Neoplasia 3 Flashcards Preview

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Flashcards in Neoplasia 3 Deck (35)
1

What is the clinical presentation of a lung tumour?

cough, haemoptysis, wheeze, dyspnoea, pneumonia, Pancoast’s syndrome

2

What are some of the common clinical presentations of metastases?

lymphadenopathy, bone pain/hypercalcaemia, jaundice, seizures

3

What causes weight loss and anorexia in cancer?

TNF-alpha and IL-1

4

What are paraneoplastic effects?

Symptoms which aren’t related to the local presence of a tumour

5

What are some common paraneoplastic effects?

endocrine problems, immunological problems, clubbing, hypertrophic osteoarthropathy, venous thrombosis, endocarditis

6

What are some paraneoplastic endocrine effects of lung cancer?

hypercalcaemia, cushings, inappropriate ADH/ACTH

7

What are some other paraneoplastic endocrine disorders?

hypoglycaemia, polycythaemia

8

What blood tests might you order for a cancer patient?

blood picture, liver function test, tumour markers

9

What are tumour markers?

Proteins in the blood which are useful in follow up of a tumour such as prostate specific antigen in prostate cancer, carcinoembryonic antigen, alpha fetoprotein in colon cancer

10

Why is tissue sampling important?

To confirm malignancy and to determine features relevant to prognosis and management

11

What type of stains may be done on a tissue sample?

H&E, stains for melanin, stains for musin, immunohistochemistry to determine cell line

12

Why is cytology not as useful as a whole tissue sample?

Can’t see stroma and don’t see relationship of cells to each other

13

What do you need to know about the tumour?

specific tumour type and subtype, grade, stage, presence of lymphovascular invasion

14

What are the 4 main types of lung carcinomas?

squamous cell carcinoma, adenocarcinoma, large cell carcinoma, small cell carcinoma

15

What type of lung carcinoma is the most common?

adenocarcinoma

16

What type of lung carcinoma is the most likely if the patient is a non smoker?

adenocarcinoma

17

What type of lung carcinoma is a result of squamous metaplasia?

squamous cell carcinoma

18

What type of lung carcinoma is the most aggressive?

squamous cell carcinoma

19

What are the macroscopic features of lung cancer?

Pale irregular mass often related to a bronchus that may be necrotic. Can lead to lung collapse or bronchiecstasis. Hilar lymph nodes often appear black.

20

What type of lung carcinoma tends to be more peripheral?

adenocarcinomas

21

What are the microscopic features of adenocarcinoma?

The cells show a glandular structure - they cell may try and form a lumen or there may just be an accumulation of mucous

22

What are the microscopic features of squamous cell carcinoma?

There are rounded areas of keratin in the centre of the tumour and intracellular bridges

23

What are the microscopic features of small cell carcinoma?

The cells are small and don’t show the typical features of malignancy

24

What are the microscopic features of large cell carcinoma?

The cells are large and atypical and are undifferentiated

25

How does immunohistochemistry work?

Labeled antibodies which are labeled either with fluorescence or an enzyme are used to detect the presence of particular proteins which indicate cell lineage

26

What does the S100 protein indicate in immunohistochemistry?

That the cells are melanocytes

27

What does the CAM5.2 protein indicate in immunohistochemistry?

That the cells are epithelium

28

What does LCA protein indicate in immunohistochemistry?

That the cells are leukocytes

29

What is the stage of a tumour?

Stage refers to how far advanced the tumour is - it incorporates size, how advances local spread is, if it has metastasised and if so where to

30

What is the TNM system?

A system for staging - T is the level of the primary tumour, N is regional lymph node metastases and M is the absence or presence of distant metastases

31

What is the action of traditional chemotherapy drugs?

Interfere with cell division

32

What is the action of targeted therapies?

Block the growth of cancer by interfering with the function of specific molecules resulting from genetic alterations

33

What specific mutation is targeted in non-small cell carcinomas?

EGFR tyrosine kinase

34

What are the benefits of this targeted treatment?

superior response rate, prolonged progression-free survival, improved quality of life

35

What causes death in cancer?

cachexia, secondary infection, damage to vital organ