L33 and L34 Neoplasia

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The term for an abnl cell population that is no longer regulated by controlling factors that govern growth, cell division, organization and differerentiation is ____. Robbins notes that the change "persists...after cessation of the stimuli which evoked [it]."

neoplasm

If recorded natural Hx predicts small to no risk that neoplasm will metastasize nor extensively infiltrate into adjacent tissue, it is termed ____.

benign

If the recorded natural Hx is that neoplasm has the potential to metastasize and/or grow relentlessly into adjacent tissue and there is significant risk for aggressive behavior, it is termed ____.

malignant

If the recorded natural Hx is that a neoplasms behavior cannot be predicted, it is termed ___.

intermediate

A malignant neoplasm is called a ____, while a benign one is not.

cancer

Some "benign neoplasms are ____ or ____: pre-invasive and have the potential to remain stable or progress to malignancy, such as tubular adenomas of the colon or intraepithelial neoplasms of cervix or bladder.

• in situ
• intraepithelial neoplasms

A lipoma is a ______, which is truly indolent and well-behaved.

benign neoplasm

Some neoplasms, like a follicular neoplasm of the thyroid, can be benign when ____ and malignant when ____.

• in situ
• infiltrating outside their space

A _____ is a nl, unmodified gene that promotes entrance into or progression through the cell cycle and cell replication. RAS is an example.

proto-oncogene

A ____ is a mutated gene that has acquired the ability to promote autonomous cell replicated unregulated by the usual gene product suppressors. Mutated RAS is an example.

oncogene

RAS is a ____gene, but can be mutated and trapped in its active state. Such mutations are dominant, and one mutated allele is sufficient for this effect.

proto-onco

A ____ is a gene that fn to limit cell entry in cell cycle or progression into S or G2M phase or insure repair or destruction of damaged DNA. Rb is an example.

tumor suppressor gene

Rb is ____ gene, which regulares progression into S-phase of the cell cycle. This effect is recessive, and BOTH alleles must be disrupted for the effect of the gene's loss occur.

tumor suppressor

To be cancerous, cells must achieve characeristics of stem cells, avoid tumor suppressor gene proteins, nourish themselves and acquire the ability to ___.

travel

____ and overexpression of growth factor receptors enable cancer cells to have self-sufficiency in growth signals.

Ras activation

____ enables cancer cells to have insensitivity to antigrowth signals.

Rb inactivation

____ gives cancer cells the ability to avoid apoptosis.

Loss of p53 function

____ allow cancers to have sustained angiogenesis.

↑ VEGF and FGFs

____ allows cancers to have limitless replication.

Telomerase upregulation

____ allows cancers to invade basement membranes, blood vessels, adhere to foreign tissue, and metastasize.

E-cadherin inactivation, proteases, and homing signals to other organs

Promotion of marked cell replication, commandeering of nl cell proto-oncogenes or inactivation of tumor suppressor genes, or production of _____ set the stage for neoplasia.

free radicals or chemicals that can damage DNA

____ of chromatin is an important epigenetic event that causes gene shutdown.

Methylation

Chronic inflammation, such as that caused by chronic burns, osteomyelitis, chronic viral hepatitis, and H. pylori gastritis, causes upregulation of growth factors, angiogenetic factors, and suppression of apoptosis (often mediated by ____)

NF-κB

Chronic burns, osteomyelitis, chronic viral hepatitis, and H. pylori gastritis are examples of ____.

chronic inflammation

HPV, polyoma, and EBV all have the ability to induce cancer because they ____.

commandeer cells' regulatory genes

Benzene and aflatoxin are both known ____.

carcinogens

Genomic instability indicates that a cell population is in a state of high susceptibility to persistence of gene mutation. ___ is the most important checkpoint in the cell cycle.

G1S

At the G1S checkpoint, DNA must be checked for defects, because once the cell enters the _____ phase, there is "no turning back."

S(ynthesis)

The G2M checkpoint also plays a role by ____.

checking replicated DNA prior to cell mitosis

Methylation is an epigenetic mechanism for alteration of gene expression without alteration of DNA base pairs. It works by ___.

compacting chromatin, leading to transcription repression

Hypermethylation can suppress expression of anti-tumor genes, while ____ can result in unwanted expression of pro-tumor genes.

hypomethylation

p53 mutation or lass impairs ____. It is an example of enabling genomic instability.

DNA repair and apoptosis

Centrosome alterations can lead to ____.

aneuploidy

___ is an important tumor suppressor gene, which is altered in >50% of cancers.

p53

Phagocytes can also be genetically mutated after phagocytosis of ___.

apoptotic bodies

___ "gives a cell a job," but then it can no longer reproduce. Cancers can be immortal because they eschew this process.

Terminal differentiation

The growth and development of epithelial cells is highly dependent on _____, which tell the cells to replicate and differentiate.

paracrine signals from stroma

Carcinomas can stimulate ____ that secrete factors that aid in tumor progression and possibly invasion and metastasis

carcinoma-associated (myo)fibroblasts (aka CAFs)

Malignant cells have mutant p53 that act as ____, essentially inactivating wild type p53.

dominant negative gene

Non-malignant neoplasms, especially epithelial ones, tend to have a ___ wall surrounding them.

fibrous

Non-neoplastic cells are regulated by molecs that effect good cell-to-cell ____ and organize them into tissues.

cohesion

Uniform nuclei, maintenance of nuclear polarity, orderly cell arrangement, cell-to-cell cohesion, relatively uniform nuclear heterochromatic distribution, and absence of mitoses containing abnl spindle apparatuses are findings of ____.

benign, non-neoplastic cells

The more dangerous types of neoplasms have chromosomal abnl and abnl DNA content, known as ____, which is biologic evidence fo genomic instability.

aneuoploidy

____ can be manifest morphologically as variations in nuclear size and shape, irregularities in nuclear membrane, and ∆ in heterochromatin/euchromatin content.

Aneuploidy

On Pap prep, high molecular weight keratin containing cells stain ___.

orange

Hepatocytes in a metastatic tumor can be identified by the presence of ___.

bile

Abnormal mitotic figures are indicative of genomic instability. High risk HPV proteins have been found to _____, which induces abnl centriole synthesis. This can cause the appearance of tri- or quadri-polar mitotic figures.

uncouple centrosome duplication from the cell division cycle

-oma means ___.

tumor, swelling (neoplasm); usually benign

carcinoma means ___.

...

Lipo- means ___.

of fatty tissue

Adeno- means ___.

of glandular tissue

Fibro- means ___.

of fibrous tissue

-carcinoma means ___.

malignant epithelial neoplasm; prefix indicates type of cells

-sarcoma means ___.

malignant mesencymal neoplasm prefix indicates type of cells

Angio- means ___

of vascular tissue

A ___ is a growth that protrudes above a flat surface.

polyp

A ___ is a polyp with finger-like projections.

papilloma

A ____ has very long, leaf-like fronds.

villous papilloma (or polyp)

Squamous metaplasia of endocervical columnar epithelium is (physiologic/pathologic).

physiologic

Squamous metaplasia of the lower resp tract is (physiologic/pathologic).

• pathologic
• due to chronic irritation (e.g. tob use)

Glandular metaplasia of the esophagus is (physiologic/pathologic).

• pathologic
• due to chronic irritation (e.g. GERD)

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