Lung Neoplasms

Question 1

True or False: lung cancer is the most common cause of cancer mortality worldwide.

Answer 1

True

Question 2

What is the most common cause of lung cancer?

Answer 2

Smoking

Question 3

What % of lung carcinomas occur in active smokers or those who’ve stopped recently?

Answer 3

87%

Question 4

Benzo[a]pyrene is a carcinogen that can cause a mutation in which protein, leading to lung cancer?

Answer 4

P53

Question 5

Uranium miners have a ___x risk of cancer if theyre non-smokers and __x risk if they are smokers.

Answer 5

4x

10x

Question 6

This is the chemical that can cause lung cancer in closed spaces and is inhaled when attached to environmental aerosols.

Answer 6

Radon

Question 7

What can inhaled carcinogens do to oncogenes and tumor supressors to cause lung CA?

Answer 7

Activate oncogenes

Inhibit tumor supressors

Question 8

What are the 3 precursor lesions that have a very good chance to progress to cancer?

Answer 8

Squamous dysplasia and carcinoma in situ
Atypical adenomatous hyperplasia
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.

Question 9

What pt population is at risk for small cell carcinoma?

Answer 9

male smokers

(cancers starting with “S” are associated with “S”mokers, they’re “c”entral, and they are assocaited with paraneoplastic “S”yndromes)

Question 10

Are small cell carcinomas benign or malignant?

Answer 10

Highly malignant

Question 11

What are the histological features of small cell carcinoma?

Answer 11

Poorly differentiated cells, most show neurosecretory granules

Question 12

Where in the lung are small cell carcinomas?

Answer 12

Central

Question 13

What are the paraneoplastic syndromes assoacited with small cell carcinoma?

Answer 13

ADH
ACTH
Eaton-Lambert syndrome

Question 14

What is the Tx for small cell carcinoma: Chemo, surgery, or both?

Answer 14

ONLY chemo

Question 15

What is the most common tumor for male smokers?

Answer 15

Squamous cell carcinoma

Question 16

What is happening during the years of asymptomatic Squamous cell carcinoma?

Answer 16

Squamous metaplasia

Question 17

When do Sx start in Squamous cell carcinoma?

Answer 17

When the tumor obstructs, destroys, or grows within the tissue

Question 18

What is the most common mutation for Squamous cell carcinoma?

Answer 18

p53 mutations

Question 19

What are the 2 u see on histology for Squamous cell carcinoma?

Answer 19

ketatin pearls or intercellular bridges

Question 20

Where in the lung are Squamous cell carcinoma?

Answer 20

Central

Question 21

What is the 1 paraneoplastic syndrome associated with Squamous cell carcinoma?

Answer 21

Hypercalcemia from fromduction of PTHrP

Question 22

What is the most common tumor in non-smokers and FEMALE smokers?

Answer 22

Adenocarcinoma

Question 23

The majority of Adenocarcinoma tumors are + for which serum protein?

Answer 23

Thyroid transcription factor-1

Question 24

What is the most common mutation to cause Adenocarcinoma?

Answer 24

KRAS mutations

Question 25

What are the 2 thing seen in histology for Adenocarcinoma?

Answer 25

Glands or Mucin

Question 26

Where in the lung are Adenocarcinomas?

Answer 26

Peripheral

Question 27

How do u get large cell carcinomas?

Answer 27

Smoking

Question 28

What shows up on histology for large cell carcinomas?

Answer 28

Poorly differentiated large cells

Question 29

What DOES NOT show up on histology for large cell carcinomas?

Answer 29

anything from prev cancers- keratin pearls, interceullar bridges, glands, or mucus

Question 30

Where are large cell carcinomas located?

Answer 30

Central or Peripheral

Question 31

Do large cell carcinomas have a good or bad prognosis?

Answer 31

Poor prognosis

Question 32

Is bronchioloalveolar carcinoma related to smoking?

Answer 32

No

Question 33

How does bronchioloalveolar carcinomas grow in the lung?

Answer 33

Grow along pre-existing bronchioles and alveoli

Question 34

Which cells give rise to bronchioloalveolar carcinomas?

Answer 34

Clara cells

Question 35

Where in the lung is bronchioloalveolar carcinoma?

Answer 35

peripheral

Question 36

Bronchioloalveolar carcinomas present with PNA-like consolidation and have a poor or excellent prognosis?

Answer 36

Excellent prognosis

Question 37

True or False: Carcinoid tumors are not related to smoking.

Answer 37

True

Question 38

What shows up on histological exams for Carcinoid tumors?

Answer 38

Well differentiated neyroendocrine cells

Question 39

Carcinoid tumors are + for which marker?

Answer 39

Chromogranin +

Question 40

Carcinoid tumors can be central or peripheral and can form what in the bronchus?

Answer 40

Polyp-like mass

Question 41

True or Fase: Carcinoid tumors often cause carcinoid syndrome.

Answer 41

False. They rarely do.

Question 42

What is the most common location for metastasis to the lung?

Answer 42

Breast or colon

Question 43

What is seen on imaging for metastasis lesions in the lung?

Answer 43

"cannon-ball" nodules

Question 44

Are metastasis in the lung more or less common and primary tumors of the lung?

Answer 44

More common

Question 45

What are the major Sx to lung carcinoma?

Answer 45

Cough, weight loss, chest pain, and dyspnea ....not very specific here....

Question 46

If the tumor causes a pleural effusion, where is the tumor located?

Answer 46

Tumor spread into the pleura

Question 47

If the tumor causes hoarseness, where is the tumor pressing?

Answer 47

Recurrent laryngeal nerve

Question 48

If the tumor causes diaphragm paralysis, where is the tumor pressing?

Answer 48

Phrenic nerve

Question 49

If the tumor causes SVC syndrome, where is the tumor pressing?

Answer 49

SVC

Question 50

If the tumor causes Horner syndrome, where is the tumor pressing?

Answer 50

Sympathetic ganglia

Question 51

Which 2 cancers tend to remain localized longer and have a slightly better prognosis than do the undifferentiated cancers?

Answer 51

Adenocarcinoma and Squamous cell

Question 52

Hyponatremia, Cushing syndrome, and Eaton-Lambert are paraneoplastic syndromes from which type of tumor?

Answer 52

Small cell carcinomas

Question 53

Hypercalcemia is a paraneoplastic syndrome from which type of tumor?

Answer 53

Squamous cell tumors

Question 54

These are benign neuroendocrine neoplasms and often seen in areas of scarring or chronic inflammation.

Answer 54

Tumorlets

Question 55

What mutation distinguises typical and atypical carcinoid tumors?

Answer 55

p53 mutations (atypical have them)

Question 56

This is the name of the lesion from a carcinoid tumor where it has penetrated the bronchial wall.

Answer 56

Collar-button lesion

Question 57

Are carcinoid tumors well- or poorly-differentiated?

Answer 57

Well-differentiated

Question 58

What are the classic Sx to carcinoid tumors?

Answer 58

persistent cough, hemoptysis, 2o infections... blahblahblahbjsghsjgnsgmpksg

Question 59

This is a relatively common lesion that is usually discovered incidentally, and shows a coin lesion on CXR.

Answer 59

Harmatoma

Question 60

What are the harmatoma nodules made of?

Answer 60

connective tissue (usually cartilage) intersected by epithelial clefts and lined by ciliated columnar epithelium

Question 61

These are rare tumors in kids that present with a fever, cough, chest pain, and hemoptysis. They're from proliferation of spindle-shaped fibroblasts and myofibroblasts.

Answer 61

Inflammatory Myofibroblastic tumor

Question 62

True or False: the lung is the most common site for metastatic neoplasms.

Answer 62

True!

Question 63

These are soft-tissue tumors in the pleura, often attached by a pedicle, and are rarely malignant.

Answer 63

Solitary fibrous tumor

Question 64

Solitary fibrous tumors have dense fibrous tissue with occasional cysts, and have spirals of what substance within them?

Answer 64

Collagen

Question 65

What are the 2 most common Sx of primary lung cancer?

Answer 65

Cough and Hemoptysis