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Pathology: Neoplasia 2

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What are the two most common sites for metastatic tumors?
Lung
Liver
Where is the rarest metastasis of tumors?
Skeletal Muscle
Spleen
What commonly metastasizes to bone?
Cancer of prostate
lung
breast
thryroid
Kidney
What commonly metastasizes to brain?
Cancer of lung
breast
kidney
What organ can a malignant melanoma metastasize to?
EVERY
What is meant when a malignant tumor is called occult?
Primary site remains unknown in spite of many metastatic lesions
What three ways do cancers spread?
Lymphatic spread (Typically Carcinomas)
Hematogenous Spread (Typically Sarcomas)
Seeding of Body Cavities
What are the three step mechanisms for invasion and metastasis?
1.) Tumor cells acquire receptors that bind to laminin and fibronectin of the extracellular matrix
2.) Proteolytic enzymes secreted by tumor cells lyse the matrix components
3.) Tumor cells migrate to the degraded zone of the extracellular matrix
How are tumors graded?
According to aggressiveness based on degree of anaplasia. (Grade I - Well differentiated) (Grade V - undifferentiated)
How are tumors staged?
Staging is based on a TNM system (T = Tumors, N = Lymph Nodes, M = Metastasis)
T rank 0-4
N rank 0-3
M rank 0-2,1
What are the markers for tumors of various tissues such as:
Epithelial cancers
Mesenchymal Tumors
Nerve, Neuroendocrine
Prostate Cancer
Lymphomas
Endocrine Tumors
Epithelial Cancers: Keratin, Epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA)
Mesenchymal tumors: Vimentin, Desmin (for muscle)
Nerve: Neuron specific enolase (NSE), Chromogranins
Prostate Cancer: Prostate Specific Antigen (PSA), Prostaticacid phosphate (PAP)
Leukocyte common antigen (LCA) T-Cell, and B-cell markers
Endocrine Tumors: Various Hormones

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