7.4 Pathology of Lung Cancer Flashcards Preview

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Flashcards in 7.4 Pathology of Lung Cancer Deck (21):
1

What is the most avoidable cause of death?

Tobacco

2

What does the relationship of disease in lung cancer depend on?

Amount of daily smoking
Tendency to inhale
Duration of smoking
Age of initiation

Smoking for 6 years
1 pk day = 22x risk of dying
2 pl = 45 x risk of dying

3

What are the smoking related changes in the lungs?

Inflammation around the bronchi and bronchioles
Enlarged air spaced next to normal appearing lung
Bullae formation - air spaces >1cm
Carbon pigment in lung
Fibrosis and scarring
Usually more severe in the upper lobes
Lung carcinoma

4

What are the risk of emphysema?

Smoking, A1 AT deficiency

5

What are the types of emphysema?

Centriacinar
Panacinar
Paraseptal

6

What are the consequences of emphysema?

Dyspnoea
Cor pulmonale (change in right ventricle from pulmonary hypertension)
CCF (congestive cardiac failure)

7

How can emphysema cause death?

Coronary heart disease
Respiratory failure
Right sided heart failure
Pneumothorax

8

What are the smokeless related cancers

Oesophagus, mouth, throat and pancreas

9

What does second hand smoke cause in children?

SIDS
Ear infections, colds
Pneumonia
Bronchitis
Severe asthma

10

What are the complications of smoking in pregnancy?

Premature birth
Low birth weight
Still birth
Abruption
Ectopic pregnancy
Preterm delivery
PROM
IUGR
Placenta praevia
Infertility
Poor response to IVF

11

What are the common presentations of lung cancer?

Cough
Weight loss
Dyspnoea
Chest pain
Haemoptysis
Bone pain
Hoarseness
15% asymptomatic

12

What are the investigations for lung cancer?

CXR, MRI, PET, FNA, bronchoscopy, sputum sample

13

What are the risk factors for lung cancer?

Smoking
Asbestos
Radon exposure
Halogen ether exposure
Chronic interstitial pneumonitis
Inorganic arsenic
Radioisotope, ionizing radiation

14

What causes lung cancer in non smokers

Passive smoking and workplace carcinogens
EGFR mutation and EML 4-ALK fusion
Decrease p53 mutations and KRAS mutations

15

What are the 4 cells types in the lungs?

ciliated, mucous, neuro-endocrine and basal

16

What are the central and peripheral cancer types?

Central: Small cell and SCC
Peripheral: ACC and large cell

17

What is the histologic appearance of small cell carcinoma?

Decrease cytoplasm, moulding of cells, finely granular nuclear chromatin (salt and pepper) and hyperchromatic

18

What is the histologic appearance of ACC

Glandular and mucin producing

19

What is the histologic appearance of SCC

keratin and intracellular bridges

20

What is the histologic appearance of Large cell carcinoma?

undifferentiated spindle cells and giant cells

21

Which lung cancer is often disseminated at presentation and hard to locate primary?

Small cell