True or False:

Abnormal mitoses are highly indicative of malignancy.

True.

-Many mitoses are not necessarily indicative of malignancy.

Benign

- metastasis is an indication of malignancy

Benign

- invasiveness is characteristic of malignant tumors

epithelioma

adenoma

papilloma

cell of origin + carcinoma

e.g. adenocarcinoma

cell of origin + "oma"

e.g. lipoma

cell of origin + "sarcoma"

e.g. fibrosarcoma 

What kind of tumor is rhabdomyoma?

Leiomyoma?

a benign tumor of skeletal muscle

"                    " of smooth muscle

Which is not a characteristic of cancer cells?

A. pleomorphism

B. chromatin clumping

C. 1:4 nucleus to cytoplasm ratio

D. tripolar or tetrapolar mitoses

E. multinucleated giant cells

C. 1:4 nucleus to cytoplasm ratio

- is a characteristic of normal cells

- cancer cells show increased ratio (1:1)

Lung, breast, and prostate

True or false:

Stomach and pancreatic cancers are more common in women.

False.

They are more common in men

Match the cancer with its chemical carcinogen:

Liver carcinoma                Polycyclic hydrocarbons

Mesothelioma                        Vinyl chlorides

Liver hemangiosarcoma            Asbestos

Squamous cell carcinoma       Aflatoxin

Polycyclic hydrocarbons- squamous cell carcinoma

Aflatoxin - liver carcinoma

Asbestos  -  mesothelioma

Vinyl chlorides - hemangiosarcoma of the liver

True or False:

Cancer cells enter the cell cycle more readily and complete mitosis faster than normal cells.

False.

While they do enter the cell cycle faster, they complete mitoses in the same amount of time or slower than normal cells.

Typical of an early subclinical cancer

- most cells are in the replicative pool

What amount of cancer cells is just clinically detectable?

What amount is incompatable with life?

clinically detectable = 1 gm or 10^9 cells

incompatable with life = 1 kg or 10^12 cells

True or False:

Carcinoma in situ is reversible if the offending stimulus is removed.

False.

Dysplasia is considered premalignant and may be reversible if the stimulus is removed, while CIS is irreversible and is considered preinvasive.

True or False:

Once a neoplasm starts, it is not reversible.

True.

Also, benign neoplasms do not give rise to malignant ones, and inversely, malignant ones don't become benign.

Non-ionizing radiation, UVB or UVA radiation

B Cell Lymphoma

squamous cell carcinoma of uterine cervix

- HPV types 1, 2, 4, 7 are associated with skin warts

HHV8 (Human Herpes virus 8) is associated with the development of what type of "cancer"?

Kaposi's sarcoma

- not really a cancer?

BCL-2 - prevents cytochrome c release - prevents apoptosis

BAX - promotes cytochrome c release - favors apoptosis

-p53 initiates apoptosis

-is the principle mediator of apoptosis in response to large-scale DNA damage by UV radiation

- is considered a tumor suppressor gene, along with RB

VEGF (vascular endothelial growth factor)

FGF (fibroblast growth factor)
PD-ECGF (platelet derived endothelial cell growth factor)

IL-10 and TGF-b are cytokines that can inhibit T-cell activation, letting tumor cells go unnoticed by the immune system.

True or False?

Most tumor cells express B7-1 (CD80) and B7-2 (CD86).

False.

These are co-receptors. Most tumor cells do NOT express co-receptors, and thus can evade detection by the immune system.

True or False?

Tumor cells secrete IL-10 and TGF-b, which leads to a Th2 response.

True.

These cytokines promote inflammation, which inhibits the cytotoxic (Th1) response, and instead leads to a T helper response. The recruitment of macrophages can then further tumor spread.

PSA is an indicator for what type of cancer?

AFP?

CEA?

PSA - prostate specific antigen-prostate cancer 

AFP - a fetoprotein-hepatocarcinoma

CEA - carcinoembryonic antigen

-adenocarcinomas of breast, lung, colon, ovary

Ataxia telangiecstasia

- a mutation in ATM gene - a protein kinase

(Ataxia telangiecstasia mutated)

-chromosome 11

DiGeorge syndrome

- Absence of thymus

- T cell defect & chromosome 22 defect

- abnormal faces

X-linked hyper IgM syndrome

- defective class switching of B cells to IgG & IgA

- compensatory increase in IgM

- No memory B cells

- Normal numbers of B cells

- Autoantibodies to PMNs, rbcs, and platelets

An excessive but focal overgrowth of cells and tissues native to the organ in which it occurs.

Hamartoma

Lymphadenopathy

k and l light chain are immunostain markers for which type of tumor?

B cell lymphomas

Viremia

-an elevation of virus levels occurring 2 to 4 weeks after infection with HIV.

HAART

(highly active antiretroviral therapy)

What disease am I?

• Absent or markedly decreased numbers of B cells in the circulation, with depressed serum levels of all classes of Igs. 
• No germinal centers in lymph nodes.
• Absence of plasma cells throughout the body (pre-B cells present in bone marrow).
• Normal T-cell–mediated responses.

 XLA

(Bruton's agammaglobulinemia)

(X-linked agammaglobulinemia)

-mutation or deletion in gene coding for B cell Tyrosine Kinase --> failure of B cell maturation

- bone marrow transplant needed to survive

True or False?

IgA is given to patients with IgA deficiency.

False.

- IgA has short half-life, so is not used as treatment

- patients are given antibiotics if they are symptomatic, to treat infections of respiratory, GI, and urogenital systems

What primary immunodeficiency disease am I?

Defective production of CD18, the b2 integrin subunit.

Leukocytes cannot extravasate.

LAD-1

(Leukocyte adhesion deficiency-1)

What disease would a patient have who has defective production of NADPH oxidase?

What test would be used to make the diagnosis?

Chronic Granulomatous disease (CGD)

-impaired killing of phagocytosed bacteria

-missing or defective cytochrome b558

-IFN-g treatment 

NBT test

(nitroblue tetrazolium stays blue in CGD)

True or False?

IgG is given to patients with IgG deficiency.

True

HANE is a disease resulting from a defect in what complement protein?

C1 inhibitor (C1INH)

-HANE: hereditary angioneurotic edema

- recurrent swelling of various parts of body

- most common complement immune deficiency

CD4 = 350

Which is more common - primary or secondary Sjogren's syndrome?

Which one involves certain HLA MHC II alleles, such as the DR3 allele?

Secondary is more common - associated with other autoimmune diseases.

Primary Sjogren's (aka sicca syndrome) involves certain MHC class II alleles.

Sjogren patients have a 40x greater risk of developing what cancer?

Lymphoma

Congo red stain is used to positively identify Amyloid. What does amyloid look like after staining when viewed with a polarizing microscope?

1. Amyloid light chain is characteristic of which cancer?

2. Which type of amyloid consists of nonimmunoglobulin  protein & is characteristic of chronic inflammatory conditions?

1. multiple myeloma

- AL consists of immunoglobulin light chains

2. AA - amyloid associated

X-linked deficiency of the common g chain of the IL-2 receptor will result in what disease?

SCID