Investigating Disseminated Malignancy Flashcards Preview

B5 Oncology > Investigating Disseminated Malignancy > Flashcards

Flashcards in Investigating Disseminated Malignancy Deck (19)
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1
Q

List the possible routes of metastatic spread.

A

Seeding into body cavities;
Neuronal;
Lymphatic;
Vascular (most common to lung, liver, brain, bone)

2
Q

List some common presentations of metastatic malignancies.

A

Systemic presentations include fatigue, weight loss, rash, night sweats, and bone pain.
Other presentations include headaches, seizures, cough, haemoptysis, dyspnoea, lymphadenopathy, hepatomegaly, jaundice, factures.

3
Q

Why is it important to investigate a disseminated malignancy?

A

To diagnose the primary tumour type, which is important for the correct treatment, adequate prognosis, genetic counselling, and to maintain accurate cancer statistics.

4
Q

What is the term for a malignant neoplasm of epithelial origin? How do these tend to metastasise?

A

Carinoma, spread by lymphatics, hematogenous, seeding.

5
Q

What is the term for a malignant neoplasm of mesenchymal origin? How do these tend to metastasise?

A

Sarcoma, spread by hematogenous, most commonly to lung.

6
Q

What is the term for a malignant neoplasm of melanocyte origin? How do these tend to metastasise?

A

Melanoma, spread by lymphatics, hematogenous.

7
Q

List some common sites for squamous cell carcinoma.

A

oral cavity, oesophagus, lung, cervix, skin.

8
Q

List some common sites for adenocarcinoma.

A

GI tract, lung, breast, pancreas, gall bladder, uterus, ovaries.

9
Q

List some common sites for urothelial cell carcinoma.

A

renal pelvis, ureters, urinary bladder, urethra.

10
Q

List some common types of sarcomas.

A

Muscle: leiomyosarcoma.
Bone: osteosarcoma.
Adipose tissue: liposarcoma.
Cartilage: chondrosarcoma.

11
Q

Which immunohistochemical stain is used to detect a tumour of epithelial origin?

A

Cytokeratin.
AE1/AE3 will stain positive in epithelial cells of all origins.
There are many different subtypes, commonly used is CK7 and CK20, as some epithelial origins express only CK7 (lung, breast, ovary, endometrium), some express only CK20 (colorectal), some express both CK7 and CK20 (pancreaticobiliary, urothelial), and some neither (prostate, liver), to further identify origin.

12
Q

Which immunohistochemical stain is used to detect a tumour of mesenchymal origin?

A

vimentin, specifically desmin for a leiomyosarcoma.

13
Q

Which immunohistochemical stain is used to detect a tumour of lymphoid origin?

A

leucocyte common antigen (LCA).

14
Q

Which immunohistochemical stain is used to detect a tumour of melanocyte origin?

A

S100.

15
Q

Which epithelial origins in cytokeratin staining are CK7 positive and CK20 positive?

A

urothelial, pancreaticobilliary.

16
Q

Which epithelial origins in cytokeratin staining are CK7 positive and CK20 negative?

A

lung, breast, ovary, endometrial.

17
Q

Which epithelial origins in cytokeratin staining are CK7 negative and CK20 positive?

A

colorectal.

18
Q

Which epithelial origins in cytokeratin staining are CK7 negative and CK20 negative?

A

renal cell, prostate, hepatocellular.

19
Q

Define neoplasm.

A

An abnormal mass of tissue, growth of which exceeds and is uncoordinated with the normal surrounding tissues, and which persists in the same excessive manner after the cessation of the stimuli which evoked it.