Flashcards in 7.4 Pathology of Lung Cancer Deck (21):
What is the most avoidable cause of death?
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
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
What are the risk of emphysema?
Smoking, A1 AT deficiency
What are the types of emphysema?
What are the consequences of emphysema?
Cor pulmonale (change in right ventricle from pulmonary hypertension)
CCF (congestive cardiac failure)
How can emphysema cause death?
Coronary heart disease
Right sided heart failure
What are the smokeless related cancers
Oesophagus, mouth, throat and pancreas
What does second hand smoke cause in children?
Ear infections, colds
What are the complications of smoking in pregnancy?
Low birth weight
Poor response to IVF
What are the common presentations of lung cancer?
What are the investigations for lung cancer?
CXR, MRI, PET, FNA, bronchoscopy, sputum sample
What are the risk factors for lung cancer?
Halogen ether exposure
Chronic interstitial pneumonitis
Radioisotope, ionizing radiation
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
What are the 4 cells types in the lungs?
ciliated, mucous, neuro-endocrine and basal
What are the central and peripheral cancer types?
Central: Small cell and SCC
Peripheral: ACC and large cell
What is the histologic appearance of small cell carcinoma?
Decrease cytoplasm, moulding of cells, finely granular nuclear chromatin (salt and pepper) and hyperchromatic
What is the histologic appearance of ACC
Glandular and mucin producing
What is the histologic appearance of SCC
keratin and intracellular bridges
What is the histologic appearance of Large cell carcinoma?
undifferentiated spindle cells and giant cells