Podcast
Questions and Answers
A pathologist observes a tumor sample with immunohistochemical staining positive for vimentin. This finding is MOST indicative of which tumor type?
A pathologist observes a tumor sample with immunohistochemical staining positive for vimentin. This finding is MOST indicative of which tumor type?
- A tumor derived from epithelial cells, showing glandular formation.
- A tumor derived from glial cells within the central nervous system.
- A poorly differentiated carcinoma with rapid lymphatic spread.
- A tumor originating from mesenchymal cells, such as smooth muscle. (correct)
In the context of tumor classification, which statement BEST highlights the clinical relevance of distinguishing between dysplasia and carcinoma in situ?
In the context of tumor classification, which statement BEST highlights the clinical relevance of distinguishing between dysplasia and carcinoma in situ?
- Dysplasia represents disorganized cellular growth confined within the basement membrane, while carcinoma _in situ_ signifies a non-invasive malignancy. (correct)
- Dysplasia is characterized by invasion through the basement membrane, while carcinoma _in situ_ remains confined within the epithelial layer.
- Dysplasia indicates a benign condition requiring no immediate intervention, whereas carcinoma _in situ_ necessitates aggressive surgical removal.
- Dysplasia is exclusively found in congenital conditions, whereas carcinoma _in situ_ is primarily acquired through environmental exposures.
Which of the following features would be LEAST expected in a well-differentiated adenocarcinoma?
Which of the following features would be LEAST expected in a well-differentiated adenocarcinoma?
- Preservation of glandular and ductal formations.
- Cells closely resembling the tissue of origin.
- A low mitotic index.
- A uniformly high nucleus-to-cytoplasm ratio across the tumor cells. (correct)
A researcher is investigating potential therapeutic targets for a sarcoma. Which aspect of sarcomas would be MOST relevant in guiding the selection of targeted therapies?
A researcher is investigating potential therapeutic targets for a sarcoma. Which aspect of sarcomas would be MOST relevant in guiding the selection of targeted therapies?
A pathologist examines a sample from a rapidly growing tumor and notes significant pleomorphism, hyperchromatic nuclei, and numerous bizarre mitotic figures. Which conclusion is MOST justified based on these observations?
A pathologist examines a sample from a rapidly growing tumor and notes significant pleomorphism, hyperchromatic nuclei, and numerous bizarre mitotic figures. Which conclusion is MOST justified based on these observations?
Which statement BEST captures the role of the reactive stroma in tumor development and progression?
Which statement BEST captures the role of the reactive stroma in tumor development and progression?
Why do melanomas and lymphomas defy the typical "-oma" suffix convention for benign tumors, and how does this exception impact clinical understanding?
Why do melanomas and lymphomas defy the typical "-oma" suffix convention for benign tumors, and how does this exception impact clinical understanding?
A researcher aims to differentiate between a poorly differentiated carcinoma and a sarcoma using immunohistochemistry. Which combination of intermediate filament markers would BEST support a diagnosis of carcinoma?
A researcher aims to differentiate between a poorly differentiated carcinoma and a sarcoma using immunohistochemistry. Which combination of intermediate filament markers would BEST support a diagnosis of carcinoma?
In determining tumor prognosis, what is the MOST critical implication of a tumor being classified as 'poorly differentiated'?
In determining tumor prognosis, what is the MOST critical implication of a tumor being classified as 'poorly differentiated'?
If a tumor is described as having a desmoplastic stroma, what specific characteristic would a pathologist expect to observe microscopically, and what does this imply about the tumor's behavior?
If a tumor is described as having a desmoplastic stroma, what specific characteristic would a pathologist expect to observe microscopically, and what does this imply about the tumor's behavior?
Flashcards
Cancer
Cancer
Derived from Greek for crab, referring to its invasive nature.
Tumor
Tumor
Latin for swelling, now primarily refers to neoplastic growths.
Neoplasm
Neoplasm
New growth, encompassing benign and malignant tumors.
Oncology
Oncology
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Benign Tumors
Benign Tumors
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Malignant Neoplasms
Malignant Neoplasms
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Dysplasia
Dysplasia
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Carcinoma
Carcinoma
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Sarcoma
Sarcoma
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Desmoplastic Stroma
Desmoplastic Stroma
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Study Notes
- Cancer is derived from the Greek word for crab because it adheres to adjacent tissue.
- Tumor is Latin for swelling; neoplasm means new growth and is a medical term for cancer or tumor.
- Oncology, derived from Greek for tumor, is the study of neoplasms and their mechanisms.
- Neoplasia involves unregulated, autonomous monoclonal cell growth dependent on the body for oxygen and nutrients.
Classification of Tumors
- Benign tumors typically end with the suffix "-oma," but there are exceptions.
- They are localized with circumscribed borders, grow slowly, do not metastasize, and can be surgically removed.
- Malignant neoplasms are designated as carcinomas or sarcomas.
- They invade surrounding tissue with irregular borders, grow rapidly with angiogenesis, metastasize, and require surgery, chemotherapy, or radiation.
- Dysplasia is disorganized growth seen in congenital conditions, like cystic dysplasias in the kidneys or lungs.
- Dysplasia is a precursor lesion for malignant tumors, remaining within the basement membrane.
- Additional gene mutations in dysplastic lesions can convert cells into a malignant state, leading to carcinoma in situ or invasive lesions.
- Invasive malignancy involves monoclonal malignant cell proliferation due to gene mutations.
Carcinomas vs. Sarcomas
- Carcinomas originate from epithelial tissue and are the most common malignancy, spreading via lymphatic channels.
- Sarcomas originate from mesenchymal tissue (blood vessels, connective tissue, cartilage, muscle), are rare, and spread via blood vessels.
Intermediate Filaments
- Intermediate filaments (IF) indicate a cell's form and function.
- Immunohistochemical stains identify specific IFs to determine if a poorly differentiated tumor is a carcinoma or sarcoma.
- Vimentin is the IF for mesenchymal cells like adipocytes.
- GFAP is the IF for glial cells in the central nervous system, like astrocytes.
- Cytokeratin is the IF for epithelial cells, whether colonic or squamous.
- Desmin is the IF specific to skeletal muscle due to its contractile properties.
Tumor Naming Conventions & Exceptions
- Most benign tumors are listed as "oma," with exceptions such as lymphomas and melanomas, which are malignant.
- Tumors related to glands or ducts are named adenoma or adenocarcinoma, with exceptions.
Histologic Components
- The tumor parenchyma consists of neoplastic cells.
- The reactive stroma is the surrounding tissue, including connective tissue, blood vessels, and immune cells.
- Desmoplastic stroma indicates abundant collagen surrounding tissue parenchyma.
Tumor Grade: Understanding Differentiation
- Differentiation measures how much tumor cells resemble their cell of origin.
- Well-differentiated adenocarcinomas have glandular and ductal formation, indicating a good prognosis.
- Moderately differentiated carcinomas have some gland and duct formation and solid formations.
- Poorly differentiated tumors lack differentiation and have a poor prognosis.
- Poorly differentiated tumors display loss of polarity, pleomorphism, increased mitosis, hyperchromatic nuclei, and increased nucleus-to-cytoplasm ratio with large nucleoli.
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