Lecture 10 Pulmonary Neoplasms Flashcards Preview

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Flashcards in Lecture 10 Pulmonary Neoplasms Deck (45):
1

____ causes 80-90% of all lung cancer. what is the most important carcinogen in it?

tobacco smoking; polyaromatic hydrocarbons (accoring to pathoma)

2

who has a higher risk of developing lung cancer, women or men?

women

3

what is the most common histological subtype of lung cancer?

adenocarcinoma

4

adenocarcinoma most likely arises from ____ cells in the _____ (central or peripheral?) bronchi. it stains ____ positive

mucin secreting, peripheral, mucin

5

the bronchioalveolar subtype of adenocarcinoma is characterized by ____ cells that grow along bronchioles/alveoli. they arise from ___ cells and ____ to smoking

columnar;
clara, unrelated

6

what is the prognosis with bronchioloalveolar carcinoma? CXR shows a ____ infiltrate similar to ____

good. hazy, pneumonia

7

what is the 'S' pneumonic?

Squamous cell and Small cell carcinoma are Sentrally located, caused by Smoking, and have paraneoplastic Syndromes associated with them.

8

squamous cell carcinoma presents as a ____ mass arising from the ____.

hilar, bronchus

9

characteristic histological findings of squamous cell carcinoma

keratin pearls and intercellular bridges

10

what are the "C"s of squamous cell carcinoma?

cavitation, cigarretes, hyperCalcemia (due to PTHrP)

11

large cell carcinoma:
central or peripheral?
surgery or chemo?
good or bad prognosis?

peripheral, surgery;
bad prognosis (aggressive)

12

small cell carcinoma: neoplasm of ____ _____ cells which are small dark ___ cells on histology

neuroendocrine Kulchitsky, blue

13

small cell carcinoma can produce ____, causing cushing syndrome. they can also cause ____. they can produce antibodies against ____ channels causing lambert eaton myasthenic syndrome

ACTH, SIADH;
presynaptic calcium

14

what might you see histologically in small cell carcinoma?

lot of mitotic activity

15

bronchial carcinoid tumor: highly ___ lesions that arise in ____ glands in the bronchial wall. characterized by red/pink ___ mass protruding from the bronchial wall

vascularized, submucosal;
polyploid

16

bronchial carcinoid tumor: stains positively to ____ markers such as _____

neuroendocrine, chromogranin

17

diagnosis of bronchial carcinoid tumor is usually made based off of history of frequent ____ or repeated bouts of ___ + bronchoscopy. what's the prognosis?

hemoptysis, pneumonia;
"excellent"

18

carcinoid syndrome: release of vasoactive amines such as _____ which cause _____ of face and upper body,diarrhea, and _____

serotonin; flushing;
wheezing

19

why shouldn't you biopsy a carcinoid tumor?

severe risk of hemorrhage

20

bronchial carcinoid tumor shows a nest of slightly spindled cells with strippled ____; " ____ and ____" pattern

chromatin; salt, pepper

21

____ is the most common benign tumor of the lung. composed of disorganized elements of tissue normally ____ in the lung

hamartoma; present (ie lung tissue and cartilage)

22

hamartoma is characterized by a ____ hard smooth mass with the "____ out"

rubber, shell

23

staging system looks at 3 things:

TNM:
Tumor size/extension, regional lymph node involvement, metastasis

24

how is small cell carcinoma staged?

limited or extensive disease (ie to contralateral hemithorax)

25

see his notes for staging system specifics

not the most high yield

26

presence of metastasis automatically makes the disease stage ___

IV

27

treatment of limited small cell cancer is ____.
what about extensive stage disease?

chemo + RT;
just chemo

28

is hypercalcemia in lung cancer typically due to bony metastasis or due to secretion of PTHrP?

PTHrP (80%)

29

hypoglycmia is due to increased insulin release and is seen typically in what type of lung cancer?

squamous cell

30

large cell carcinoma can contain cells that secrete _____, leading to ____ or clubbing

gonadotropin, gyneocomastia

31

a right apical lung mass or thrombosis from indwelling catheter is usually the cause of _____

SVC syndrome

32

Symptoms of SVC: ___ discoloration and edema of the ____ and ____, JVD.

blue; upper extremity, face

33

Pancoast tumors involve the ___ dermatomes with invasion of the brachial plexus, resulting in ____ and ___ pain along with weakness and atrophy of ___ muscles. can also cause ____ syndrome

C8-T2; shoulder, arm;
hand;
horner's

34

horner's syndrome causes what 3 symptoms? (better know this or you will be haunted by Dr. Walker);

due to involvement of the sympathetic chain and _____ ganglion. does it cause ipsi or contralateral symptoms?

ptosis, miosis, anhidrosis;
inferior cervical (stellate);
ipsi

35

acanthosis nigricans is brownish hyperpigmentation and is common with _____

bronchial adenocarcinoma

36

what is the most useful diagnostic test in screening for cancer? What is the most useful radiologic test?

sputum cytology; CT

37

look for ____ lesion on CXR or a _____ nodule on CT

"coin"; noncalcified

38

____ determines the diagnosis of lung cancer and determines the cell type

bronchoscopy

39

non-small cell lung cancer: for stage 1 and 2, use ____;
for stage 3, use ____; stage 4 use ____

surgery + adjuvant chemo RT;
chemo + RT; chemo

40

limited disease small cell lung cancer is very responsive to _____; although still low survival :(

chemotherapy + RT

41

extensive stage small cell lung cancer:
_____ irradiation is used to improve quality of life and decrease mets

brain

42

asbestos usually causes _____ and can cause _____

lung cancer; mesothelioma

43

mesothelioma is characterized by pleural _____ or ___

thickening, effusion

44

mesothelioma stains positive for ____ and _____

cytokeratin, calretinin

45

characteristic ____ bodies are seen on histology with mesothelioma

psammoma