Cancer Patho

Define Metastasis

the development of secondary malignant growths at a distance from a primary site of cancer

Define Neoplasia

an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of normal tissue and which persists even after the evoking stimulus is removed

What are the 2 basic components of all tumors

parenchyma and supportive stroma

What is parenchyma

proliferating neoplastic cells

What is supportive stroma

connective tissue and blood vessels

What are the two types of benign tumors

mesenchymal (fleshy) origin and epithelial (lining) tumors

What is the suffix of benign tumors

oma

What are examples of mesenchymal origin benign tumors

-bone (osteoma)
-muscle (rhabdomyoma; leiomyoma)
-cartilage (chondroma)
-fat (lipoma)
-vessels (hemangioma)
-connective tissue (fibroma)

What are examples of epithelial tumors (benign tumor)

-adenoma
-cystadenoma
-papilloma
-polyp

What is a papilloma

macro-/microscopic from epithelium

What is a polyp

macroscopic from mucosa

Whats the difference between a papilloma and a polyp

papillomas have irregular sur- faces and are warts, but polyps have smooth surfaces

What is the difference between a malignant tumor and a benign tumor

Benign tumors tend to grow slowly and do not spread. Malignant tumors can grow rapidly, invade and destroy nearby normal tissues, and spread throughout the body.

What is the suffix for mesenchymal origin

sarcoma

What are some examples of mesenchymal origin

-bone (osteosarcoma)
-muscle (rhabdomyosarcoma; leiomyosarcoma)
-cartilage (chondrosarcoma)
-fat (liposarcoma)
-vessels (hemangiosarcoma)
-connective tissue (fibrosarcoma)

What is the suffix for epithelial tumors

carcinoma

What are some examples of epithelial tumors

-adenocarcinoma
-cystadenocarcinoma
-mixed cells tumors (teratomas)
-lymphoma/leukemia

Whats the difference between a mesenchymal origin and a epithelial tumor

Mesenchymal phenotypic cancer cells degrade the extracellular matrix, thereby enabling cancer cell invasion, intravasation and transport, epithelial phenotypic cancer cells eventually reestablish colonies at distant sites

Whats a mixed cell tumor

A rare type of cancer that is made up of at least two different types of germ cell tumors. These include teratomas

What is a teratoma

a tumor composed of tissues not normally present at the site (the site being typically in the gonads). Made up of tissue such as hair, bone and muscle

What is lymphoma

-a cancer of the lymphatic system
-consists of Hodgkins and non-hodgkins lymphoma
-symptoms include enlarged lymph nodes, fatigue and weight loss
-treatments include chemotherapy, medication, radiation therapy, and stem cell transplant

What is the difference between Hodgkins and non-hodgkins lymphoma

Hodgkins- lymphoma arises in a single node or chain of nodes, Reed-Sternberg cells are present
Non-Hodgkins- lymphoma originates at extranodal sites and spreads to anatomically contiguous nodes, Reed-Sternberg cells are not present

What is a risk factor associated with mononucleosis

Hodgkins lymphoma

What is Colorectal cancer

-3rd most common cancer in men and women

-2nd leading cause of cancer death in the united states

-etiology is unknown

-starts in the colon or rectum

What is hepatoma

-most common type of primary liver cancer

-Hepatocellular carcinoma most commonly occurs in people with liver disease, particularly in people with chronic hepatitis B and C

What is melanoma

-most serious type of skin cancer

-Melanoma occurs when the pigment-producing cells that give color to the skin become cancerous

-Symptoms might include a new, unusual growth or a change in an existing mole

-malignantmelanoma/benign nevus

What are the three types of skin cancer

-basal cell carcinoma

-squamous cell carcinoma

-melanoma

What is the difference between basal cell carcinoma, squamous cell carcinoma, and melanoma

Nonmelanoma skin cancer can refer to any cancer that forms in the basal, squamous or Merkel cells of the skin. Melanoma is a cancer that develops in the skin's melanocytes.

Who gets skin cancer

most common amongst fair skinned people

What is basal cell carcinoma (BCC)

-most common type

-these skin cancers are common after age 40

-basal cell cancer can appear waxy or pearly bumps, usually on your face, ears and neck. They can also appear flat, pink, scar like growths on your chest or back

What is squamous cell carcinoma (SCC)

-these cancers can be firm, red bumps or flat

-scaly and crusty growths on your face, ears, neck, hands, or arms. they're more common in fair-skinned people after age 50

What is malignant melanoma

-melanoma is the least common but most dangerous skin cancer

-its incidence is doubled in the last 20 years, and its estimated that one in 75 Americans will get melanoma at some time

-melanoma arises in pigment cells (melanocytes)

-it can develop anywhere on your body at any age and has a variety of appearances

What is favorable soil

-sites that cancer favors

-common sites for hematogenous spread

What is the rate of growth of a benign tumor

slow growth, usually doesn't cause death unless expansion as issue

What is the growth rate of malignant tumor

fast growth, death unless treated

Compare malignant vs benign tumors

malignant tumors grow much faster than benign and malignant will cause death unless treated where's benign doesn't typically cause death

Describe permanent cells or fixed

leave and don't come back in cell cycle

Describe stable cells

can re-enter the cell cycle

Describe labile cells

constantly going through cell cycle, we see a lot of cancer here

Describe Growth Fraction (GF)

-GF= cells within a tumor population that are in the proliferative pool

-"labeling (mitotic) index"= % cells in active stages of replication

-most tumors= 8-10%

-rapidly growing tumors= 20-30%

-normally growing intestinal epithelium= 16%

What is labeling index

% of cells in active stages of replication

Overall growth of tumor

dependent upon growth fraction and balance between cell production and cell loss

What type of cancer has a high growth factor

leukemias/lymphomas, and some lung cancers

What does high growth factor mean

rapidly growing, more symptomatic

What type of cancer has a low growth factor

colon/breast cancers

What does low growth rate mean

slow growing, not as many symptoms, less responsive to chemotherapeutic agents

What is doubling time

time it takes for the tumor to double in size and amount of cells (growth factor)

Tumors with high GF will equal decrease in _______

doubling time

Differentiation and or degree or anaplasia

-benign (well differentiated)

-malignant (poorly differentiated, anapestic, loss of common cellular characteristics)

What does anapestic mean

not good on biopsy, A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells

Degrees and differentiation of tumors

Low grade or grade I tumors are well-differentiated. This means that the tumor cells are organized and look more like normal tissue. High grade or grade III tumor cells are poorly differentiated. This means that the tumor cells don't look like normal cells

How to determine benign vs malignant tumors

A benign tumor has distinct, smooth, regular borders. A malignant tumor has irregular borders and grows faster than a benign tumor

Degree of local invasion

-Benign (restricted local growth, expansion, line of demarcation)

-malignant (locally invasive, infiltration,, tissue damage)

Define carcinoma in situ

A condition in which abnormal cells that look like cancer cells under a microscope are found only in the place where they first formed and haven't spread to nearby tissue

What is metastasis

-string determining factor in cancer treatment and prognosis

-development of secondary growth distant from the primary site

-all cancers have the potential to metastasize (exceptions: gliomas, basal cell carcinomas)

What can cause metastasis

Metastases most commonly develop when cancer cells break away from the main tumor and enter the body's bloodstream or lymphatic system

What are the methods of spread for metastasis

direct seeding and peritoneal

What is direct seeding

when tumor cells seed into an anatomical "open field"

What is peritoneal

pleural, pericardial, subarachnoid, joint spaces

What are the 4 most common sites of metastasis

lung, liver, bone, and brain

How does lymphatic spread in metastasis

(typical of carcinomas)- spread follows anatomical design of lymphatic vessels/nodes

Method of spread for hematogenous

-typical of sarcomas

-A hematogenous route of metastasis is the transfer of tumor cells from the primary tumor with the bloodstream

How are the liver and lungs affected by how metastasis spreads

commonly affected because of their relationship to portal and systemic circulation, respectively

What does metastasis look like in the liver

-Metastases may look like almost any lesion that occurs in the liver. Hemangiomas may be easily mistaken for metastases when they are multiple. On nonenhanced CT, they often form well-defined hypoattenuating lesions that mimic vascular metastases

-abdominal swelling or bloating. jaundice, a yellowing of the skin or the whites of the eyes. pain in the right shoulder. pain in the upper right abdom

What is iatrogenic

-during biopsy/surgery

-relating to illness caused by medical examination or treatment

What are the characteristics of metastases

-have the morphology of primary tumor

-tend to be encapsulated and well circumscribed

-location is sometimes predictable but sometimes not

-based on favorable soil

What are metastatic tendencies

-prostate cancer to bone

-bronchogenic Ca to adrenal and brain

-neuroblastoma to liver and bones

-very few spread to hear, skin, and skeletal muscle