Neoplasia II: Paraneoplastic Syndrome

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Questions and Answers

What is the primary mechanism through which paraneoplastic syndromes are mediated?

Production and release of physiologically active substances from tumor cells (correct)

Direct invasion of tumor cells into nearby tissues

Genetic mutations in normal tissue cells

Increased immune response without antibody involvement

Which of the following is NOT classified as a paraneoplastic syndrome?

Endocrine syndromes

Genetic syndromes (correct)

Neurological syndromes

Hematological syndromes

What term describes inappropriate hormone production by tumors that do not normally produce those hormones?

Autocrine secretion

Endocrine signaling

Ectopic hormone production (correct)

Paraneoplastic signaling

Which condition is a common paraneoplastic syndrome associated with lung cancer?

Cushing syndrome Signup and view all the answers

What is the role of antibodies in the context of paraneoplastic syndromes?

To cross-react with normal tissues leading to damage Signup and view all the answers

Which symptom is most likely associated with hypercalcemia in paraneoplastic syndromes?

Increased thirst and urination Signup and view all the answers

What is a paraneoplastic syndrome primarily characterized by?

Remote effects caused by cancer Signup and view all the answers

Which of the following statements correctly describes the role of humoral factors in paraneoplastic syndrome?

They are hormones or cytokines secreted by tumor cells. Signup and view all the answers

What is one major significance of paraneoplastic syndromes in relation to cancer diagnosis?

They may precede tumor diagnosis as early manifestations. Signup and view all the answers

Which of the following best describes a potential consequence of paraneoplastic syndrome?

They can mimic metastatic disease, complicating treatment. Signup and view all the answers

Which aspect of paraneoplastic syndrome relates to immune response?

It involves an immune response against the tumor. Signup and view all the answers

Which of the following classifications accurately fits paraneoplastic syndrome's influence on clinical problems?

They often lead to significant health issues and may even be lethal. Signup and view all the answers

Which underlying cancer is most commonly associated with Cushing syndrome?

Small cell carcinoma of lungs Signup and view all the answers

What is a known mechanism behind neurological manifestations in associated cancers?

Cross-reactivity of antibodies against nervous system antigens Signup and view all the answers

What dermatological condition is characterized by thickened darker skin in the neck and armpits?

Acanthosis nigricans Signup and view all the answers

What hematological complication is commonly seen with underlying malignancies?

Increased red blood cell count Signup and view all the answers

Which underlying cancer is NOT typically associated with subacute cerebellar degeneration?

Gastric carcinoma Signup and view all the answers

What mechanism is suggested in the development of acanthosis nigricans in cancer patients?

Secretion of epidermal growth factor Signup and view all the answers

Which of the following is NOT a common hematological manifestation in cancer patients?

Iron deficiency anemia Signup and view all the answers

What is a common immunological mechanism associated with subacute cerebellar degeneration?

Autoimmunity against neuronal cells Signup and view all the answers

Which of the following mechanisms is associated with venous thrombosis?

Prolonged immobilization Signup and view all the answers

Which cancer is linked to disseminated intravascular coagulation (DIC)?

Prostatic carcinoma Signup and view all the answers

What is a potential response mechanism in polycythemia vera that may lead to its occurrence?

Hypoxia or ectopic EPO production Signup and view all the answers

Which condition is marked by hypercoagulability due to abnormalities in blood composition?

Venous thrombosis Signup and view all the answers

Which cancer type is primarily associated with pancreatic carcinoma?

Bronchogenic carcinoma Signup and view all the answers

What typically results from increased clotting factors in the blood?

Increased tendency for clot formation Signup and view all the answers

Study Notes

Paraneoplastic Syndrome Overview

Defined as diseases or symptoms resulting from cancer, not due to the direct presence of tumor cells.
Mediated by humoral factors like hormones or cytokines secreted by tumors or an immune response targeting tumors.

Significance of Paraneoplastic Syndrome

May present as the earliest sign of neoplasm prior to tumor diagnosis.
Can lead to serious clinical complications and may be life-threatening.
Might mimic metastatic disease, complicating treatment decisions.

Pathogenesis

Involves immune system response resulting in cross-reacting antibodies targeting both tumor and normal tissues.
Tumors can produce active substances (hormones, enzymes, etc.) disrupting normal metabolic pathways, serving as tumor markers.
Some mechanisms remain idiopathic (unknown cause).

Classification

Categorized into multiple groups:
- Endocrine
- Hematological
- Neurological
- Mucocutaneous
- Others (not specified)

Endocrinopathies

Most frequent form of paraneoplastic syndromes, arising from tumors not of endocrine origin.
Characterized by ectopic hormone production; tumors synthesize hormones typically produced in other tissues.

Common Endocrinopathies

Cushing syndrome: Most prevalent; linked to small cell lung carcinoma, pancreatic carcinoma, neural tumors. Caused by excessive production of corticotrophin.
SIADH (Syndrome of inappropriate antidiuretic hormone secretion).
Hypercalcemia: Excess calcium in blood often due to cancer.
Hypoglycemia, Polycythemia, Hyperaldosteronism, and Carcinoid syndrome also noted.

Neurological Effects

Includes peripheral neuropathies, subacute cerebellar degeneration, and polymyopathy.
Mechanisms poorly understood; antibodies against cancer cell antigens may react with nervous system antigens.

Specific Neurological Conditions

Subacute cerebellar degeneration: Associated with small cell lung cancer, breast cancer, ovarian/uterine cancer, Hodgkin’s lymphoma. Mechanism is immunological.

Mucocutaneous Effects

Acanthosis Nigricans: Characterized by thickened, darker skin in neck and armpits; linked to gastrointestinal tumors, prostate, breast, or ovarian cancer. Mechanisms involve immunological responses and secretion of epidermal growth factor.

Hematological Manifestations

Conditions include venous thrombosis, disseminated intravascular coagulation (DIC), polycythemia, anemia, granulocytosis, thrombocytosis, and autoimmune thrombocytopenia.

Venous Thrombosis and DIC

Mechanisms involve hypercoagulability via abnormal blood composition or increased clotting factors.
Risk factors include chemotherapy leading to endothelial damage and prolonged immobilization.
Commonly associated with pancreatic carcinoma and bronchogenic carcinoma for venous thrombosis, while DIC is linked to acute promyelocytic leukemia and prostatic carcinoma.

Polycythemia Vera

Associated cancers include renal carcinoma, cerebellar carcinoma, and hepatocellular carcinoma.
Mechanism may involve hypoxia or ectopic production of erythropoietin or similar substances.

Conclusion

Paraneoplastic syndromes represent a diverse and critical aspect of cancer-related pathophysiology with significant clinical implications. Understanding their mechanisms, classifications, and manifestations is essential for effective diagnosis and treatment.

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Description

This quiz focuses on the definition, significance, pathophysiology, and pathogenesis of paraneoplastic syndromes in the context of neoplasia. Students will deepen their understanding of how these syndromes affect patient care and outcomes. This knowledge is essential for those studying molecular haematology.