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Pathoma: Neoplasia

Terms in this set (57)

Most common cause of death in adults (3)
CV disease, cancer, cerebrovascular disease
Most common cause of death in children (3)
accidents, cancer, congenital defects
most common INCIDENTAL cancers
breast/prostate, lung, colorectal
most common cancerous mortalities
lung, breast/prostate, colorectal
how many mutations occur before the first clinical symptoms arise in cancer?
30
Screening is designed to catch what?
Dysplasia
3 cellular systems disrupted by mutations which lead to carcinogenisis
proto-oncogenes, tumor suppressor genes and regulators of apoptosis
How does a mutation concerning RAS lead to a cancerous outcome?
Ras is normally bound to GDP when in the inactivated state. When the receptor is bound by a ligand, it turns GDP to GTP. This activates RAS, sending growth signals to the nucleus. When RAS is mutated, it doesn't respond to GTPase activating protein (GAP), so GTP doesn't get turned to GTP. This then causes RAS to be continuously activated with no "off" swtich.
Cyclin D does what?
It phosphorylates proteins to allow a cell to move from G1 to the S phase.
What chromosome is IgH located on?
C 14
Example of a growth factor and its associated tumor
PDGF; astrocytoma
Example of growth factor receptors, what their functions are, and their associated tumor (3)
Her2/neu--epidermal growth factor receptor--breast carcinoma
RET-neural growth factor receptor--MEN2A, 2B, and medullary carcinoma of thyroid
KIT--stemm cell growth factor receptor--GI stromal tumor
Example of signal transducers, their function and associated tumor
RAS--GTP-binding protein--all types of cancer
ABL--Tyrosine kinase--CML
Examples of nuclear regulators, their function and associated tumor
c-MYC--transcription factor--burkitt lymphoma (starry sky)
n-MYC-transcription factor--neuroblastoma
l-MYC--transcription factor--lung carcinoma (small cell)
Cell cycle regulators, their function and associated tumor
Cyclin D1--Cyclin--Mantle cell lymphoma
CDK4--Cyclin dependant kinase--Melanoma
t (11:14)
Mantle cell lymphoma, Cyclin D1 (on chromosome 11, IgH on 14)
t (9:22)
CML and some ALL
t (8:14)
Burkitt Lymphoma (8 is c-MYC, 14 is IgH)
How does p53 induce apoptosis?
It induces BAX, which destroys bcl2, which decreases inner mitochondrial membrane stability, releasing cytochome c, leading to apoptosis.
2 tumor suppressing genes
p53 and Rb
How does a mutation in Rb lead to cancer?
Rb is bound to E2F, which induces G1 to S phase. To release E2F, CyclinD1 phosphorylates Rb, releasing E2F to do its job. In the mutation, E2F isn't bound, which causes continuous transitioning.
How does a sporadic vs germline mutation reveal itself with respect to retinoblastoma?
Sporadic: unilateral rb
Genetic: Bilateral retinoblastoma with osteosarcoma
t (14:18)
follicular lymphoma (bcl2 is overexpressed)
Job of telomerase
(counterintuitive) preserves telomeres
How do tumor cells evade the immune system?
They downregulate MHC I, so CD8 cells don't attack them.
what kind of spread is characteristic for carcinomas? (lymphatic or heatogenous)?
lymphatic
what kind of spread is characteristic for sarcomas? (lymphatic or heatogenous)?
hematogenous and some carcinomas (Renal cell carcinoma goes into renal vein, hepatocellular carcinoma via hepatic vein, follicular carcinoma and choriocarcinoma).
characteristics of benign tumors (4)
slow growing, well circumscribed, mobile and distinct (not getting into nearby tissues)
characteristic of malignant tumors (4)
fast growing, poorly circumscribed, immobile, and infiltrative
Keratin stains:
epithelium (carcinomas)
Vimentin stains:
mesenchyme (CT)--sarcomas
Desmin stains:
muscle
GFAP stains:
neuroglia
Neurofilament stains:
neurons
PSA stains:
prostatic epithelium
Estrogen receptor stains:
breast epithelium
Chromogranin stains
neuroendocrine cells (small cell carcinoma of lungs/ carcinoid tumors)
which is more important; grade or stage of cancer?
Stage
Size of cancer is more important with what kind of cancer?
breast cancer
depth of cancer is more important with what kind of cancer?
GI cancer
Most important prognostic factor for cancer?
metastasis!
Aflatoxins cause what cancer? Are derived from what?
hepatocellular carcinoma; aspergillus
Alkylating agents cause what cancer?
leukemia/lymphoma
Asbestos causes what cancer?
lung cancer > mesothelioma
Cigarette smoke causes what cancer?
oropharynx, esophagus, lung, kidney, bladder, pancreas (caused by polycyclic hydrocarbons)
Arsenic causes what cancer?
squamus cell carcinoma of skin, lung cancer and angiosarcoma of liver
nitrosamines cause what cancer?
stomach cancer
Vinyl chloride (found in pipes) causes what cancer?
angiosarcoma of the liver
nickel, chromium, berylliu or silica cause what cancer?
lung carcinoma
EBV mostly presents in what ethnicities?
African or chinese males
EBV causes what cancer?
Burkitt lymphoma, CNS lymphoma in AIDS, nasopharyngeal carcinoma
HHV-8 causes what cancer?
Kaposi sarcoma
HBV and HCV cause what cancer?
hepatocellular carcinoma
HTLV-1 causes what cancer?
Adult T-cell leukemia/lymphoma
Ionizing radiation causes what cancer?
AML, CML, papillary carcinoma of the thyroid
UVB radiation causes what cancer?
melanoma, basal cell carcinoma, squamus cell carcinoma
drug that blocks HER2/neu receptor
trastuzumab
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