path--Neoplasia I & II
Terms
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What does neoplasm mean?
What are the 2 definitions for neoplasm? -
new growth
1. mass of tissue that results from IRREVERSIBLE and INHERITABLE TRANSFORMATION in a somatic cell or cells leading to their uncontrolled proliferation.
The resulting neoplastic tissue is purposeless, preys on the host, and to some extent is autonomous.
A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissue and persists in the same excessive manner after cessation of the stimuli that caused the change -
What is the disease process that results from neoplasms?
Is this benign or malignant? -
neoplasia
benign OR malignant - What is the disease produced by malignant neoplasms?
- cancer
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What is a tumor?
Currently is it used to define a malignant or benign growth?
What else does the old (clinical) definition refer to as a tumor? -
literally means any mass or swelling.
At present this is mostly used to mean malignant OR benign neoplastic growths.
In the old ( clinical ) definition, an abscess or a hematoma, or a non-neoplastic growth are also referred to as tumors. - What are the two basic components of all tumors, benign or malignant?
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1. parenchyma - the proliferating neoplastic cells
2. supportive stroma - connective tissue and blood vessels - What are the proliferating neoplastic cells of a tumor known as?
- parenchyma
- What are the connective tissue and blood vessels of a tumor known as?
- supportive stroma
- What are the types of supportive stoma in a tumor?
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desmoplasia - abundant collagenous stroma
scirrhous - dense, fibrous stroma; stony hard ("harder than hard") - How are neoplasms named?
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The cell type or tissue of origin is used to name the tumor.
Ex. for squamous epithelium the neoplasm would begin with squamous cell ______. - What is the prefix for galndular epithelium?
- adeno
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What is the prefix for:
--skeletal muscle
--smooth muscle
--fat cell? -
skeletal = ( rhabdomyo )
smooth = ( leiomyo )
fat cell = ( lipo ) -
What is the prefix for:
cartilage
bone
endothelium
vascular
lymphatic -
cartilage = (chondro)
bone = (osteo)
endothelium =(hemangiopericytoma)
vascular = (angio)
lymphatic = (lymphangio) - What is the USUAL suffix for BENIGN tumors?
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-oma
Ex.
Fibroma - from fibroblastic cells
Chondroma - from cartilage
Osteoma - from bone - In addition to the cell type how else might a tumor be classified?
- microscopic architecture or macroscopic patterns.
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What is an adenoma?
A papilloma?
Cystadenoma?
Papillary cystadenoma?
Polyp? -
A tumor with...
Adenoma - glandular pattern
Papillomas - finger-like projections
Cystadenomas - cystic masses
Papillary cystadenoma - papillary patterns that protrude into cystic spaces
Polyp -projection above a mucosal surface - Which type of tumor, benign or malignant, is characterized as being surrounded by a fibrous capsule and having well defined smooth edges?
- Gross appearance of a BENIGN tumor
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Is a malignant tumor well defined?
What does it mean to be well-differentiated? -
On a microscopic level...
No, a benign tumor is well differentiated.
Means their parenchymal cell component resemble closely the normal cell in morphology and function. - What is the usual suffix for a malignant tumor?
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sarcoma
Ex. fibrosarcoma - fibrous tissue
liposarcoma - fat tissue
leiomyosarcoma - smooth muscle
rhabdomyosarcoma - striated muscle - What is a carcinoma? Give 2 examples.
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Malignant tumors that arise from epithelial cell origin (three germ layers).
Ex. adenocarcinomas and squamous cell carcinomas - What is the gross appearance of a malignant tumor?
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do NOT have capsules
margins are irregular due to "fingers" or malignant cells growing into adjacent normal tissue.
Hemorrhage, necrosis, and ulceration are usually present. Due to rapid growth - What happens to a malignant tumor on a microscopic level? With respect to the nucleus, staining, nucleoli and mitosis...
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Enlargement - increased nucleo:cytoplasmic ratio (N:C ratio)
Hyperchromasia - darkly staining due to increased DNA content
Coarsely clumped chromatin
Nucleoli are prominent, maybe multiple
Increased number of mitoses (not always present)
Abnormal mitotic forms (tripolar, quadripolar) -
What happens to the size and shape of a cell in a malignant tumor?
What kind of cells form? -
pleomorphism--variation in size and shape of the cells and nuclei.
tumor giant cells are formed - what is a mixed tumor? Is this benign or malignant?
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Ex. (pleomorphic adenoma) - tumor contains epithelial components scattered within a myxoid stroma
Could be either benign or malignant - What do you call a tumor that contains contains parenchymal cells of all 3 germ layers?
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teratoma--can have hair, sebaceous glands, tooth etc.
could be benign or malignant -
What do you call a tumor that is an overgrowth of mature tissue(s)normally present in an organ that results in disorderly histomorphology?
Is this neoplastic? -
Hamartoma (greek for error tumor)
**non-neoplastic - Give 2 examples of a hamartoma.
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1. skin hemangiomas 2. lung hamartomas - a mass of tissues mostly consisting of normal cartilage and bronchial epithelium.
These are often present at birth and may regress in time. -
What are normal cells or tissues that are present in abnormal places called?
What are synonyms for this? -
choristoma AKA aberrant, heterotropc, or ectopic rest
Ex. normal pancreatic tissue present in the intestinal mucosa, adrenal cells present in the kidney or elsewhere. - What is wrong with the following: melanoma, hepatoma, hypernephroma?
- All end in -oma meaning benign. But all are malignant conditions. These are based on old terminology and now more specific terminology would be malignant melanoma, hepatocellular carcinoma, renal cell carcinoma
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What is the tissue of origin for the following:
Brenner's tumor
Burkitt's lymphoma
Ewing's Sacrcoma
Grawitz's tumor
Kaposi's sarcoma? -
brenner's tumor= ovary
burkitt's lymphoma = lymph node
ewing's sarcoma--bone
Garwitz's tumor--kidney
Kaposi's sarcoma--blood vessels -
What is the tissue of origin for the following:
Krukenberg's tumor
Warthin's tumor
Wilm's tumor
Hodgkins disease? -
krukenberg's tumor= carcinoma of ovary--usually metastatic from stomach
warthins tumor--salivary gland
wilm's tumor = adenomyosarcoma of kidney
hodgkins disease= lymph nodes - What does leukemia infect? Malignant or benign?
- hematopoietic cells--malignant
- Is a lymphoma benign or malignant?
- malignant of lymph nodes
- What is a seminoma? Is it malignant or benign?
- malignant of testicular epithelium
- What is nevus?
- benign tumor of the melanocytes
- What is the term for naming a disease by a person's name instead of origin of disease?
- eponym
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What is differentiation?
Which is better differentiated: benign or malignant tumors? -
extent to which parenchymal cells resemble comparable normal cells--morphologically AND functionally
benign better differentiated -
Is metaplasia reversible?
What is metaplasia? -
yes--reversible
which one adult cell type ( epithelial or mesenchymal ) is replaced by another adult cell type. - What is dysplasia?
- deranged development. Proliferation and atypical cytologic alterations involving cell size, shape, and organization
- What does carcinoma in situ mean?
- cancer in site--stuck where it belongs--has not yet metastasized; hasn't penetrated the basal membrane
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Are malignant tumors well differentiated or not?
What is a reliable feature of malignancy?
What does this result in? -
Range from well differentiated to undifferentiated.
**Invasiveness is a reliable feature of malignancy
Invasiveness results in destruction of the surrounding tissue. - What does anaplasia mean?
- lack of differentiation
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Which grows more rapidly--malignant or benign tumors?
Why is this? -
malignant
Factors such as hormone dependence, adequacy of blood supply, “geneticsâ€, all influence growth. - Which type of tumor grow as cohesive expansile masses?
- Almost all benign tumors
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What do benign tumors often grown around themselves?
Give an example. -
They develop a rim of compressed connective tissue, a fibrous capsule, a discrete, easily movable mass.
Wx. Benign fibroadenoma of the breast -
What does metastasis imply?
Can ALL cancers metastasize?
What % of newly diagnosed patients with solid tumors (excludes most skin cancer) present with metastases? -
malignancy
yes, with few exceptions
30% -
What are the most common way of spreading cancer?
Which is most common? -
lymphatic--most common. Follows normal route of drainage
hematogenous--usually thru venous, drains to liver and lung! -
Which cancer has the highest incidence in men? women?
Which cancer has the greatest death rate in men? women? -
Incidence: men=prostate ; women = breast
Death: men and women: lungq - Which cancers have gone decreased in women since 1930? Which is on the rise?
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uterine cancer b/c of pap smear.
stomach cancer down due to warnings about smoked foods.
colon and rectum down due to screening and health habits
Since 1960--lung cancer on the rise due to smoking
Note that breast cancer has remained about the same. - Which cancers have gone decreased in men since 1930? Which is on the rise?
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decrease in stomach cancer = to warnings about smoked food.
massive increase in lung cancer since 1930.
All other cancers remain about the same since 1930's -
What can lead to stomach cancer?
melanomas?
GI cancer?
Cervical cancer? -
stomach cancer--smoked fish (japan esp)
melanomas--fair skinned people and sun exposure
GI tract--alcohol abuse
Cervical cancer--promiscuity and STDs - Besides lung cancer what else can smoking cause?
- bladder cancer--toxins sit in bladder for extended periods of time, could cause cancer