Neoplasia & Cancer Overview

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Questions and Answers

What is the most frequent location for hamartomas?

  • Spleen
  • Kidney
  • Lungs (correct)
  • Liver

Which of the following features is NOT associated with malignant tumors?

  • Pleomorphism
  • Anaplasia
  • Rapid growth
  • Well-defined capsule (correct)

What type of cancer originates from muscle tissue?

  • Lymphoma
  • Carcinoma
  • Sarcoma (correct)
  • Teratoma

Which of the following is a characteristic of a benign hamartoma?

<p>Well-encapsulated growth (B)</p> Signup and view all the answers

What describes germ cell layer derived tumors?

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

What type of teratoma is typically malignant and found in males?

<p>Immature Teratoma (D)</p> Signup and view all the answers

How do benign tumors typically grow compared to malignant tumors?

<p>By pushing other tissues aside (D)</p> Signup and view all the answers

Which of the following symptoms can be caused by tumors?

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

Which tumors commonly metastasize through the lymphatic system?

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

What condition can be caused by tumors producing hormone-like substances?

<p>Cushing syndrome (C)</p> Signup and view all the answers

Which of the following is NOT a common target for metastasis?

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

What is a characteristic feature of paraneoplastic syndromes?

<p>Hormonal abnormalities (D)</p> Signup and view all the answers

What is a common manifestation of cancer-related cachexia?

<p>Severe fatigue (D)</p> Signup and view all the answers

What term refers to the uncontrolled, disorderly proliferation of cells resulting in a tumor?

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

Which of the following is a characteristic of benign neoplasms?

<p>They are often encapsulated. (C)</p> Signup and view all the answers

Which suffix is commonly used to designate benign tumors?

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

What distinguishes malignant tumors from benign tumors?

<p>Malignant tumors are undifferentiated. (D)</p> Signup and view all the answers

In what type of tissue does a papilloma arise?

<p>Surface epithelium (C)</p> Signup and view all the answers

What does cancer specifically refer to in terms of tumor classification?

<p>Malignant tumors only (C)</p> Signup and view all the answers

What is one significant aspect of the biological behavior of benign tumors?

<p>They do not metastasize. (A)</p> Signup and view all the answers

Which of the following statements about cancer incidence and mortality is correct?

<p>Incidence indicates the probability of developing cancer. (D)</p> Signup and view all the answers

What condition is primarily associated with selective loss of fatty tissue and muscle mass in cancer patients?

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

What is the prognostic significance of weight loss in cancer patients?

<p>30-35% weight loss indicates imminent death. (D)</p> Signup and view all the answers

Which type of cancer is associated with the highest weight loss?

<p>Pancreatic cancer (C)</p> Signup and view all the answers

What are cytokines such as TNF and IL-6 primarily involved in with respect to cancer?

<p>Affecting lipid and protein metabolism. (D)</p> Signup and view all the answers

How does cancer-induced anorexia primarily affect patients?

<p>It causes a loss of appetite. (C)</p> Signup and view all the answers

Which diagnostic test is NOT commonly associated with cancer diagnosis?

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

What happens to muscle mass during cancer cachexia?

<p>Muscle mass decreases. (B)</p> Signup and view all the answers

Which parameter shows the MOST significant difference between normal individuals and cachectic cancer patients?

<p>Total body weight (C)</p> Signup and view all the answers

What is the primary purpose of grading and staging in cancer diagnosis?

<p>To help determine prognosis and therapy decisions (D)</p> Signup and view all the answers

What does the 'T' in the TNM staging system represent?

<p>Size and extent of the tumor (B)</p> Signup and view all the answers

Which grading indicates a cancer that is poorly differentiated?

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

What does the ann arbor system specifically classify?

<p>Hodgkin disease and non-Hodgkin lymphomas (A)</p> Signup and view all the answers

Which of the following is NOT applicable to leukemias and tumors of the central nervous system?

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

What does a designation of N1 in the TNM system indicate?

<p>Regional lymph node involvement (A)</p> Signup and view all the answers

What characterizes cancer at stage Tis?

<p>In situ and non-invasive, confined to epithelium (D)</p> Signup and view all the answers

Which of the following best describes chromosomal translocations in relation to carcinogenesis?

<p>They bring together genes that can cause uncontrolled growth (C)</p> Signup and view all the answers

What genetic change is associated with Burkitt’s lymphoma?

<p>Translocation of proto-oncogene c-myc to chromosome 14 (B)</p> Signup and view all the answers

What is the first step in the process of carcinogenesis?

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

Which of the following is considered a natural carcinogen linked to liver cancer?

<p>Aflatoxin B1 (C)</p> Signup and view all the answers

Which chromosome is involved in the Philadelphia chromosome associated with chronic myelogenous leukemia?

<p>Chromosome 22 (C)</p> Signup and view all the answers

What type of radiation is mainly linked to causing skin cancer?

<p>UV light (C)</p> Signup and view all the answers

What is one of the outcomes of the promotion phase in carcinogenesis?

<p>More cells with mutations (C)</p> Signup and view all the answers

Which chemical carcinogen is associated with leukemia?

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

The Epstein-Barr virus is primarily associated with which type of cancer?

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

Which carcinogen is specifically cited for causing scrotal cancer in chimney sweeps?

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

What type of genetic alteration typically occurs before cancer develops?

<p>Inactivation of tumor suppressor genes (C)</p> Signup and view all the answers

Flashcards

Neoplasia

Uncontrolled, disorderly cell proliferation resulting in a benign or malignant tumor.

Neoplasm

A neoplastic growth, which can be benign or malignant.

Benign Neoplasm

A tumor that resembles original tissue, grows slow, doesn't spread, is often encapsulated, and doesn't destroy surrounding tissues.

Malignant Neoplasm

An undifferentiated, uncontrolled growth that invades surrounding tissue, metastasizes, and is destructive.

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Cancer

Malignant tumor.

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Tumor Components

Tumors have proliferating tumor cells and supporting stroma with connective tissue and vessels.

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Naming Benign Tumors

Benign tumors are named using the suffix "-oma" (e.g., lipoma, fibroma, adenoma).

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Characteristics of Benign Tumors

Slow growth, encapsulated, do not metastasize, and are not destructive.

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Papilloma

Benign neoplasm arising from surface epithelium; finger-like projections.

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Hamartoma

Benign overgrowth of malformed tissue, often found in lungs, kidneys, or spleen.

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Malignant Tumor

Cancerous tumor with invasive growth and potential metastasis.

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Metastasis

Spread of cancer cells from the primary tumor to other parts of the body.

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Anaplasia

Poorly differentiated cancerous cells.

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Pleomorphism

Wide variation in the shape and appearance of cancer cells.

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Carcinoma

Cancer originating from epithelial cells (skin, glands, lining of organs).

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Squamous Cell Carcinoma

Carcinoma originating from squamous cells, often found in skin, mouth, esophagus.

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Adenocarcinoma

Carcinoma originating from glandular tissue, frequently in the digestive system.

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Sarcoma

Cancer originating from muscle, bone, or connective tissue.

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Teratoma

Tumor derived from germ cells (e.g., ovary, testis).

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Cancer Cachexia

Selective loss of muscle and fat tissues in cancer patients; not fully understood but a significant prognostic factor.

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Cachexia's effect on weight loss

Weight loss of 30-35% is often seen as fatal in cancer patients with cachexia, this is especially prominent in gastric and pancreatic cancer.

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Cancer cachexia effects on body composition

Cancer-related cachexia significantly decreases total body weight, fat, and muscle protein, while leaving other tissues relatively unchanged.

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Cancer's impact on Metabolism

Cancer can disrupt lipid and protein metabolism, producing factors and cytokines to promote this disruption.

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Effect of Cancer on Appetite

Cancer often leads to decreased appetite (anorexia) in afflicted patients.

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Impact of Cancer on Respiratory Function

Loss of muscle mass in cachectic patients can lead to respiratory failure, such as hypostatic pneumonia due to reduced mobility.

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Cancer-related Diagnostic Clues: Weight Loss

Notable weight loss in cancer patients serves as a significant clinical sign for diagnosis.

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Cancer-related Diagnostic Methods

Diagnosis often includes clinical observation (like weight loss), imaging techniques (like X-ray, CT, MRI), biopsies, and laboratory tests (like CBC, PSA, CEA).

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Teratoma

A tumor containing different types of tissues, often benign, but capable of being malignant. Typically develops from stem cells.

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Immature Teratoma

A malignant type of teratoma, usually found in male testicles, and containing immature tissues.

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Mature Teratoma

A benign type of teratoma, often found in females. It contains well-developed tissues.

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Benign Lesion

A non-cancerous growth that grows by pushing surrounding tissue aside, usually with its own capsule.

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Malignant Tumor

A cancerous growth that invades surrounding tissues without respect for boundaries. Doesn't have a capsule.

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Metastasis

The spread of cancer from one part of the body to another through the bloodstream or lymphatic system.

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Carcinomas

Cancers that arise from epithelial cells, most commonly spread through lymphatics.

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Sarcomas

Cancers that arise from connective tissue, more likely spread by bloodstream.

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Paraneoplastic syndromes

Symptoms caused by cancer, but not directly from the tumor's local effects. These are related to the cancer's production of hormones or antibodies.

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Hypercalcemia (cancer)

Elevated calcium levels caused by cancer-produced parathyroid hormone-like protein.

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Invasion & Metastasis

Essential steps in the biological behavior of cancerous cells. Invasion is the local spread, metastasis is the spread to distant sites.

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Cancer Death Causes

Death due to cancer often results from the tumor's effects on organs, obstruction, bleeding, or the spread (metastasis) to vital tissues (liver, lungs, brain) that are essential for the body to function.

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Cancer Diagnosis Difficulty

Cancer symptoms can mimic other conditions (like infections or benign growths), making diagnosis challenging.

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Grading & Staging Cancer

Classifying cancer based on its characteristics (like tissue appearance, size, and spread) to predict its behavior and guide treatment.

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Grading Cancer

Evaluating cancer cells' differentiation (how much they resemble normal cells) to assess its aggressiveness.

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Staging Cancer

Determining cancer's size, spread to lymph nodes, and distant metastasis to understand its extent for effective treatment targeting.

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TNM System

A system for staging cancer based on Tumor size/spread (T), Lymph Node involvement (N), and Metastasis (M).

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Tumor Grade I

Well-differentiated cancer cells; closely resemble normal cells; often slow-growing.

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Tumor Grade IV

Nearly anaplastic cancer cells; little resemblance to normal cells; usually aggressive.

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Cancer Staging Tis

Cancer is in situ; non-invasive (confined to the original tissue layer).

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Cancer Staging T4

Cancer is large and/or highly invasive, spreading to adjacent organs.

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Cancer Staging M1

Cancer has spread to distant locations in the body (metastasis).

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Carcinogenesis

The process by which cancer forms; involves changes in a cell's genome.

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Viral Oncogenes

Genes introduced by viruses that stimulate cancer development.

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Burkitt's Lymphoma

A cancer of the lymphatic system, often linked to a translocation involving chromosome 8 and 14.

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T(8;14)

A chromosomal translocation in Burkitt’s lymphoma, where a proto-oncogene (c-myc) moves to the Immunoglobulin heavy chain locus.

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Chronic Myelogenous Leukemia (CML)

A cancer of the blood characterized by a specific translocation (Philadelphia chromosome T(9;22)).

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T(9;22)

A chromosomal translocation in CML leading to the formation of the Philadelphia chromosome and activation of oncogene BCR-ABL

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BCR-ABL

A fusion protein formed by a translocation in Chronic Myelogenous Leukemia (CML). It activates a tyrosine kinase.

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Chemical Carcinogenesis

Cancer development from exposure to chemicals; involves initiation and promotion.

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Tumor Initiator

A substance that causes initial genetic damage leading to cancer.

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Tumor Promoter

A substance that stimulates abnormal cell growth and proliferation in the presence of initiated cells.

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Carcinogens

Substances that can increase the risk of developing cancer.

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Asbestos

A carcinogen linked to lung and mesothelioma cancer.

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Benzene

A carcinogen associated with leukemia.

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UV light

A carcinogen leading to skin cancer.

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Ionizing radiation

Carcinogens leading to leukemias, lung cancer, and other cancers.

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HPV

A virus linked to cervical cancer development.

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Percivall Pott

Noted chimney sweeps' cancer in 18th-century England.

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Study Notes

Neoplasia & Cancer

  • Neoplasia means "new growth" (Greek)
  • Neoplasm is neoplastic growth
  • Neoplasia is uncontrolled, disorderly proliferation of cells, forming a benign or malignant tumor
  • Cancer is a malignant tumor; a crab-like growth that takes hold of tissue
  • In 2023, more than 20 million new cancer cases globally and 10 million deaths
  • In 2023, over 1.9 million new cancer cases annually in the US, with approximately 610,000 deaths

General Characteristics of Benign Tumors

  • Naming: Benign tumors end in "-oma" (e.g., lipoma, fibroma, adenoma).
  • Biological behavior: slow growth, encapsulated, do not metastasize, not destructive
  • Papilloma: benign neoplasm arising from surface epithelium (finger-like projections)
  • Adenoma: benign neoplasm arising from glandular epithelium
  • Benign neoplasms from mesenchymal origin (e.g., muscle, connective tissue, fat, bone, cartilage): fibroma, lipoma, leiomyoma, rhabdomyoma, chondroma.

General Characteristics of Malignant Tumors (Cancer)

  • Form metastasis—most defining characteristic of malignant tumors.
  • Invasive growth; no capsule.
  • Undifferentiated; may hardly resemble the original tissue.
  • Important cellular features:
    • Anaplasia (poorly differentiated).
    • Pleomorphism (wide variation in shape and appearance of tumor cells).
    • Hyperchromatic nucleus (dark staining nucleus).
    • High nuclear-to-cytoplasm ratio.
    • Prominent nucleoli.
    • Rapid growth.
    • Frequently necrosis (lack of sufficient blood supply).

Cancer Naming

  • Carcinoma: malignant tumor of epithelial cell origin (e.g., squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma).
  • Sarcoma: cancer of muscle, bone, connective tissue, fat tissue (e.g., leiomyosarcoma, rhabdomyosarcoma, osteosarcoma, chondrosarcoma, liposarcoma).

Specific Cancers

  • Burkitt's lymphoma
  • Hodgkin's disease
  • Wilms' tumor

Teratoma

  • Germ cell layer-derived tumor (ovary, testis); may contain bone, teeth, etc.
  • Immature teratoma: malignant, typically in males.
  • Mature teratoma: benign, typically in females.

Cancer Invasion and Metastasis

  • Benign lesions grow by pushing surrounding tissue.
  • Malignant tumors invade nearby tissues.
  • Metastasis: tumor cells enter blood or lymphatic vessels, travel, and form new tumors in other parts of the body (e.g., metastasis to lymph nodes, liver, lungs, brain, bone marrow).

Clinical Manifestations of Malignancies

  • Symptoms due to location of the tumor or metastasis: pain, swellings, obstruction, bleeding, color changes, edema, body function changes.
  • Symptoms related to features of the tumor: wasting (cachexia), weight loss, weakness, loss of appetite, anemia, infection.
  • Hormones that may be produced by tumors can cause hormone abnormalities (e.g. growth hormone causing gigantism or acanthosis nigricans)
  • Paraneoplastic syndromes: cancer-related symptoms such as hypercalcemia (parathyroid hormone-like protein), hypoglycemia or Cushing’s syndrome from hormone-like effects and neurologic abnormalities (antibodies associated with cancer).

Diagnosis of Cancer

  • Symptoms (visual tumor, bleeding, weight loss).
  • Diagnostic tests (X-rays, CT scans, MRIs, biopsies).
  • Lab tests (CBC, PSA, CEA).

Grading and Staging

  • Grading: histopathologic evaluation of cellular differentiation (degree of abnormality)
  • Staging: assessment of tumor size, lymph node involvement, and metastasis (extent of spread)
  • TNM system (Tumor, Node, Metastasis) is used to classify and stage specific cancers.

Carcinogenesis

  • Cancer development occurs due to changes in the cell's genome—DNA changes.
  • New genes or damaged/mutated genes that promote uncontrolled growth

Causes of Cancer

  • Chemical carcinogens (e.g., asbestos, arsenic, benzene, vinyl chloride, benzopyrene, tobacco smoke components, and radiation like UV light, ionizing radiation)
  • Viral carcinogens (e.g., HPV, Epstein-Barr virus, other viruses).
  • Other factors: environmental exposure

Why Do People Die of Cancer?

  • Direct interference with body functions (obstruction).
  • Bleeding.
  • Treatment-related deaths.
  • Production of substances that alter tissue function (e.g., hormones).
  • Cancer-induced cachexia and anorexia (loss of muscle and fat tissue).

Cachexia and Cancer Death

  • Selective loss of fatty tissue and muscle mass.
  • Cancer cells may disrupt lipid and protein metabolism, and produce factors that induce lipolysis and proteolysis.
  • Loss of muscle mass due to immobility and insufficient protein intake.
  • Anorexia (loss of appetite).

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