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an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change |
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swelling caused by inflammation |
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the study of tumors/neoplasms |
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the common term for all malignant tumors. |
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having properties of anaplasia [primitive], invasion [secondary], metastasis[primary], and immortality. |
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proliferating neoplastic cells |
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Importance of Parachyma in the growth of neoplasms |
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largely determines its biologic behavior, component from which the tumor derives its name. |
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made up of connective tissue, blood vessels, and possibly lymphatics |
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Importance of Supportive stroma in the growth of neoplasms |
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necessary to maintain tumor growth |
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soft, cellular tumor with little connective tissue stroma |
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desmoplastic tumor stroma |
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abundant collagenous or mucinous stroma and are grossly hard to the touch |
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benign tumor nomenclature |
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malignant mesenchymal tumors nomenclature |
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malignant epithelial tumors nomenclature |
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mixed tumors nomenclature |
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tumors showing both epithelial and mesenchymal differentiation. Can be benign or malignant. Carsinosarcoma, or pleomorphic adenoma/mixed |
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teratogenous tumors nomenclature |
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tumor made up of a variety of parenchymal cell types representative of more than one germ layer (often all three, called teratoma |
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Benign tumor of fibrous tissue |
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Malignant tumor of fibrous tissue |
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Benign tumor of Fatty issue |
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Malignant tumor of fatty tissue |
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Benign tumor of cartidlege tissue |
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Malignant tumor of cartilege tissue |
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Benign tumor of bone tissue |
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Malignant tumor of bone tissue |
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Benign tumor of mesothelium |
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Malignant tumor of mesothelium |
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Benign tumor of blood vessels |
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Malignant tumor of blood vessels |
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Benign tumor of lymph vessels |
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Malignant tumor of lymph vessels |
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Benign tumor of hemopoietic cells |
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Malignant tumor of hemopoietic cells |
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Benign tumor of lymphoid tissue |
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Malignant tumor of lymphoid tissue |
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lymphomas (note ending -oma) |
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Benign tumor of smooth muscle |
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Malignant tumor of smooth muscle |
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Benign tumor of striated (skeletal) muscle |
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Malignant tumor of striated (skeletal) muscle |
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Benign tumor of stratified squamous cell epithelium |
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Malignant tumor of stratified squamous cell epithelium |
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squamous cell or epidermoid carcinoma |
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Benign tumor of granular epithelium |
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Malignant tumor of granular epithelium |
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Benign tumor of liver cells |
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Malignant tumor of liver cells |
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Benign tumor of melanocytes |
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Malignant tumor of melanocytes |
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Malignant tumor of placenta |
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Differentiation difference between benign and malignant tumors |
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benign tumors are usually well-differentiated and malignant tumors can range in differentiation |
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the extent to which parenchymal cells resemble comparable normal cells, both morphologically and functionally. Poorly differentiated cells are more likely to be malignant. |
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lack of differentiation, backward formation, dedifferentiaion or loss of the structural and functional differentiation of normal cells |
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Anaplastic differences between benign and malignant tumors |
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Anaplasia is a hallmark of malignancy |
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refers to the time it take the tumor to grow |
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Rate of growth differences between benign and malignant tumors |
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benign tumors grow more slowly and most cancers grow much faster |
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development of a fibrous capsule that separated the tumor from the host tissue |
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Encapsulation differences between benign and malignant tumors |
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Most benign tumors have capsules, and most malignant tumors do not. Encapsulation is not the rule in benign tumors, the lack of a capsule does not mean that a tumor is malignant |
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progressive infiltration, invasion, destruction and penetration of surrounding tissue. |
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Invasion differences between benign and malignant tumors |
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most reliable feature that distinguishes malignant from benign, malignant cancer. Malignant cancers develop crablike feet penetrating the margin and infiltrating adjacent structures. |
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secondary implants of a tumor that are discontinuous with the primary tumor and located in remote tissues |
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metastasis differences between benign and malignant tumors |
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Benign tumors do not metastasize. The more anaplastic and the larger the primary neoplasm, the more likely it is to metastasize |
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loss of structural and functional differentiation of normal cells |
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the cells are very immature and "primitive" and do not look like cells in the tissue from it arose |
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extremely hyperchromic and large nuclei, characteristic of undifferentiated ananplastic cells |
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numerous and distinctly atypical, tripolar or quadrpolar mitotic figures, characteristic of undifferentiated anaplastic cells |
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considerably larger than their neighbors with enomorous nucleus or severl nuclei, characteristic of anaplastic undifferentiated cells |
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keratinization- characteristic of well-differentiated squamous cell carcinomas |
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Disorganized sheets of tumor cells |
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common in well-differentiated cancers |
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Factors that are related to rate of growth of benign and malignant neoplasms |
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circulationing levels or hormones, adequacy of blood supply, and cancer stem cells |
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Four ways that a tumor cell can disseminate throughout the body |
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(1)Direct seeding of body cavities or surfaces (2)Lymphatic spread (3)Blood vessels spread- hematogenous spread (4)Transplantation- mechanical transport of tumor fragments |
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Geographic location and cancer |
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Environmental factors are the predominant cause of the most common sporadic cancer.
For example - breast cancer is much more common in the United States than in Japan. Stomach cancer is relatively uncommon in the United States but is much more common in Japan. |
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as carcinogens found the workplace, food, exposure to cigarette smoking, asbestos [mesothelioma], alcohol, etc. |
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in general the frequency of cancer increases with age, although certain cancers occur primarily in children (Wilms tumor, retinoblastoma). Explained by the accumulation of somatic mutations associated with the emergence of malignant neoplasms. Also the decline in immune competence that accompanies ageing. |
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hereditary factors and cancer |
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familial predisposition has been noted in such tumors as carcinoma of the breast, colon, ovary, prostate, uterus, and melanoma. |
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predisposing factors and cancer |
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conditions that may, but do not always, predispose to development of cancer |
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Genetic damage and carcinogensis |
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nonlethal genetic damage lies at the heart of carcinogenesis. Genetic damage can be acquired by action of environmental agents, or can be inherited. The tumor mass results from the clonal expansion of a single progenitor cell that has incurred genetic damage |
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normal regulatory genes ane carcinogensis |
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(growth promoting proto-oncogenes, growth inhibiting tumor suppressor genes, genes that regulate programmed cell death, and genes involved in DNA repair)- principle targets of genetic damage, genetic alterations in tumor cells confer growth and survival advantages over normal cells. |
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direct-acting alkylating agents, polycyclic aromatic hydrocarbons, amines and azo dyes, and naturally occurring carcinogens.
Example: cigarette smoke |
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UV light, ionizing radiation, |
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HPV, Epstein-Barr Virus, AIDS |
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Local and hormonal effects on tumor on host |
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can be due to benign or malignant tumors - compression, obstruction, elaboration of hormones, ulceration, secondary infection, bleeding, torsion and infarction. |
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Cachexia effects of tumor on host |
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progressive loss of body fat and lean body mass, profound weakness, anorexia, and anemia, seen in patients with advanced cancer |
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Paraneoplastic syndromes of tumor on host |
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Definition
symptoms in cancer patients that are not due to local or distant spread of tumor or to production of hormones native to the tissue from which the tumor arose |
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humoral and cellular immune defense mechanisms |
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the cytologic differentiation of the tumor cells (how much they resemble normal cells) and the number of mitoses within the tumor as presumed |
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Significance of grading neoplasms |
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correlates of the neoplasms' aggressiveness and level of malignancy. |
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Well differentiated-(25% of cells are dedifferentiated; 75% of cells resemble normal counterpart) |
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Moderately differentiated- (50% of cells are dedifferentiated; 50% of cells resemble normal counterpart) |
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Poorly differentiated-(75% of cells are dedifferentiated; 25% of cells resemble normal counterpart) |
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Undifferentiated, anaplastic- (100% of cells are dedifferentiated) |
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is based on the size of the primary lesion, its extent of spread to regional lymph nodes, and presence or absence of blood-borne metastases |
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Significance of staging neoplasms |
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Purpose of staging system is to be able to enter patients into various clinical protocols. |
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"T" - size of the primary tumor and can be designated "T 0"(T zero) (an in situ lesion) or T1-T4 with increasing size of the primary lesion. "N"-regional lymph node involvement and can be designated "N 0" (N zero) (indicates no nodal involvement) or N1-N3, indicating involvement of an increasing number of nodes. "M”-metastasis and can be designated "M 0" (M zero) (indicates no metastasis) or M1 or M2, indicating the presence and amount of metastases. |
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usefulness of identifying tumor markers in the classification of malignant neoplasms |
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Definition
there are markers that may be useful in identifying the cell of origin of a metastatic tumor or a poorly differentiated primary tumor |
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E rosettes, MaBs, Specific heavy-chain immunoglobulins, Kappa, lambda light chains |
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Leukemia/lymphoma T cells |
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Leukemia/lymphoma T and B cells |
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Specific heavy-chain immunoglobulins |
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Leukemia/lymphoma B cells |
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Kappa, lambda light chains |
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Leukemia/lymphoma B cells |
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Tumor associated antigens |
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Carcinoembryonic antigen, Colon, pancreatic, gastric and breast carcinomas |
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Alpha-fetoprotein, Hepatocellular carcinoma, yolk-sac tumor (endodermal sinus tumor) |
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calcitonin, chorionic gonadotrophin |
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Thyroid medullary carcinoma |
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Human chorionic gonadotropin |
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Choriocarcinoma, hydatidiform mole |
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A well differentiated ductal carcinoma of the breast closely resembles |
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normal ductal tissue of the breast. |
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Of the following, which finding is the BEST indication that a breast neoplasm is malignant? |
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A typical breast carcinoma feels firm/hard on palpation. This is due to what type of tissue reaction? |
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In a woman with breast carcinoma, the MOST important factor for predicting prognosis is |
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Inflammatory breast cancer clinically presents with reddened, inflamed skin because |
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cancer cells have obstructed dermal lymphatic channels causing local edema and erythema. |
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Which is the highest incidence cancer in males? |
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Which is the highest incidence cancer in females? |
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Which cancer has the highest death rate in males and females? |
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ectopic rest of normal tissue |
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mass of disorganized (but mature) tissue native to a particular site |
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Which mutation is more likely to lead to malignant cell development |
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name 4 tumor suppressor genes |
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3 criteria for diagnosing cancer |
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morphology, relationship to surrounding tissue and experience |
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4 steps to developing metastasis |
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tissue and vascular invasion tumor cell migration remote localization successful colonization and progressive growth |
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how is cancer presumptively diagnosed |
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how is cancer definitively diagnosed? |
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cytologic/histologic means |
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