Pathology of Neoplasia

Vocabulary flashcards for the Pathology of Neoplasia lecture.

Neoplasia

An abnormal growth of tissues exceeding and un-coordinating with the evoking stimuli, and a loss of responsiveness to normal growth stimuli.

Monoclonal

Neoplastic cells originate from one transformed cell, thus the cells are:

Normal Cartilage

Normal cartilage.

Normal cartilage

A benign chondroma closely resembles _.

Chondrosarcoma of bone

Composed of malignant chondrocytes, which have bizarre shapes and irregular hyperchromatic nuclei, embedded in a cartilaginous matrix.

gland, epithelial, and hepatic cells

The parenchyma origin cells consisting of:

supporting stroma, fibrous, muscle, and bone tissue (connective tissue)

The mesenchymal origin cells consisting of:

Fibrosarcoma

Tumor from fibrous tissues

Seminoma

Malignant tumor of spermatocyte.

Lymphoma

Malignant tumor of lymphoid tissue.

Melanoma

Malignant tumor of melanocyte.

Teratoma

Originates from germ cells, (sperm or ovarian), mixed tissue, benign or malignant.

Papilloma

Benign epithelial neoplasms growing on any surface epithelium.

Polyp

Above the epithelial surface to form a microscopically visible structure, colonic polyps and nasal polyps.

Leiomyoma

A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called fibroid.

Nodular Fasciitis

This cellular reactive lesion contains atypical and bizarre fibroblasts, which may be mistaken for a fibrosarcoma.

Well Differentiated Tumors

High degree of resemblance to the normal tissue of origin (has good prognosis).

Moderately Differentiated Tumor

Moderate degree of resemblance to the tissue of origin (moderate prognosis).

Poorly Differentiated Tumor

Means no resemblance to the tissue of origin, sometimes are called anaplastic tumors. They have the worse prognosis.

Anaplasia

Lack of differentiation, pleomorphism, abnormal cell morphology (atypia), abundant and/or atypical mitoses, and loss of polarity.

Hyperplasia

Increase in cell number.

Metaplasia

Change from one cell type to another (reversible).

Dysplasia

“Deranged” cell growth resulting in cells that vary in size, shape, and organization. Can demonstrate some degree of nuclear atypia.

Neoplasia

New, uncontrolled growth of cells that is not under physiologic control. Cells have abnormal cellular architecture, with nuclear atypia, nuclear hyperchromasia and loss of cell polarity.

Dysplasia (Disordered Growth)

Irreversible premalignant change affecting a focal area of epithelial tissues, without invading the basement membrane, represents a state between hyperplasia and carcinoma in situ (preinvasive neoplasia).

Invasion

Local spread when it breaches the basement membrane and invade the neighboring tissue.

Metastasis

Secondary spread of cancer in a remote area.

Cancer Staging

Describes the size of a tumour and how far it has spread from where it originated.

Cancer Grading

Reflects tumor architecture and cytology.

Tis

In situ, non-invasive (confined to epithelium).

T1

Small, minimally invasive within primary organ site.

T2

Larger, more invasive within the primary organ site.

T3

Larger and/or invasive beyond margins of primary organ site.

T4

Very large and/or very invasive, spread to adjacent organs.

N0

No lymph node involvement.

N1

Regional lymph node involvement.

N2

Extensive regional lymph node involvement.

N3

More distant lymph node involvement.

M0

No distant metastases.

M1

Distant metastases present.

Grade I

Well differentiated.

Grade II

Moderately differentiated.

Grade III

Poorly differentiated.

Grade IV

Nearly anaplastic.

History and Physical Examination

What the health care worker learns from talking to the patient and through direct examination may give clues to the presence of a neoplasm. Signs and symptoms such as weight loss, fatigue, and pain may be present. A mass may be palpable or visible.

Radiographic Techniques

The use of plain films (x-rays), computed tomography (CT), magnetic resonance imaging (MRI), mammography, and ultrasonography (US) may be very helpful to detect the presence and location of mass lesions. The findings from these methods may aid in staging and determination of therapy.

Laboratory Analyses

General findings such as anemia, enzyme abnormalities (such as an increased alkaline phosphatase), and hematuria or positive stool occult blood are helpful to suggest further workup More specific testing, such as measurement of prostate specific antigen levels, may help to determine the presence of specific neoplasms, but such tests are not perfect screening tools in a general population.Detection of specific genes (such as BRCA-1 for breast cancer) may suggest an increased risk for some malignancies.

Cytology

Methods that sample cells can be simple and cost-effective and minimally invasive A good example is the Pap smear for diagnosis of cervical dysplasias and neoplasms. Cells exfoliated into body fluids may also be examined. Fine needle aspiration (FNA) can be used to sample a variety of mass lesions

Tissue Biopsy and Surgery

Methods that sample small pieces of tissue (biopsy) from a particular site, often via endoscopic techniques (such as colonoscopy, upper endoscopy, or bronchoscopy) can often yield a specific diagnosis of malignancy At surgery, portions of an organ or tissue can be sampled, or the diseased tissue(s) removed and examined in surgical pathology to determine the stage and grade of the neoplasm.

Autopsy

Sometimes neoplasms are not detected or completely diagnosed during life The autopsy serves as a means of quality assurance for clinical diagnostic methods, as a way of confirming diagnoses helpful in establishing risks for family members, as a means for gathering statistics for decision making about how to approach diagnosis and treatment of neoplasms, and to provide material for future research.

Choriocarcinoma

Malignant tumor of germ cell origin.

Hepatocellular Carcinoma

Malignant tumor of liver.

Thyroid Medullary Carcinoma

Neurocrest tumor of thyroid.

Prolactin Pituitary Adenomas

Anterior pituitary tumor.

CA 125 Ovarian Carcinoma

Malignant tumor of ovary

PSA Prostate Carcinoma

Tumor marker associated with malignant prostate.

Chromogranin A Endocrine Neoplasias

Neurocrest tumor.

Ancillary Studies

A. metastatic bladder cancer H&E stain B. Positive immunostaining for cytokeratin of the tumor depicted in A, which identifies it as a carcinoma C. A metastasis to the colon of an undifferentiated malignant melanoma H&E stain D. Immunoperoxidase stain of the tumor in C showing that the cells express S-100 protein, a commonly used marker for cells of melanocytic origin.

Immunohistochemistry

A. metastatic bladder cancer H&E stain B. Positive immunostaining for cytokeratin of the tumor depicted in A, which identifies it as a carcinoma

Cytogenetics

Study the number and look of chromosomes.

Flow Cytometry

Measure the number of cells with specific characteristic.

Electron Microscopy

Study the ultra structure of tissues and structures.

Tumor Progression

Acquisition of permanent changes in characteristics of selected subpopulations of the tumor.

CagA Bacterial Protein

Stimulating oncogenesis and inflammation.

metabolic activation

Chemicals act either directly or after _.

Direct-acting carcinogens

Directly bind covalently to cellular macromolecules: nitrogen mustard, and certain.

Aflatoxin B1

A natural product of the fungus Aspergillus flavus.

Ionizing radiation

Includes: X-rays, gamma rays, as well as particulate radiation; alpha, beta, positrons, protons, neutrons and primary cosmic radiation.

Slow growth rate

Benign neoplasms

Well-differentiated

Benign neoplasms

Remain localized

Benign neoplasms

Faster growth rate

Malignant neoplasms

Well to poorly differentiated

Malignant neoplasms

Invade surrounding tissues

Malignant neoplasms

Metastasize

Malignant neoplasms

Myc

Cellular proliferation, favors stemness, energy production, and facilitates tumor cell invasiveness, and activate cell death programs

Androgen and estrogen receptors

Cytoplasmic receptor proteins are both receptors and transcription factors cell proliferation, breast tumorigenesis., and prostate tumorigenesis

Distant Spread; Metastasis of Cancer

The most important step is angiogenesis -> intravasation -> transport through the circulation -> arrested in micro-vessel in liver, lung or bones -> extravasations of cells from the vessels -> formation of micro-metastasis -> formation of macrometastasis (tumors).