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Lung cancer Flashcards

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1
Q

leading cause of cancer death

A

lung cancer

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2
Q

MC lung cancer

A

metastasis

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3
Q

lung metastasis is most often from

A
  1. breast 2. colon 3. prostate 4. bladder cancer
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4
Q

sites of metastasis from lung cancer

A
  1. adrenals 2. Brain 3. bone 4. liver
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5
Q

lung cancer metastasis to bone - manifestation

A

pathologic fracture

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6
Q

lung cancer metastasis to liver - manifestation

A
  1. jaundice

2. hepatomegaly

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7
Q

lung cancer - presentation

A
  1. cough 2. hemoptysis 3. bronchial obstruction
  2. wheezing 5. loss of weight 6. anorexia
  3. noncalcified nodule on CT
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8
Q

Lung cancer - complication

A

mnemonic: SPHERE + dysphagia + phrenic nerve paresis - heart or pericardial invasion +pleural invasion
1. Superior vena cava syndrome 2. Pancoast tumor
3. Horner syndrome 4. Endocrine (paraneoplastic)
5. Recurrent laryngeal nerve compression (hoarseness)
6. Effusions (pleural or pericardial)

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9
Q

Lung cancer - risk factors

A
  1. smoking 2. secondhand smoking 3. radon 4. asbestos 5. family history 6. Asbestosis 7. Silicosis
  2. Coal
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10
Q

primary lung cancer - divided to

A
  1. small cell carcinoma

2. Non-small cell

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11
Q

primary lung cancer - types (small or non small?)

A
  1. small cell (oat cell) carcinoma
  2. adenocarcinoma (non-small)
  3. Squamous cell carcinoma (non-small)
  4. Large cell carcinoma (non-small)
  5. Bronchial carcinoid tumor (non-small)
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12
Q

lung small cell (oat cell) carcinoma - location

A

central

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13
Q

lung adenocarcinoma - location

A

peripheral

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14
Q

lung Squamous cell carcinoma - location

A

central

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15
Q

lung Large cell carcinoma - location

A

peripheral

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16
Q

lung metastasis on image

A

usually multiple lesions

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17
Q

bronchial carcinoid tumor - location

A

central or peripheral

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18
Q

lung small cell (oat cell) carcinoma may cause/produce

A
  1. Cushing syndrome (ACTH) 2. SIADH
  2. antibodies against presynapitc Ca2+ channels (Lambert-Eaton myasthenic syndrome)
  3. or neurons (paraneoplastic myelitis/encephalitis, sabacute cerebellar degeneration)
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19
Q

lung small cell (oat cell) carcinoma - manegment

A

inoperable

treat with chemotherapy +/- radiation

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20
Q

lung small cell (oat cell) carcinoma - gene amplification

A

myc oncogenes common

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21
Q

lung small cell (oat cell) carcinoma - aggressiveness

A

very aggressive

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22
Q

lung small cell carcinoma is also called

A

oat cell

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23
Q

lung small cell (oat cell) carcinoma - histology

A
  1. neoplasm of neuroendocrine Kulchitsky cells (small dark blue cells)
  2. chromogranin A positive
  3. undifferentiated (very aggressive)
  4. Neuron specific enolase positive
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24
Q

lung small cell (oat cell) carcinoma - histology positive to

A

chromogranin A

Neuron specific enolase

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25
Kulchitsky cells appearance
small dark blue cells
26
lung squamous cell carcinoma - histology
keratin pearls and intercellular bridges
27
lung squamous cell carcinoma - may cause/produce
1. cavitation | 2. hypercalcemia (produce PTHrP
28
lung squamous cell carcinoma - CXR
Hillar mass arising from bronchus
29
bronchial carcinoid tumor - histology
nests of neuroendocrine cells | chromogranin A positive
30
chromogranin A positive lung tumors
1. bronchial carcinoid tumor | 2. lung small cell (oat cell) carcinoma
31
bronchial carcinoid tumor - prognosis
excellent
32
bronchial carcinoid tumor - metastasis
rare
33
bronchial carcinoid tumor - presentation/symptoms
1. symptoms due to mass effect | 2. carcinoid syndrome (flashing, diarrhea, wheezing)
34
lung Large cell carcinoma can secrete
β-hCG
35
lung Large cell carcinoma - histology
1. β-hCG secretion 2. pleomorphic giant cells 3. highly anaplastic undifferentiated tumor
36
lung Large cell carcinoma - prognosis
poor
37
lung Large cell carcinoma - treatment
1. less responsive to chemotherapy | 2. remove surgically
38
MC primary lung cancer
adenocarcinoma
39
MC lung cancer in non smokers
adenocarcinoma
40
lung adenocarcinoma activating mutations
1. KRAS 2. EGFR 3. ALK
41
lung adenocarcinoma is associated with (paraneoplastic)
hypertrophic osteorarthropathy (clubbing)
42
lung adenocarcinoma - histology
1. glandular pattern | 2. often stains mucin (+)
43
adenocarcinoma in siitu
bronchioarveolar subtype
44
bronchioarveolar subtype - CXR
hazy infiltrates similar pneumonia
45
bronchioarveolar subtype - prognosis
excellent
46
bronchioarveolar subtype - histology
grows allong alveoral septa --> apparent thickening of alveolar wall --> Tall columnar cells containing mucus
47
excellent prognosis lung tumors
1. bronchioarveolar subtype | 2. Bronchial carcinoid tumor
48
lung tumor - c myc
small cell carcinoma
49
lung tumor - clubbing
adenocarcinoma
50
lung tumor less responsive to chemotherapy
Large cell carcinoma
51
Small cell carcinoma - effects on nervous system
antibodies against presynapitc Ca2+ channels (Lambert-Eaton myasthenic syndrome) or neurons (paraneoplastic myelitis/encephalitis, sabacute cerebellar degeneration)
52
lung tumor - similar to pneumonia CXR
bronchioarveolar subtype
53
lung tumor - β-hCG secretion
Large cell carcinoma
54
lung tumor - nests od neuroendocrine cells
Bronchial carcinoid tumor
55
MC tumor in male smokers
squamous cell lung
56
lung small cell carcinoma epidemiology
male smokers
57
lung squamous cell carcinoma epidemiology
male smokers
58
MC tumor in female smokers
lung adenocarcinoma
59
large cell carcinoma -epidimiology
smokers
60
bronchioarveolar subtype - smoking
no relationship
61
Bronchial carcinoid tumor - smoking
no relationship
62
mesothelioma
malignancy of the pleura
63
mesothelioma is associated with
asbestosis
64
mesothelioma may result in
1. hemorrhagic pleural effusion (exudative) | 2. pleural thickening
65
mesothelioma - risk factors
asbestosis | smoking is not a risk factor
66
mesothelioma - histology
- psammoma bodies | - calretinin and cytokeratin (+) in almost all mesotheliomas, ((-) in most carcinomas)
67
A psammoma body is a
A psammoma body is a round collection of calcium
68
pancoast tumor is also called
superior sulcus tumor
69
Pancoast syndrome?
pancoast lung cancer that invade cervical sympathetic chain
70
pancoast tumor (superior sulcus tumor) may cause
Compression of locoregional structures: 1. Horner syndrome 2. Superior vena cava syndrome 3. hoarseness 4. sensorimotor deficits
71
pancoast tumor - horner - why
invades cervical sympathetic chain
72
Horner syndrome clinical findings
1. ipsilateral ptosis 2. miosis 3. anhidrosis
73
superior vena cava syndrome - caused by
1. malignancy (pancoast tumor) | 2. thrombosis from indwelling catheter
74
superior vena cava syndrome - medical emergency because
it can raise intracranial pressure (if obstruction is severe) --> headaches, dizziness, increased risk of aneurysm/rupture of intracranial arteries
75
superior vena cava syndrome - pathophysiology
an obstruction of the SVC that impairs blood drainage from head, neck, and upper extremitires
76
superior vena cava syndrome - clinical characteristics
1. facial plethora 2. bleaching after fingertip 3. jugular venous distension 4. upper extremities edema
77
Lung Ca - MC symptom
cough (75%)
78
Lung Ca - proportion of cough/hemotpysis/dyspnea
cough -->75% hemoptysis --> 35% dyspnea --> 60%
79
Lung Ca - single most common area of metastasis
brain
80
lung ca - metastasis to bone - labs
1. increased ALP | 2. hypercalcemia
81
lung Ca in CXR
pneumonic coin lesion
82
lung Ca in CT
noncalcified nodule
83
Lung cancer - effusions
1. Pleural | 2. Pericardial
84
primary lung cancers that have lesser association with smoking
1. Bronchial carcinoid | 2. Bronchioalveolar

respiratory (27 decks)

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