Rapid Review·General Pathology
Select any text to highlight it or add a note.
NEOPLASIA
T1Must knowCarcinogens
P221
Focus on
Matching an occupational or dietary exposure to the exact organ and histologic subtype it produces.
Key takeaways
How to read this page
How to read this table
the exam almost never names the carcinogen outright. It names the job, the hobby, or the food, and expects you to jump straight to the organ and the histologic subtype.Exposure to organ to cancer
| Toxin | Exposure | Organ → Cancer |
|---|---|---|
| Aflatoxins (Aspergillus) | Stored grains and nuts | Liver → hepatocellular carcinoma, via a TP53 G→T transversion |
| Alkylating agents | Oncologic chemotherapy | Blood → leukemia and lymphoma |
| Aromatic amines (benzidine, 2-naphthylamine) | Textile dyes, tobacco smoke | Bladder → transitional cell carcinoma |
| Arsenic | Herbicides (vineyard workers), metal smelting, wood preservation | Liver → angiosarcoma; Lung → cancer; Skin → squamous cell carcinoma |
| Asbestos | Old roofing, shipyard workers | Lung → bronchogenic carcinoma > mesothelioma |
| Tobacco smoke | Cigarettes | Bladder (TCC), cervix (SCC), esophagus (SCC and adeno), kidney (RCC), larynx (SCC), lung (SCC and small cell), oropharynx (SCC), pancreas (adenocarcinoma) |
| Ethanol | Alcohol | Esophagus → SCC; Liver → HCC |
| Ionizing radiation | Fallout, radiotherapy | Thyroid → papillary carcinoma; Blood → leukemia; Breast → breast cancer |
| Nickel, chromium, beryllium, silica | Occupational | Lung → cancer |
| Nitrosamines | Smoked foods and processed meats | Stomach → gastric cancer, intestinal type |
| Radon | Byproduct of uranium decay, accumulates in basements | Lung → second leading cause of lung cancer after tobacco |
| Vinyl chloride | PVC pipe manufacturing | Liver → hepatic angiosarcoma |
A 55-year-old man who worked for decades in a textile dye factory presents with painless hematuria. What is the carcinogen, and what is the tumor?
Aromatic amines (benzidine, 2-naphthylamine) from textile dyes, causing transitional cell (urothelial) carcinoma of the bladder.
How it's tested
Note that asbestos causes bronchogenic carcinoma MORE OFTEN than mesothelioma. Mesothelioma is the pathognomonic tumor but not the most common one, and asbestos combined with smoking is multiplicative for bronchogenic carcinoma.
Three separate exposures converge on hepatic angiosarcoma: arsenic, vinyl chloride, and Thorotrast. A rubber or PVC plant worker with a vascular liver tumor is that question.
Finally, radon is the number two cause of lung cancer overall and the number one cause in nonsmokers, classically in a homeowner with an unventilated basement.
Go deeper
First Aid "Carcinogens" table; Pathoma Ch. 3. Anchor the highest-yield pairs — aflatoxin → HCC (p53 mutation), aromatic amines → bladder TCC, asbestos → bronchogenic carcinoma (more common than mesothelioma), vinyl chloride → hepatic angiosarcoma, nitrosamines → gastric.
Flashcards for this page
Card 1 of 5 · try-out only, nothing is saved
(...) cancer
You just read one page of 944
The rest of Step 1, written exactly like this.
Rapid Review is the reading layer of a full Step 1 platform: a schedule fitted to your exam date, flashcards for every page, and a mentor a message away.
Every Step 1 system
Written the same way: what to know, how it’s tested, where to go deeper.
A plan built to your exam date
Tell us when you sit, and the schedule fits the whole library and your question bank to it.
Flashcards for every page
Ready-made spaced-repetition decks linked to each topic, so nothing you read gets forgotten.
