cancer (SCC, BCC, melanoma) related to?
radiation (UV, x ray)
what is melanoma linked to?
UV light
what is lung cancer, lip cancer, and SCC of the esophagus related to?
tobacco smoking, chewing (mainly lip)
what are angiosarcomas of the liver linked to?
vinyl chloride
what can commonly cause papillary cancer of the thyroid?
radiation
what are BRCA-2 genetic associated with?
heavily with breast CA, also linked to ovarian, melanoma, colon, prostate, pancreatic, and gastric CA
what is the chance of someone with familial adenomatous polyposis developing colon CA?
about 100%, tx includes removing the colon or large parts of it
what is an osteogenic sarcoma?
a common primary tumor of the bone, metastasizes by the hemotogenous route
and ovarian cysts become malignant?
yes, if they rupture they can spread borderline malignant.
what are borderline malignant cells?
malignant cells that are not as aggressive as malignant cells
what does grading of a neoplasm refer to in comparison to staging?
grading refers to the architectural features of a neoplasm, while staging refers to how far it has spread. grading is an assessment of architectural differentiation, cytolofic pleomorphism (anaplasia), mitoses (tripolar?), necrosis, vascular/lymphatic capillary permeation and blunt vs stellate invasion
what does papilloma refer to?
benign tumor (squamous or transitional cells)
what is leio- vs rhabdo-?
leio- is smooth muscle, rhabdo- is skeletal muscle
what does the tumor’s ability to proliferate depend on?
the genetic abnormality of the tumor (oncogenes, mutations)
what receptors do tumors have more of?
laminin receptors which allow tumors cells to more readily attach to the basement membrane of an organ, a feature which can precipitate metastases
what is a common site of tumor cell metastasis?
local lymph nodes to axillary lymph nodes
what is vascular invasion indicative of?
malignancy
what is a leiomyoma?
a benign tumor of the smooth muscle, commonly seen at the uterus. they can be large, but still benign (smooth, well circumscribed)
what is a leiomyosarcoma?
a malignant smooth muscle tumor with disturbed cell polarity, dark nuclei, and abundant mitotic figures
what is a rhabdomyosarcoma?
a malignant tumor of skeletal muscle – no striations, no order, “complete mess”
what is the most common soft tissue tumor?
a lipoma, a benign fat tumor -> tend to be in superficial areas like the skin
how does a liposarcoma appear?
more prominent and multiple nucleoli, no more big open cells
how does a hemangioma appear vs an angiosarcoma?
well-defined vascular channels vs non-well defined
what is kaposi’s sarcoma?
a vascular malignancy commonly seen w/HIV and HHV-8
what is an osteochondroma?
benign tumor of cartilage & bone that has a mushroom-like outgrowth w/cartilage on top and bone underneath. if it has multiple outgrowths, it can become malignant, but they are benign for the most part
what is an osteosarcoma?
malignant tumor of the bone – infiltrates cortex and raised the periosteum of the bone
what is a meningioma?
benign tumor of the meninges
what does keratin function as a biomarker for?
keratin is a broad biomarker for all carcinomas (stain for this to differentiate from a sarcoma)
what is carcinoembryonic antigen a biomarker for?
adenocarcinomas
what is keratin 7 a biomarker for?
lung cancer
what is keratin 20 a biomarker for?
GI CA
what is thyroid transcription factor 1 a biomarker for?
thyroid and lung CA
what are calretinin and WT-1 biomarkers for?
mesotheliomas
what are estrogen/progesterone biomarkers for?
breast CA
what is CA-19-9 a biomarker for?
pancreatic CA
what is prostate-specific antigen a biomarker for?
prostate CA
what are neuroendocrine markers (neuron-specific enolase, synaptophysin, chromogranin) biomarkers for?
small cell carcinoma
what is desmoplasia?
a firm characteristic of tumors due to paracrine stimulation of stellate stromal myofibroblasts (desmin/smooth muscle actin + cells) w/type 1 collagen and c-fibronectin matrix production. this is responsible for “gritty” nature of breast tumors
what is a carcinoma in situ?
a group of dysplastic cells in the epithelial surface that have not perforated the basement membrane – which is when you want to get a neoplasm (before it can stimulate angiogenesis)
what does it mean if a tumor has a higher level of aneuploidy?
it is more likely to metastasize
where does prostate CA often metastasize to?
the bone, so an elderly man complaining of lower back pain should be screened for prostate CA (which is osteoblastic like breast CA)
what does T score correlate with in colon cancer?
the higher the T score, the larger the tumor is and the farther it has progressed. T0, tumor is limited to the mucosa, T4, the tumor extends beyond the serosa of the bowel wall
what is TNM classification?
tumor status, nodal status, metastatic status
what are some examples of tumors which are systemic by definition?
leukemias, non-hodgkin’s lymphoma
what is an example of localized spread of cancer affecting other organs?
hydronephrosis of the kidney due to squamous cell carcinoma of the cervix
what is a virchow’s node?
supraclavicular node seen in GI/pancreatic CA
what is sister mary joseph’s node?
lymph node in the periumbilical region in GI CA
how would a metastatic adenocarcinoma appear in a lymph node?
as glandular tissue
what is lymphadnodapathy characterized by in infectious processes? CA?
painful and bilateral – infectious, unilateral and painless – malignancy
what are nasopharyngeal carcinomas associated with?
EBV
what are sentinel nodes?
virchow’s sister mary joseph etc that warn you
what cancer is superior vena cava syndrome seen in?
lung cancer, their head becomes engorged w/blood b/c the tumor prevents blood from draining from the head
where can breast cancer metastasize?
lung, liver, bone, and brain
where can sarcomas metastasize?
lungs
where can lung cancer metastasize?
brain, liver, bone, adrenal
where can colon cancer metastasize?
liver, lung
where can rectum cancer metastasize?
lung, liver
where can prostate cancer metastasize?
bone
where can head and neck cancer metastasize?
lung
where can kidney cancer metastasize?
lung and bone
can the primary tumor be determined by gross observation of metastases?
no, except if there are black dots on the heart, which is indicative of melanoma metastasis (heart is a common area of melanoma metastasis)
what is the progression of pathologic staging?
involvement of regional lymph nodes, involvement of distant lymph nodes, biopsy of liver/bone marrow, laparotomy – splenectomy
what is paraneoplastic hormonal production?
tumors can produce hormones, for example: lung cancer can produce ACTH, each situation can have different effects

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