Benign vs. Malignant

Benign: expansive growth, slow growth, doesn't metastasize, systemic effects rare, well differentiated(looks like parent organ), normal mitoses

Malignant: infiltrative growth, rapid growth, able to metastasize, may have systemic effects, range from well-differentiated to anaplastic, mitoses increases number and/or abnormal shapes

Carcinoma

A cancer that arises in the epithelium

Sarcoma

A malignancy arising in connective tissue such as muscle, fat, blood vessels

Hematologic Malignancies

Leukemias(bone marrow and circulating blood)

Lymphomas (lymph nodes)

"In situ"

Cancerous cells have not penetrated the basement membrane

Knudson's 2-hit hypothesis

1. genetic abnormality

2. environmental change

ex. pt has predisposition for lung CA and begins to smoke will give rise to disease

What are the general characteristics of solid tumor malignancy?

- invades locally

- grow locally

- involves lymph nodes

- sometimes size is an issue

- metastasis

- example of a solid tumor malignancy: Superior Vena Cava Syndrome

Describe Grade and Stage

Hint: TNM

Grade: what it looks like under a microscope

High - less differentiated

Low - looks like the tissue of origin

Stage: describes growth of tumor

T = tumor size T0,1-4

N = lymph nodes 1-3

M = metastases binary either M0/M1

Clinical Presentations of CA

Local signs and symptoms

- mass

- necrosis

- obstruction

- bleeding

- change in wart/mole

- pain

- ABCD's asymmetry, borders, color, diameter

Clinical Presentation

Systemic Symptoms

- unexplained weight loss

- cachexia "wasting"

- anemia

- infections

- bleeding

- paraneoplastic syndromes

- metastases may be first sign

Diagnostic Tests

- Blood tests: CBC w/ diff; evidence of cell destruction; tumor markers(exs. CEA: adenocarcinomas; AFP: liver; PSA: prostate) genetic markers (philadelphia chromosome)

- Imaging studies: CT, MRI, Plain films

- Tissue: fine needle aspiration; biopsy