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