Neoplasia and Tumors
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Questions and Answers

Which characteristic distinguishes malignant tumors from benign neoplasms?

  • Capacity to infiltrate, invade, and metastasize to distant sites. (correct)
  • Well-differentiated cells resembling normal tissue.
  • Localized growth with a fibrous capsule.
  • Slow growth over an extended period.

A tumor is examined and described as 'anaplastic'. What does this term indicate about the tumor's cells?

  • The cells are undifferentiated, demonstrating very poor cellular differentiation. (correct)
  • The cells exhibit a slow rate of growth over many years.
  • The cells are well-differentiated and closely resemble normal cells.
  • The cells are encapsulated and non-invasive.

What is the MOST accurate definition of 'neoplasm'?

  • An accumulation of inflammatory cells at the site of an infection.
  • A mass of tissue formed as a result of abnormal, excessive, uncoordinated, autonomous, and purposeless proliferation of cells even after cessation of stimulus for growth which caused it. (correct)
  • A temporary swelling of tissue due to injury.
  • A mass of tissue formed by normal, coordinated cell proliferation in response to a stimulus.

Which of the following statements accurately describes the typical growth pattern of benign tumors?

<p>Benign tumors grow as cohesive, expansile masses that remain localized. (C)</p> Signup and view all the answers

What is the primary significance of metastasis in the context of neoplasms?

<p>It marks the tumor as malignant, indicating a capacity to spread to distant sites. (C)</p> Signup and view all the answers

Which of the following is NOT a recognized pathway for the spread of metastasis?

<p>Transdermal absorption (D)</p> Signup and view all the answers

What best describes 'carcinogenesis'?

<p>The process by which a normal cell transforms into a malignant cell. (B)</p> Signup and view all the answers

Which of the following is NOT a recognized pattern of occurrence in carcinogenesis?

<p>Emotional carcinogenesis (D)</p> Signup and view all the answers

Exposure to ionizing radiation is MOST strongly associated with the development of which type of cancer?

<p>Leukemia (A)</p> Signup and view all the answers

Aflatoxin B1, a potent chemical carcinogen, is MOST strongly associated with which type of cancer?

<p>Hepatocellular carcinoma (B)</p> Signup and view all the answers

Which virus is MOST strongly associated with the development of Kaposi sarcoma?

<p>Human herpesvirus 8 (HHV-8) (A)</p> Signup and view all the answers

Which clinical feature is characterized by profound weakness, anorexia, anemia, and progressive loss of body fat in cancer patients?

<p>Cachexia (B)</p> Signup and view all the answers

Which of the following BEST defines paraneoplastic syndromes?

<p>A group of symptoms seen in some cancer patients that are not directly caused by the physical presence of the tumor or its metastases. (A)</p> Signup and view all the answers

What is the PRIMARY purpose of tumor markers in cancer management?

<p>To aid in diagnosis, prognosis, monitoring treatment response, and surveillance for recurrence. (C)</p> Signup and view all the answers

Which tumor marker is MOST commonly associated with ovarian cancer?

<p>CA 125 (C)</p> Signup and view all the answers

What is the MOST likely origin of a neoplasm described as a 'leiomyoma'?

<p>Smooth muscle (B)</p> Signup and view all the answers

Which of the following neoplasms is an exception to the general rule that benign tumors end with the suffix '-oma'?

<p>Hepatoma (A)</p> Signup and view all the answers

In the classification of tumors, what is the PRIMARY distinction between a benign and a malignant tumor?

<p>The capacity for local invasion and distant metastasis (B)</p> Signup and view all the answers

A pathologist examines a biopsy and notes that the tumor cells exhibit significant pleomorphism, hyperchromatism, and a high nuclear-to-cytoplasmic ratio. Which of the following is the MOST likely interpretation of these findings?

<p>The tumor is malignant and exhibits features of anaplasia. (A)</p> Signup and view all the answers

Which statement BEST describes the role of metabolic activation in chemical carcinogenesis?

<p>Metabolic activation converts relatively inert compounds into reactive forms that can damage DNA and other cell components. (B)</p> Signup and view all the answers

Which of the following is MOST likely to be a consequence of chronic exposure to high levels of aflatoxin B1?

<p>Elevated risk of hepatocellular carcinoma due to formation of DNA adducts in liver cells. (C)</p> Signup and view all the answers

What is a key difference in the mechanism of action between DNA and RNA viruses in viral carcinogenesis?

<p>DNA viruses can integrate their genetic material into the host cell's genome, whereas RNA viruses typically use reverse transcriptase. (A)</p> Signup and view all the answers

A patient presents with muscle weakness, sensory neuropathy, and small cell lung cancer. Symptoms began before cancer diagnosis. What is the MOST likely explanation?

<p>Paraneoplastic syndrome associated with the lung cancer. (C)</p> Signup and view all the answers

What is the PRIMARY reason why tumor markers are NOT ideal for cancer screening in the general population?

<p>Tumor markers often lack sufficient sensitivity and specificity, leading to both false positives and false negatives. (D)</p> Signup and view all the answers

Which characteristic is MOST indicative of a malignant neoplasm's capacity to invade the extracellular matrix (ECM)?

<p>Secretion of enzymes that degrade the basement membrane and interstitial connective tissue. (C)</p> Signup and view all the answers

In the context of tumor growth and development, what is the significance of angiogenesis?

<p>Angiogenesis provides nutrients and oxygen to the growing tumor and removes metabolic waste products. (C)</p> Signup and view all the answers

Which of the following cellular changes is LEAST likely to be associated with anaplasia?

<p>Uniformity in the size and shape of cells. (D)</p> Signup and view all the answers

A patient is diagnosed with basal cell carcinoma. What is the MOST significant risk factor?

<p>Chronic exposure to sunlight (B)</p> Signup and view all the answers

Which of the following viruses is MOST closely linked to cervical cancer?

<p>Human papillomavirus (HPV) (D)</p> Signup and view all the answers

What is the BEST rationale for using multiple tumor markers, rather than a single marker, in cancer management?

<p>Different tumor markers can provide complementary information about different aspects of the tumor. (D)</p> Signup and view all the answers

How does the process of 'homing' contribute to metastasis?

<p>Homing describes the selective adhesion and migration of tumor cells to specific distant organs. (C)</p> Signup and view all the answers

Which of the following is the LEAST likely characteristic of cancer cachexia?

<p>Increased appetite and food intake (D)</p> Signup and view all the answers

Which statement CORRECTLY describes how tumor markers are used in monitoring cancer treatment?

<p>A decrease in tumor marker levels during treatment suggests a positive response to therapy. (B)</p> Signup and view all the answers

What is the BEST description of the role of tumor suppressor genes in preventing carcinogenesis?

<p>Tumor suppressor genes regulate the cell cycle, DNA repair, and apoptosis to prevent uncontrolled cell growth. (C)</p> Signup and view all the answers

Which of the following scenarios is the BEST example of direct seeding as a pathway for metastasis?

<p>Ovarian cancer cells exfoliate and spread across the peritoneal surface. (B)</p> Signup and view all the answers

A researcher is investigating the role of the microenvironment in cancer progression. Which aspect of the tumor microenvironment would MOST likely promote metastasis?

<p>Hypoxia and acidosis, leading to increased expression of pro-angiogenic factors and matrix-degrading enzymes. (C)</p> Signup and view all the answers

Which of the following is NOT a typical factor contributing to the development of cancer cachexia?

<p>Reduced inflammation (C)</p> Signup and view all the answers

In the context of tumor immunology, what is the PRIMARY mechanism by which cancer cells evade detection and destruction by the immune system?

<p>Downregulation or loss of tumor-associated antigens, preventing T cell recognition. (A)</p> Signup and view all the answers

Flashcards

Tumor (Neoplasm)

A mass of tissue formed by abnormal, excessive, uncoordinated, autonomous, and purposeless cell proliferation even after the stimulus that caused it has stopped.

Oncology

The science that studies tumors or neoplasms.

Benign Tumors

Tumors that are grossly and microscopically innocent, localized, and do not spread. They can typically be easily excised and recurrence is rare

Malignant Tumors

Tumors generally called cancers that invade and destroy adjacent structures and can spread to distant sites.

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Adenoma

Benign neoplasm of glandular epithelium.

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Adenocarcinoma

Malignant neoplasm of glandular tissue.

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Differentiation

Extent to which parenchymal cells resemble comparable normal cells morphologically and functionally.

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Anaplasia

Malignant tumors composed of undifferentiated cells, indicating very poor cellular differentiation.

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Metastasis

Tumor implant discontinuous with the primary tumor; marks the tumor as malignant.

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Carcinogenesis

Process by which a normal cell transforms into a malignant cell, resulting from genetic mutations.

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Physical Carcinogenesis (Sun)

Cancers like basal & squamous cell carcinoma and malignant melanoma caused by sun exposure.

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Physical Carcinogenesis (Radiation)

Cancers like Acute myeloid leukemia (AML), Chronic myeloid leukemia (CML), and Thyroid cancer caused by X-rays & Gamma rays.

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Chemical Carcinogenesis

Scrotal cancer linked to chimney sweepers, skin cancer linked to coal tar exposure, and lung carcinoma linked to cigarette smokers.

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Chemical Carcinogenesis (Aflatoxin B1)

Hepatocellular carcinoma caused by Aflatoxin B1 from aspergillus fungus growing on improperly stored grains and nuts.

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Viral Carcinogenesis

Viral infections responsible for 15% of all human cancers.

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HPV

HPV virus strains 16 and 18: squamous cell carcinoma.

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EBV

double stranded DNA virus that usually targets B lymphocytes.

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Hepatitis B & C viruses

Partially double stranded DNA virus that can cause Chronic hepatitis which can lead to hepatocellular carcinoma.

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HHV 8

Kaposi sarcoma and lymphoma.

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Cancer Cachexia

Profound weakness, anorexia and anemia along with progressive loss of body fat.

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Paraneoplastic Syndromes

Group of symptoms seen in 10% of cancer patients include : difficult in walking and maintaining balance , loss of muscle coordination , loss of muscle tone and motor skills ,difficulty swallowing , slurred speech and memory loss.

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Tumor Markers

Substances found at higher than normal levels in the blood, urine, or body tissues of some people with cancer.

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Diagnosis

Confirm the results of other tests and symptoms

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Prognosis

Predict the cancer’s behavior response  to treatment, and chance of recovery

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Monitor Treatment

Determine how the  cancer is responding to treatment

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Surveillance

Determine the likelihood the cancer will return after treatment

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Screening

Find cancer in healthy or high-risk people before symptoms develop

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CA 15-3 and CA 27-29

Tumor marker for breast cancer.

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CA 125

Tumor marker for ovarian cancer.

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PSA

Tumor marker for prostate cancer.

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AFP

Tumor marker for liver cancer, and cancers of the ovary or testicles.

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Study Notes

  • Neoplasia is a mass of tissue formed from abnormal, excessive, uncoordinated, autonomous, and purposeless cell proliferation, even after the growth stimulus has stopped.
  • Oncology is the study of tumors or neoplasms.

Classification of Tumors

  • Benign tumors are grossly and microscopically innocent, localized, and do not spread, and can generally be easily excised with no recurrence.
  • Malignant tumors, generally called "cancers," invade and destroy adjacent structures and spread to distant sites.

Tumor Nomenclature

  • Benign neoplasms often end with "-oma" (e.g., adenoma, fibroadenoma, leiomyoma).
  • Exceptions to the "-oma" rule include hepatoma, melanoma, mesothelioma, and seminoma, which are malignant.
  • Malignant neoplasms often end with "-carcinoma" or "-sarcoma" (e.g., adenocarcinoma, rhabdomyosarcoma, leiomyosarcoma, squamous cell carcinoma, prostatic adenocarcinoma).

Characteristics of Neoplasms: Differentiation and Anaplasia

  • Differentiation refers to how much the parenchymal cells resemble normal cells morphologically and functionally.
  • Benign tumors are typically well-differentiated.
  • Malignant neoplasms range from well-differentiated to undifferentiated.
  • Anaplastic tumors are malignant and composed of undifferentiated cells, indicating poor cellular differentiation.

Characteristics of Neoplasms: Rate of Growth

  • Benign tumors generally grow slowly over years.
  • Cancers tend to grow rapidly, sometimes erratically, and can spread and kill the host.

Characteristics of Neoplasms: Local Invasion

  • Benign tumors grow as cohesive, expansile masses and remain localized.
  • They lack the capacity to infiltrate, invade, or metastasize, and may have a fibrous capsule.

Characteristics of Neoplasms: Metastasis

  • Metastasis, tumor implants discontinuous with the primary tumor, marks a tumor as malignant.
  • Benign tumors never metastasize.

Metastasis Pathways

  • Direct seeding of body cavities or surfaces.
  • Lymphatic spread.
  • Hematogenous spread.

Mechanism of Invasion and Metastasis

  • Invasion of the extracellular matrix.
  • Vascular dissemination and homing of tumor cells.

Carcinogenesis

  • Carcinogenesis is the process by which a normal cell transforms into a malignant cell, resulting from genetic mutations.

Patterns of Occurrence in Carcinogenesis

  • Physical carcinogenesis.
  • Chemical carcinogenesis.
  • Viral carcinogenesis.

Physical Carcinogenesis

  • Sun exposure can cause basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, predominantly among white races, with a direct correlation between sun exposure and skin cancer incidence.
  • Ionizing radiations (X-rays & Gamma rays) can induce acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and thyroid cancer.

Chemical Carcinogenesis

  • Potent carcinogenic compounds require metabolic activation before reacting with cell constituents.
  • Examples include scrotal cancer in chimney sweepers, skin cancer from coal tar exposure, and lung carcinoma in cigarette smokers.
  • Aflatoxin B1 from Aspergillus fungus on improperly stored grains and nuts can cause hepatocellular carcinoma.

Viral Carcinogenesis

  • Viral infections account for 15% of human cancers.
  • Associations between viruses and human cancer are known among RNA and DNA viruses.

Common Cancer-Causing DNA Viruses

  • Human Papilloma virus (HPV).
  • Epstein Barr virus (EBV).
  • Hepatitis B virus.
  • Human Herpes virus 8 (HHV).
  • HPV strains 16 and 18 are associated with squamous cell carcinoma.
  • EBV is a double-stranded DNA virus that usually targets B lymphocytes.
  • Hepatitis B & C viruses, partially double-stranded DNA viruses, may cause chronic hepatitis, leading to hepatocellular carcinoma.
  • HHV 8: Kaposi sarcoma and lymphoma.

Clinical Features of Cancer

  • Cancer cachexia: Profound weakness, anorexia, anemia, and progressive loss of body fat.
  • Paraneoplastic syndromes: Symptoms in 10% of cancer patients, including difficulty walking, loss of coordination, muscle tone, motor skills, difficulty swallowing, slurred speech, and memory loss.

Tumor Markers

  • Substances found at higher than normal levels in the blood, urine, or body tissues of some people with cancer, also known as serum markers or biomarkers.

Common Uses of Tumor Markers

  • Diagnosis: Confirm the results of other tests and symptoms.
  • Prognosis: Predict the cancer’s behavior, response to treatment, and chance of recovery.
  • Monitor treatment: Determine how the cancer is responding to treatment.
  • Surveillance: Determine the likelihood the cancer will return after treatment.
  • Screening: Find cancer in healthy or high-risk people before symptoms develop.

Examples of Tumor Markers

  • CA 15-3 and CA 27-29: Breast cancer.
  • CA 125: Ovarian cancer.
  • PSA: Prostate cancer.
  • AFP: Liver cancer, and cancers of the ovary or testicles.

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Description

Explore the classification and nomenclature of tumors, including benign and malignant neoplasms. Understand tumor naming conventions, using '-oma,' '-carcinoma,' and '-sarcoma' suffixes. Learn about differentiation and anaplasia in neoplasms.

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