B4-080 CBCL Approach to a Lung Nodule Flashcards
1
Q
well differentiated neuroendocrine tumors
A
carcinoid tumor
2
Q
tobacco related neuroendocrine tumors
2
A
large cell and small cells
3
Q
- mitoses < 2 per 2 mm
- no necrosis
A
typical carcinoid
4
Q
- mitoses 2-10 per 2 mm
- or necrosis
A
atypical carcinoid
5
Q
- mitoses > 10 per 2 mm
- cytologic features of SCLC
A
small cell carcinoma
6
Q
- mitoses >10 per 2 mm
- cytologic features of NSCLC
A
large cell NET
7
Q
chemotherapy is first line for […] and second line for […]
A
first: large and small cell
second: typical/atypical carcinoid
8
Q
usually found in lung or GI tract
A
NET
9
Q
- well differentiated
- 2% of lung neoplasms
- metastatic potential 5-20%
A
typical carcinoid
10
Q
- intermediate grade
- <1% of lung neoplasms
- metastatic potential 30-40%
A
atypical carcinoid
11
Q
- high grade variant of large cell lung cancer
- 3% of lung neoplasms
A
large cell NET
12
Q
- high grade
- 15-20% of lung cancers
A
SCLC
13
Q
functional NETs may present with
3
A
- carcinoid syndrome
- cushing syndrome
- acromegaly, hypercalcemia, hypoglycemia
14
Q
carcinoid syndrome
3 symptoms
A
wheezing, cutaneous flushing, diarrhea
15
Q
clinical presentation for large cell NET
4 symptoms
A
cough
hemoptysis
chest pain
dyspnea
16
Q
- present with cough, hemoptyisis, dyspnea, chest pain, wheezing, hoarseness
- SVC syndrome
- may have paraneoplastic syndromes
A
small cell lung cancer
17
Q
A
typical carcinoid
18
Q
A
atypical carcinoid
19
Q
A
Large cell NET
20
Q
A
small cell
21
Q
used to differentiate carcinoids vs. large/small cell
cannot distinguish typical vs atypical
A
Ki67
22
Q
more Ki67 indicates
A
high grade NET
small or large cell
23
Q
least aggressive type of cancer with uniform, round to oval tumor cells
A
carcinoid
24
Q
workup for carcinoid tumor includes
3
A
- 24 hr urine for 5 HIAA
- chromogranin A level
- sometimes somatostatin receptor
25
has the poorest prognosis
small cell carcinoma
26
the diagnosis of carcinoid syndrome includes
| 3 symptoms
flushing
diarrhea
bronchospasm
27
ptosis, miosis, ipsilateral anhidrosis
horner's syndrome
| can be due to pancoast tumor
28
has revolutionized the way many cancers are treated, including small cell lung cancer
immunotherapy
29
small cell lung cancer
30
number one cancer killer of women in US
lung cancer
31
diarrhea, facial flushing, asthmatic symptoms
carcinoid tumor
32
test for definitive diagnosis of cancer
| tissue diagnosis is necessary
CT guided biopsy of lesion
33
altered mental status
hyponatremia
lung mass in upper lobe
SIADH
| paraneoplastic syndrome
34
sympathetic ganglia invasion due to cancer may cause
horner's syndrome
35
ptosis, miosis, ipsilateral anhidrosis
horner's
36
apical lung tumors may cause impingement of what surrounding structures?
| 3
1. brachial plexus
2. recurrent laryngeal nerve
3. sympathetic chain
37
a mass effect on the brachial plexus could cause
upper extremity weakness
38
a mass effect on the reccurent laryngeal nerve could cause
hoarse voice
39
a mass effect on the sympathetic chain could cause
horner's syndrome
40
carcinoid syndrome is caused by increased
serotonin
41
carcinoid syndrome is usually apparent after
metastasis, usually to liver
42
what laboratory finding is most likely with carcinoid syndrome?
elevated 5-HIAA in urine
43
shows some advantage in the treatment of low grade carcinoid tumors
| drug
everolimus
44
carcinoid tumors are most commonly in the
| anatomic location
GI tract
45
carcinoid tumors typically arise from the [...] cells of the GI tract
enterochromaffin
46
syndrome caused by excessive serotonin release via GI tumors
carcinoid syndrome
47
generally, metastasis to the [...] is required for carcinoid syndrome to occur
liver
48
neurosecretory granules
necrotic debris
high mitotic count
small cell carcinoma
49
obstructing mass of a bronchus
carcinoid tumor
50
first line treatment for carcinoid tumors
surgical resection
51
first line treatment for small cell lung cancer
combination chemotherapy
52
treatment to control flushing and diarrhea
long acting octreotide therapy
53
metabolite of serotonin that can be detected in urine
5-HIAA
54
synthetic octapeptide analog of somatostatin
octreotide
55
used to treat pancreatic secretory tumors and carcinoid syndrome
octreotide
56
glucose intolerance
coarsening of facial hair
macroglossia
thickened fingers
fatigue
sweating
| sign of
excessive growth hormone synthesis (acromegaly)
| associated with carcinoid tumor
57
altered mental status
convulsive episodes
hyponatremia
SIADH
| small cell lung cancer
58
may manifest with SIADH, cushings, or pancost tumor
small cell carcinoma
59
may manifest with hypercalcemia, hypoglycemia, acromegaly
carcinoid tumor
60
weight gain
abdominal striae
moon facies
poor wound healing
facial plethora
cushing syndrome
61
high mitotic rate
large cells with nucleoli
necrosis
neuroendocrine differentiation
large cell neuroedocrine tumor
