Neoplasia and Tumor Development

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Questions and Answers

Which characteristic distinguishes carcinoma in situ from invasive carcinoma?

  • Presence of metastasis
  • Cellularity
  • Involvement of the entire epithelium thickness
  • Penetration of the basement membrane (correct)

What cellular mechanism is primarily responsible for the invasion of the basement membrane in invasive carcinoma?

  • Release of collagenases and hydrolases (correct)
  • Increased E-cadherin expression
  • Enhanced cell-cell contacts via integrins
  • Apoptosis of surrounding stromal cells

Which of the following best describes the role of the stroma in neoplastic growth?

  • Provides structural and nutritional support to neoplastic cells (correct)
  • Directly participates in monoclonal proliferation
  • Suppresses the growth of neoplastic cells
  • Induces apoptosis in parenchymal cells

In the context of neoplastic progression, what process is typically associated with the loss of cell-cell contacts?

<p>Inactivation of E-cadherin (C)</p>
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Which of the following features is characteristic of dysplasia but not necessarily of carcinoma in situ?

<p>Reversibility (C)</p>
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How does the growth pattern of a benign tumor typically differ from that of a malignant tumor?

<p>Well-differentiated and well-demarcated (A)</p>
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Which characteristic is most indicative of a malignant tumor's potential for aggressive behavior?

<p>Poor differentiation (anaplasia) (B)</p>
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What distinguishes a hamartoma from a choristoma?

<p>Tissue organization and location (D)</p>
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Which of the following factors has the greatest impact on the prognosis of a patient with cancer?

<p>Tumor stage (B)</p>
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In the context of tumor grading, what does 'high-grade' typically indicate?

<p>Undifferentiated or poorly differentiated cells with high mitotic activity (C)</p>
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What is the primary mechanism by which carcinomas typically spread?

<p>Through lymphatic vessels (B)</p>
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What is the correct order of cancer formation from normal cells?

<p>Normal cells → Dysplasia → Carcinoma in situ → Invasive carcinoma → Metastasis (C)</p>
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How do sarcomas primarily disseminate throughout the body?

<p>Via hematogenous spread (D)</p>
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What cellular feature is most indicative of anaplasia?

<p>Pleomorphism and hyperchromasia (D)</p>
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Which of the following best explains the term 'monoclonal proliferation' in the context of neoplasia?

<p>The tumor cells are derived from a single progenitor cell (A)</p>
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What is a key microscopic feature that differentiates dysplasia from normal tissue?

<p>Loss of tissue orientation (B)</p>
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Which of the following statements best describes how the TNM staging system is applied in cancer diagnosis?

<p>It evaluates the size and invasion, lymph node involvement, and distant metastasis. (B)</p>
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A pathologist examines a tissue sample and observes cells that have invaded the basement membrane, which is composed of collagen and other proteins. Which cellular process is most likely enabling this invasion?

<p>Secretion of metalloproteinases (A)</p>
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A researcher is studying a new drug that aims to prevent metastasis. Which of the following mechanisms of action would be most effective in achieving this goal?

<p>Enhancing E-cadherin function on cancer cells (D)</p>
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A pathologist is examining a biopsy from a suspicious skin lesion. The report indicates the presence of dysplasia but no invasion of the basement membrane. How should this condition be classified?

<p>Carcinoma in situ (A)</p>
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Which characteristic is most frequently observed in malignant neoplasms compared to benign tumors?

<p>Potential for metastasis (B)</p>
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If immunohistochemistry of tumors identifies them as originating in the epithelium, how would these tumors be classified?

<p>Carcinomas (D)</p>
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What distinguishes a leiomyosarcoma from a leiomyoma?

<p>Degree of differentiation and potential for metastasis (C)</p>
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Which of the following types of tumors is most likely to spread via the bloodstream?

<p>Osteosarcoma (B)</p>
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A new drug inhibits the action of metalloproteinases. What is the most likely intended effect of this drug?

<p>Inhibition of metastasis (B)</p>
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How does determining the "grade" of a tumor typically contribute to cancer management?

<p>By assessing the aggressiveness of the tumor (D)</p>
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A patient has a tumor that is staged as T1N0M0. What does this staging generally indicate?

<p>Small tumor with no lymph node involvement or distant metastases (B)</p>
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What is one key difference between a benign tumor and a malignant tumor regarding their interaction with surrounding tissues?

<p>Malignant tumors invade and destroy adjacent tissues (D)</p>
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A pathologist reports that a sample shows 'loss of uniformity in cell size and shape' and 'increased nuclear:cytoplasmic ratio'. What condition do these findings suggest?

<p>Dysplasia (B)</p>
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What role does fibronectin play in the metastatic process?

<p>Serving as a substrate for cancer cell attachment and spread (B)</p>
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What is the significance of identifying atypical mitotic figures in a tumor sample?

<p>Suggests rapid, uncontrolled cell division and anaplasia (A)</p>
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How does the presence of pleomorphism in tumor cells influence tumor grading?

<p>Characterizes high grade anaplastic tumors (A)</p>
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What is 'omentatal caking' and what does it signify?

<p>Advanced staged ovarian cancer (B)</p>
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During a biopsy analysis, which finding would classify a tumor as anaplastic?

<p>Cells that do not resemble the tissue of origin (B)</p>
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What is the term 'stroma' refer to in neoplastic context?

<p>Supporting, non-neoplastic host cells (A)</p>
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What is 'hematoma' when referring to patterns of cancerous spread?

<p>Cancer spread through the blood stream (D)</p>
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Flashcards

Neoplasia

Uncontrolled, monoclonal cell proliferation that can be benign or malignant. It includes parenchyma and stroma.

Parenchyma (neoplasia)

The functional tissue of a tumor, consisting of neoplastic cells.

Stroma (neoplasia)

The supporting tissue of a tumor, including blood vessels and connective tissue.

Normal cells

Normal cells that exhibit basal to apical polarity.

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Dysplasia

Loss of uniformity in cell size and shape (pleomorphism); loss of tissue organization; nuclear changes; often reversible.

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Carcinoma in situ

Irreversible severe dysplasia involving the entire thickness of the epithelium but not penetrating the basement membrane.

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Invasive carcinoma

Cells have invaded the basement membrane using collagenases and hydrolases, losing cell-cell contacts.

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Metastasis

Spread to distant organs via lymphatics or blood.

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Carcinoma

Implies epithelial origin of the tumor.

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Sarcoma

Denotes mesenchymal origin of the tumor.

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Hamartoma

Organized tissue overgrowth in native location.

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Choristoma

Normal tissue in a foreign location.

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Tumor Grade

Degree of cell differentiation and mitotic activity.

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Tumor Stage

Degree of invasion and spread from the initial site.

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Study Notes

  • Neoplasia involves uncontrolled, monoclonal cell proliferation, and can be benign or malignant
  • Neoplastic growth: parenchyma (neoplastic cells) & supporting stroma (non-neoplastic cells, vessels, connective tissue)

Neoplastic development stages

  • Normal cells exhibit basal to apical polarity
  • Dysplasia involves loss of uniformity in cell size/shape (pleomorphism), loss of tissue orientation & nuclear alterations, reversible
  • Carcinoma in situ/preinvasive stage: severe dysplasia spans entire epithelium thickness, without penetrating basement membrane
  • Invasive carcinoma: cells invade basement membrane using collagenases and hydrolases; cell-cell contacts lost via E-cadherin inactivation; cells attach to fibronectin to spread
  • Metastasis: cancer spreads to distant organs via lymphatic system or blood

Tumor Nomenclature

  • Carcinoma: epithelial origin, spread via lymph nodes
  • Sarcoma: mesenchymal origin, spread via blood
  • Benign tumors: well-differentiated, well-demarcated, low mitotic activity, no metastases or necrosis
  • Malignant tumors (cancers): poor differentiation, erratic growth, local invasion, metastasis, decreased apoptosis, pleomorphic, hyperchromatic nuclei sizes and shapes vary

Malformation terms

  • Hamartoma: disorganized overgrowth of tissues in native location
  • Choristoma: normal tissue in a foreign location

Benign vs Malignant Tumors

  • Adenoma/papilloma: benign epithelial tumor
  • Adenocarcinoma/papillary carcinoma: malignant epithelial tumor
  • Hemangioma: benign blood vessel tumor
  • Angiosarcoma: malignant blood vessel tumor
  • Leiomyoma: benign smooth muscle tumor
  • Leiomyosarcoma: malignant smooth muscle tumor
  • Rhabdomyoma: benign striated muscle tumor
  • Rhabdomyosarcoma: malignant striated muscle tumor
  • Fibroma: benign connective tissue tumor
  • Fibrosarcoma: malignant connective tissue tumor
  • Osteoma: benign bone tumor
  • Osteosarcoma: malignant bone tumor
  • Lipoma: benign fat tumor
  • Liposarcoma: malignant fat tumor
  • Nevus/mole: benign melanocyte tumor
  • Melanoma: malignant melanocyte tumor

Tumor Grade vs Stage

  • Grade: degree of cell differentiation and mitotic activity, low-grade to high-grade; requires biopsy
  • Stage: degree of invasion and spread, based on clinical or pathological findings; uses TNM staging system
    • T: Primary tumor size/invasion.
    • N: Regional lymph node metastasis.
    • M: Distant metastasis.
  • Stage is more prognostic than grade because spread determines survival

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