K = koilocytes

Microinvasive Squamous Cell CA: Invasive Squamous Cell CA:

What is the most sensitive test for high grade dysplasia of the cervix?
A. Pap smear
B. HPV DNA test for high risk types
C. HPV test for DNA type 16
D. HPV test for DNA type 18
E. HPV serum antibodies to DNA type 16

Test q (almost the same): What is the most sensitive test for high grade dysplasia of the cervix? HPV DNA test for at least 13 high risk types

HPV DNA is most sensitive test for High Grade dysplasia: Pap smear 55%; HPV DNA 95%

LUNG CANCER
• Large cell carcinoma, adenocarcinoma and squamous cell
carcinoma: can be cured by surgery if caught early (<1/3);
radiation may offer palliation; chemotherapy works poorly
• SMALL CELL carcinoma: “always” metastatic at diagnosis,
therefore, surgery is not possible; chemotherapy an option but
works poorly

 Bronchogenic CA
 Squamous cell carcinoma: Small cell carcinoma:

Paraneoplastic Syndromes:
• Adeno CA (gastric)  Acanthosis nigricans
• Small Cell CA  Eaton-Lambert
• Bronchogenic CA  Osteoarthropathy
• Gastric CA  Seborrheic keratosis
• Pancreatic CA  Migratory thrombophlebitis (Trousseau’s)
• Small Cell CA  ACTH (Cushings); ADH (iADH)
• Squamous cell CA hypercalcemia  PTH-like (Hypercalcemia)
• Carcinoid tumor (lung or liver usually)  Serotonin, bradykinin (Carcinoid syndrome)

Test q: A 64y/o man has noted changes in the texture and color of skin in his armpit and groin over the past 3mo. On phys exam, there is thickened,
darkly pigmented skin in the axillae and flexural areas of the neck and groin. These areas are neither painful nor pruritic. A punch biopsy specimen of
the axillary skin shows undulating epidermal acanthosis w/hyperkeratosis and basal layer hyperpigmentation. Which of the following underlying
diseases is most likely to be present in this patient? Gastric adenocarcinoma (see above – acanthosis nigricans)
Test q: A 50y/o white male is seen for a life insurance phys exam. Under his arms, in his groin area, and on the sides of his neck the skin is thickened
and black. You must examine the patient for possible __? Gastric adenocarcinoma (see above – acanthosis nigricans)
Test q: The most common paraneoplastic syndrome: Hypercalcemia.
Test q: Autopsy of a 58y/o woman reveals calcified deposits in otherwise normal appearing lung and kidney tissues. Which of the following would most
likely also be found during this autopsy? Parathyroid adenoma.
Test q: A 62y/o male long-time cigarette smoker presents w/a 3mo history of new onset muscle weakness. He complains that during the day his
muscles gradually become weaker in a pattern similar to myasthenia gravis. Suspecting a paraneoplastic syndrome, the astute physician orders a plain
film of the chest. The radiograph reveals a hilar mass of the left lung. Transbronchial endoscopic needle aspiration biopsy confirms malignancy. What
type of neoplasm is most probable? Squamous cell carcinoma of lung.
Viruses and Cancer (RNA)
• HCV  Hepatocellular
• HTLV-1  T-cell leukemia/lymphoma
Test q: An RNA virus now known to participate in some cases of liver cancer is: HCV
Viruses and Cancer (DNA)
• EBV t(8;14)  Burkitt L., NP CA, MC Hodgkin
• HBV (<p53)  Hepatocellular CA
• HPV 16 (E6/p53)  SC CA cervix, anus
• HPV 18 (E7/RB)  Same as HPV 16
• HHSV-8 (HIV/cytokines)  Kaposi’s sarcoma in AIDS