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Checklist for metastasis
1) generates own growth signals
2) insensitive to antigrowth signals (loss of Rb, p21, p16)
3) able to evade apoptosis
5) sustained angiogenesis
6) ability to invade basement membrane
capability to transgress epithelial basement membrane; lesion now considered cancer; invasion does not equal metastasis
2) bleed easily, even without trauma
3) dilated and highly permeable
4) premature lack of mural cells
5) sluggish blood flow
How to get through basement membrane
1) loosen up cell junction
2) degrade BM and interstitial tissues
3) expression of receptors for stromal elements
4) get the cells moving
Tumor Spread Methods
1) direct invasion into adjacent tissue
2) invade lymphatics
3) seeding of body cavities
4) intravascular dissemination (hematogenous)
Seed and soil hypothesis
means tumor has metastasize and a tissue has to the right receptors/conditions/fertile ground for the tumor cells to take up residence
Benign neoplasm characteristics
1) usually well-circumscribed
2) push, don't infiltrate
3) may have capsule/pseudocapsule
4) respect borders
5) sometime hang out (leiomyoma)
transformed epithelium with some cytologic features of malignancy but lacking the biological ability to invade and metastasize
1) hepatocellular carcinoma
2) renal cell carcinoma
3) carcinoid tumors
Basal cell carcinoma of skin
Invades locally and can destroy large parts of the area it evolves in if it isn't treated, but rarely metastasizes
Papillary carcinoma of the thyroid
cancer tends to do nothing or spread locally to the nodes of the neck. one of the more benign cancers
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