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Path - Prognosis of Neoplasms (iii) (tumour markers (detected in…
Path - Prognosis of Neoplasms (iii)
Glial neoplasms
brain tumours are usually mets
astrocytoma: poor prognosis
oligodendroglioma: rare
symptoms due to space-occupying lesion in brain (stroke + raised ICP symptoms)
Embryonic tumours
agressive
occur in children
inherited loss of 1 allele + subsequent acquired loss of other
consist of 1 embryonal-like cell
neuroblastoma, nephroblastoma, retinoblastoma, medulloblastoma (cerebellum)
Borderline tumours
uncertain malignant potential
no definitive findings on histological assessment
usually ovarian serous/mucinous tumours
increased cancer incidence in old age
more time for mutations + carcinogen exposure
less lymphoid tissue (physiological immunosupression)
Harmatoma
excess tissues (normal to site) haphazardly arranged
benign (malformation rather than a neoplasm)
e.g. capill angioma
tumour markers
antigens/Igs specific to a tumour
used for Dx/screening/followup post tx (98% successful)
HCG: choriocarcinoma
alpha-fetoprotein: hepatocellular carcinoma + yolk sac tumour
PSA: prostatic carcinoma (but also increased in benign prostate hyperplasia, so associated with overdx)
detected in blood/serum, urine, tissue using IHC
brown dye labelled Ig poured on sample, if antigen present, Ig will irreversibly bind + not be washed off
cytokeratine: carcinoma
vimentin: sarcoma
HMB45, S100P, MelanA: melanoma
thyroglobulin: thyroid
experimental use: magic bullet theory (targeted Tx)