10-MC TUMOUR, Tm MARKER, HPE, GENE, ROUTE OF SPREAD, PROGNOSTIC

FACTOR

MC tm

in
tm-World-ca lung, India-ca oropharynx(buccal mucosa> lip> ant tongue)
tm mal World-incid,mort-ca lung> prostate> colon, preval-ca prostate
tm mal India-incid,mort-ca lung, preval-ca oropharynx(buccal mucosa> lip> ant
tong)> ca esoph

s.
tm fem-World,India-ca breast>cx
Child
solid tm neonat-sacrococcygeal teratoma(primitive streak)
bn tm infancy-hemangioma
bn tm infant spont regression-hemangioma
iim
malign infancy-neuroblastoma
malign infant spont regression-neuroblastoma
tm Down synd infant-M7AML(a/c megakaryoblastic leukemia)
tm child-ALL> brain tm> neuroblastoma
tm brain child best progn-astrocytoma
bn tm child-hemangioma
solid organ malign child-brain tm
4a
inherited tm child-retinoblastoma
abd malign child-neuroblastoma
abd malign old child-Wilms tm
tm Down synd child-ALL
Anal canal
malign anal canal-epidermoid ca
m

Appendix
tm appendix-adenoca
Bone
tm bone-met
bn bone tm-osteochondroma
Ai

true bn bone tm-osteoid osteoma

prim for bone met-mal-prostate> lung, fem-breast>lung, child-neuroblastoma
osteoblastic met-mal-prostate, fem-breast
osteolytic met-mal-lung, fem-breast
bone→ bone met-Ewing sarcoma> osteosarcoma
prim malign bone-multiple myeloma> osteosarcoma
prim tm bone <10ychild-Ewing sarcoma
prim bone tm hand-enchondroma
 malign bone tm hand-chondrosarcoma
malign bony chestwall-chondrosarcoma
Brain
tm brain-met
prim tm brain-glioma> astrocytoma
prim tm brain child-pilocytic astrocytoma
prim tm brain adult-glioblastoma
malign brain/CNS child-medulloblastoma

in
prim malign brain/CNS adult-glioblastoma
prim tm brain supratentorial-craniopharyngioma
Midline cerebellar tm-Medulloblastoma
tm CP angle-vest schwannoma
post fossa tm-cerebellar astrocytoma

s.
tm pineal gld-germinoma
Breast
tm breast-fibroadenoma
malign breast-duct[adenoca(scirrh ca)]

tm CNS-met
prim for CNS met-lung
iim
malign breast mal-ductal
CNS

prim tm CNS-glioma> meningioma> astrocytoma> oligodendroglioma

tm CNS HIV-prim CNS lymphoma
tm CNS with prim amenorrhoea-craniopharyngioma
4a
Diaphragm
prim tm diaphr-lipoma
prim malign diaphr-fibrosarcoma
Ear
vasc tm middle ear-glomus tm
Endocrine
endocrine tm-insulinoma
m

endocrine tm mal-gastrinoma
ENT
bn tm ENT-skull base osteoma
Esophagus
Ai

bn tm esoph-leiomyoma> GIST
malign esoph-SCC
lower esoph malign-adenoca
tm Baretts esoph-adenoca
prim for esoph met-melanoma
Eye
intraocular prim malign-malign melanom> retinoblastoma
intraocular tm child-retinoblastoma
 intraocular malign adult-met> choroidal melanoma(epitheloid)
tm eyelid-BCC
bn tm eyelid-sq papilloma
tm lacrimal gld-lymphoid tm> inflamm pseudotm
epith tm lacrimal gld-pleomorph adenoma
malign cornea-SCC
malign conjunctiva-SCC
tm intrinsic CNII-glioma(juvenile pilocytic astrocytoma)

in
GB
prim tm GB-adenoca(scirrhous)
Heart
tm heart-met
prim tm heart-myxoma(LA)

s.
prim malign heart-angiosarcoma
prim tm heart child-rhabdomyosarcoma(LV)
prim for heart met-ca breast> ca lung
tm heart valve-papillary fibroelastoma
iim
tm tuberous sclerosis-rhabdomyoma
tm pericardium-met
prim tm pericardium-mesothelioma
Kidney
renal tm-RCC(adenoca-clear cell)
renal bn tm-papillary adenoma
renal malign infant-Wilms tm
4a
renal malign child-Wilms tm
Wilms tm bone met-clear sarcoma
Large intestine
malign GIT-ca colon(adenoca)
bm tm rectum-adenoma(tubular)
adenoma rectum with malign potential-villous
Larynx
m

tm larynx-SCC
bn tm larynx-papillomatosis
vasc tm larynx-hemangioma
Leukemia
Ai

lymphoma-non Hodgkin> Hodgkin lymphoma

Hodgkin lymphoma World-NS>MC
Hodgkin lymphoma child-NS
Hodgkin lymphoma India-MC
Hodgkin lymphoma fem-MC
Hodgkin lymphoma EBV+ve-risk-LD, incid-MC
Hodgkin lymphoma EBV–ve-NS
Hodgkin lymphoma HIV-LD
 non Hodgkin lymphoma-B(85%)> T(15%)
BNHL-DLBCL> Burkitt lymphoma
NHL skin,thymus,testis child-T> B
lymphoma Nasal cavity-NK cell
malign HIV-lymphoma(BNHL-DLBCL> Burkitt lymphoma)> Kaposi sarcoma
lymphoma AIDS-immunoblastic
lymphoma cause AIHA-BCLL/SLL
tm LN-met

in
leukemia adult-CLL
leukemia child-ALL
malign adolescence-lymphoma
posttransplant lymphoma-BNHL(DLBCL> Burkitt)
lymphoma Spleen-nonHodgkin(Small lymphocytic)

s.
malign a/w erythroderma-cut Tcell lymphoma
malign Sweet synd-a/c myelogenous leukemia
malign post heart transpl-post transpl lymphoproliferat ds> ca lung
malign post lung transpl-<2y-post transpl lymphoproliferative ds, >2y-SCC skin
Liver
tm liver-met
iim
prim tm liver-cavernous hemangioma
prim malign liver-HCC
prim for hep met-ca colon> ca breast
malign liver child-hepatoblastoma
Lung
4a
tm lung-met
prim for lung met-brain> adrenal(most detected)
prim malign lung-World,fem,nonsmoker,Asbestosis-Adenoca,
India,mal,smoker,hypercalcem-SqCC, aggressive,paraneoplastic synd-SmCC
tm pleura-met
Mediastinum
mediast tm adult-neurogenic tm(23%)> thymoma
m

mediast tm child-neurogenic tm
tm ant mediast-thymoma
tm middle mediast-lymphoma
tm post mediast-neurogenic tm(neurofibroma, neurilemmoma)
Ai

Mesentery
bn tm mesentery-chylolymphatic cyst> lipoma
malign mesentery-lymphoma> fibrosarcom
Nose
bn tm nose-capillary hemangioma/blding polypus> inverted papilloma
malign nose-SCC
bn tm nasopharynx-angiofibroma
ca nasopharynx-III
 Omentum
solid tm omentum-met
Oral cavity
malign lip-SCC
Orbit
bn tm orbit adult-cavernous hemangioma
malign orbit adult-met> lymphoma
prim for met orbit adult-breast> bronch> prostate> skin

in
tm orbit chiLd-capiLL hemangioma> dermoid cyst
malign orbit child-rhabdomyosarcoma
prim for met orbit child-neuroblastoma
tm periorbit area child-capill hemangioma
periph n tm orbit-plexiform neurofibroma

s.
Ovary
tm ovary-serous cystadenoma
malign ovary-serous cystadenoca
tm ovary preg-dermoid cyst
iim
malign ovary preg-dysgerminoma
tm ovary young fem-dysgerminoma
tm ovary torsion-dermoid cyst
GCT-dermoid cyst
GC malign-immature teratoma
GCT best progn-dysgerminoma
GCT worst progn-endoderm sinus/yolk sac tm
4a
tm ovary a/w endometriosis-clear cell
tm a/w dermatomyositis-ca ovary
Palate
malign palate-adenoca
Pancreas
tm pancr-adenoca
bn tm pancr-insulinoma
m

non fn pancr tm-parapolypeptidoma

Penis
malign penis-SCC
Peritoneum
Ai

tm peritoneum-met
Pituitary gld
tm ant pituitary-prolactinoma
Placenta
prim for met to placenta-melanoma
PNS
bn tm PNS-inverted papilloma
malign PNS-SCC> adenoca
 Prostate
malign prostate-adenoca
malign mal >65y-adenoca prostate
Salivary gld
sal gld tm-pleomorph adenoma(mixed tm)
sal gld malign-mucoepidermoid ca> medullary ca
min sal gld tm-adenoid cystic ca
min sal gld malign-mucoepidermoid ca

in
parotid gld tm child-hemangioma> lymphangioma> mucoepidermoid ca
Skin
malign skin-BCC(nodular)
malign head&neck-SCC
malign post kidn transpl-SCCskin+lip> cx

s.
melanoma-superf spreading
melanoma black,Asian,hippanic-acral lentiginous
melanom perineur invasion-desmoplastic
Small intestine
bn tm SI-adenoma

bn tm duod-adenoma
iim
sympt bn tm SI-leiomyoma

malign SI-adenoca(polypoid)> carcinoid

lymphoma GIT-DLBCL> Burkitt lymphoma
malign GIT child-lymphoma
enteropancr tm-gastrinoma
4a
Soft tissue
soft ts tm-lipoma
soft ts sarcoma adult-malign fibrous histiocytoma> liposarcoma
soft ts sarcoma young adult-synovial cell sarcoma
hemangioma-capillary
soft ts tm child-hemangioma
soft ts sarcoma child-rhabdomyosarcoma
m

rhabdomyosarcoma-embryonal
tm hand-ganglion
Spinal cord
spin cord tm-met
Ai

prim spinal cord tm-nerve sheath tm

intramedullary spinal cord tm-ependymoma
Stomach
tm stom-leiomyoma
bn tm stom-leiomyoma> adenoma
malign stom-adenoca
mesenchymal tm GIT-GIST
mesenchymal tm stom-GIST(spindle)
 lymphoma stom-DLBCL
Testis
tm testis-mixed> seminoma(typical)
tm undescend testis-gonadoblastoma
malign undescend testis-seminoma
tm testis child-yolk sac tm
tm testis puberty-teratoma
tm testis old age-lymphoma

in
Thyroid gld
tm thy-papillary ca
bn tm thy-follicular adenoma
tm thy child-papillary ca
tm thy a/w MEN II-Medullary ca

s.
tm thy a/w goitre-follicular ca
tm thy a/w LN met-papillary ca
tm thy a/w Cowden synd-papillary ca
tm thy a/w Hashimoto thyroiditis-papillary ca

Tonsil
iim
tm thyroglossal cyst-papillary ca
prim for thy met-breast>lung

malign tonsil child-lymphoma

malign tonsil aduld-mucoepidermoid ca
UB
tm UB-transitional cell ca
4a
malign in ectopia vesicae-adenoca
malign SChistosomiasis-SCC UB
prim for UB met-melanoma
Uterus
pelvic tm fem-leiomyoma/fibroid uterus
tm uterus-leiomyoma(intramural> subserosal >submucosal)
malign uterus-adenoca
m

ca endom-endometrioid ca
PTEN ass tm-ca endometrium type1
ca cx-SCC
sarcoma uterus-leiomyosarcoma
Ai

tm—marker—HPE
angiomyolipoma-HMB45-—
angiosarcoma-CD34,31,fact VIIIa,XIIIa-—
BCC skin-—-nuclear palisading
bn fibrohistiocytoma-vimentin,CD68-—
Brenner-—-Walthard cell nest,puffed Wheat nuclei
ca breast-CEA,CA15-3,HER2neu-—
 ca breast lobular-—-Indian file
ca colon-CEA,CA19-9,50,242-—
ca lung SmCC-—-azzopardy effect
ca meD thy-calcitonin,neuron sp enolase-amyloiD
ca ovary-HER2neu-—
ca pancr-CEA,CA19-9,50,242-—
ca pap thy-thyroglobulin-Orphan Annei eye nucleus,Psammoma body
ca prostate-acid phosphatase,PSA-—

in
ca stom-CEA,CA19-9,50,72-4,125,242,βhCG,HER2neu-—
ca UB-FGF-—
carcinoid-5HIAA-—
chordoma-—-physaliferrous cell
ChorioCa-hCG-—

s.
clearcell/mesonephroid-—-hobnail cell
Dermoid cyst-—-Rokitansky boDy
dysgerminoma-LDH,AFP,hCG-—
embryonal ca-βhCG+AFP-—
iim
epithelial(ca)-cytokeratin-—
epith ovary ca-CA125-—
epitheloid sarcoma-epith membAg(EMA)-—
fibrolamellar ca liver-neurotensin-—
fibroma-vimentin-—
fibrosarcoma-vimentin-—
GIST-CD117(C-KIT),CD34,DOG1(best),S100,SMA,BCL2,prot kinase Cθ-—
4a
GLioblastoma(WHO grade IV)-—-pseudopalisading,GLomeruloid vess
glioma-GFAP(GlialFibrillaryAcidProt),VEGF-—
granulosa cell tm-inhibin-Call Exner body
HCC-AFP,HepPar1,arginase,PIVKA2,neurotensin,hepatocyteGF-—
hemangioma-CD34,31,fact VIIIa,XIIIa-—
hematolymphoid cell-CD45(common leucocyte Ag)-—
hilus/Leydig cell tm-—-Reinke crystal
m

Kaposi sarcoma-CD34,31,fact VIIIa,XIIIa-—

Krukenberg tm-—-signet ring cell
leiomyoma-sm m actin(SMA),desmin-—
Medullary ca sal gld-—-Mucin,keratinising stratif sq epith
Ai

melanoma-S100,HMB45-—
meningioma-—-whorling,Psammoma body
mesenchymal-vimentin-—
mesothelioma-cytokeratin,calretinin-—
mucinous CystadEnomA-CEA-—
multiple myeloma-Ig-—
myocyte(smooth/skeletal)-desmin-—
myxoma heart-—-spider cell
 neuroblastoma-neuron sp enolase,HVA,VMA-—
neurofibroma-S100-—
nonseminomatous testis-hCG,AFP-—
oligodendroglioma-—-fried egg app
optic n glioma-GFAP-hair like projection,rosenthal fibre
osteosarcoma-alk phosphatase-—
pheochromocytoma-HVA,VMA-Zelballen
pleomorph adenoma-—-chondromyxoid material

in
rhabdomyosarcoma-desmin,myogenin,myoD1(best)-spider cell
Schwannoma-S100-—
serous cystadenom ovary-—-Psammoma body
SqCC lung-CEA-keratin pearl,keratinization
synovial sarcoma(unknown cell origin)-Mic2(CD99),cytokeratin,epith memb

s.
Ag(EMA)-epitheloid/spindle cell
trophoblastic-hCG-—
yoLksac/enDoDermaL sinus-AFP,LDH- Schillar Duval body

tm-gene
Burkitt lymphoma-cmyc
ca breast-BRCA1,2,PTEN
ca breast mal-BRCA2
ca Colon-KRAS,Cmyc,PTEN
iim
ca endometrium(1)-PTEN
ca esoph-p53
4a
ca lung-KRAS
ca SmCC Lung-Lmyc
ca ovary-BRCA1
ca pancr-PTEN,P53,BRCA2,KRAS
ca prost-PTEN,GSTP1,RASSF1A,AMACR
ca stom-p16,53,cox2
ca thy folli-PTEN,p53,RAS,PAX8/PPAR1
m

ca thy mEd-RET
GIST-ckit
HCC-βcatenin
hepatoblastoma-βcatenin
Ai

melanoma-BRAF
Neuroblastoma-myc
RCC-HRAS

tm-route of spread
BCC-transepith
brochoalveolar ca-lepidic
ca ovary-direct invasion into peritoneum
 ca thy follicular-bld
ca thy papillary-lymph
carcinoma-lymph
chorioca-bld
HCC-bld
Krukenberg tm-transcoelomic, retrograde lymph
malign melanoma-lymph
medulloblastoma-drop met

in
RCC-bld
sarcoma-bld

PROGNOSTIC FACTOR
ALL

s.
Good:
age=2-10y
hyperploidy
TLC<5000/mm³
t(12;21)
fem
Bad:
Black
age<2y,>10y
iim
TLC>50000/mm³
pre Bcell ALL
4a
t(9;22),t(4;11),MLL-AF4
mal
met-mening,testis
LNpathy

AML
Good:
m

age<40y
t(8;21),t(15;17),i(16)
TLC<25000/mm³
M2,3,4
Ai

blast cell with Auer rod

leukemia without preceding MDS
Bad:
extreme age<2y,>55y
myeloid sarcoma
i(3),t(3;3),t(6;9),t(6;11),t(10;11)t(9;22)
monosomy5,7,20
11q23,3q21,3q26,FLT3,MDR1
 TLC>1lac/mm³
M0,6,7
leukemia with preceding MDS
anticancer drug exposure

BCLL/SLL
Good:
ZAP>0

in
Burkitt lymphoma
MiB1(Ki67) labelling index-proliferative index=100%

carcinoma

s.
Bad:
invasion(basement memb)

ca adrenal gld
size

ca breast
iim
major prognostic criteria
LN met/axillary LN status
tm size
distant met
4a
invasive ca in situ
locally advanced ds
inflammatory ca
good prog marker
ER+ve
PR+ve
HER2neu–ve
m

diploidy
low cathepsin D
tubular
tm labelling index<3%
Ai

Nottingham prog criteria

(0.2×size)+grade+LN

ca cx
stage>LN

ca colon
Good:
 rectal blding
Bad:
LN&stage
age<30y
colon obstruct
mal
rectum

in
ca endometrium
histologic type

ca esoph
TNM staging

s.
ca GB
depth of invasion

ca penis
LN

ca stom
depth of invasion>node
iim
ca thy(MACIS)
4a
Age
Met
Completeness of resection
Invasion
Size

ca UB
m

depth of invasion

CNS tm
histologic grade
Ai

Ewing sarcoma
Bad:
dist met
↑size
prox locat
fever,anem,↑TLC,ESR,LDH
↑age
 mal

GIST
Bad:
size>5cm
met
mitotic index>5/HPF
cellular atypia

in
necrosis
ckit mutat

GTN/chorioca
Bad:

s.
age≥40y
hCG≥10000IU/l
full term preg
duration≥12mth
tm size>5cm
met>8
site of met-liver&brain
prev h/o multi agent CT
iim
hairy cell leukemia
Good:
4a
age>60y

Hodgkin lymphoma
Bad:
age>45y
stage IV
mal
m

Hb<10.5g%(anem)
WBC≥15000/mm³(15×10^9/l)
ALC<600/μl,DLC<8%
sr alb<4g/dl
Ai

LDHL
EBV+ve

malignant melanoma
depth of invasion
BrESlow(BESt)>Clarke

Multiple Myeloma
 β2 Microglobin level

Neuroblastoma
Bad:
age>18mth
Schwannian stroma,gangliocytic differ entiat-absent
Nmyc gene absent
TrkA-Absent

in
TrkB-present
telomerase-highly expressed
1p,11q,17q loss present
near diploid
stage-3,4

s.
karyorrhexis mitosis index>200/5000

non Hodgkin lymphoma-International prog factor

Bad:
Age>60y
stage>II
iim
>1 extranodal organ involvem
↑sr LDH
performance status
risk-high=4-5,interm=2-3,low=0-1
4a
oral ca
LN

pheochromocytoma
Bad:
met
invasion of surround ts
m

RCC
Robson path staging
Good:
Ai

chromophobe
papillary type I
Bad:
sarcomatoid

sarcoma
Bad:
mitosis,necrosis
 soft ts sarcoma
stage&grade

tm hollow visceral organ

depth of invasion

Wilms tm

in
stage&histology(Devita)
LOH at 1P(CamPbell)

Abbreviations
a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune

s.
bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch,
Bx-biopsy
ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral,
conc-concentration, cong-congenital, Cx-cervix
d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis
E-estrogen
fem-female, fr-from
gld-gland, glu-glucose
h-hormone
iim
idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury
lig-ligament, LL-lower limb, l/t-leading to
m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor,
mtx-methotrexate, Mx-management
n-nerve, norm-normal
4a
P-progesterone, pl-plasma, prot-protein, pt-patient
Rx-treatment
SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure
tm-tumour, ts-tissue
UL-upper limb, u/l-unilateral
vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume
w-week, wt-weight
m

Xr-X ray
y-year
#-fracture
°-degree

-THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP
Ai

TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE

HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS.