Neoplasms

Question 1

Of the 3 tumors, which one has the worst prognosis: squamous cell, adenocarcinoma, large cell carcinoma?

Answer 1

Large cell carcinoma

Question 2

Which of the malignant tumors is associated with cigarette smoking?

Answer 2

a) Squamous cell carcinoma
b) Large cell carcinoma
c) Small/Oat cell carcinoma
d) Atypical carcinoid

Question 3

Where does squamous cell carcinoma M/C like to occur?

Answer 3

Centrally (within the brochi) and proximal

Question 4

What are some of the clinical features of a Pancoast tumor?

Answer 4

• pain or atrophy of muscles of ipsilateral upper extremity (involvement of lower brachial plexus)
• Horner syndrome (involvement of sympathetic chain)

Question 5

Which pulmonary tumor has the highest prevalence for central necrosis & cavitation?

Answer 5

Squamous cell carcinoma

Question 6

What is the most common cause of a Pancoast tumor?

Answer 6

Squamous cell carcinoma

Question 7

Which tumor contains neurosecretory granules?

Answer 7

small cell carcinoma, carcinoid tumors (typical & atypical), large cell neuroendocrine carcinoma

Question 8

What is the M/C seen syndrome associated with small cell carcinoma?

Answer 8

Cushing’s syndrome – inappropriate secretion of ADH

Question 9

What is the M/C/C of superior vena cava obstruction?

Answer 9

Small cell carcinoma

Question 10

Why do small cell carcinomas have poor prognosis?

Answer 10

Because grow rapidly & metastasize early!

Question 11

Small cell carcinomas typically grow in which location?

Answer 11

Centrally (within bronchi) and proximal (main stem or lobar)

Question 12

Adenocarcinomas occur in which pop’n?

Answer 12

Women & non-smokers (but hx of tobacco use)

Question 13

Where does adenocarcinomas M/C occur?

Answer 13

upper lobes & peripherally

Question 14

What is a subtype of adenocarcinoma and what unique feature is present about this condition?

Answer 14

Bronchioloalveolar carcinoma (BAC)

Lepidic Growth = grows along the bronchioloar & alveolar walls without invasion, distortion or destruction of these structures.

Question 15

What is the average size that 60% of large cell carcinomas are greater than?

Answer 15

4cm

Question 16

True or false: large cell carcinomas are seen closer to the mediastinum?

Answer 16

False. They are seen peripherally (segmental or subsegmental).

Question 17

Where is adenosquamous carcinoma seen and what is its prognosis?

Answer 17

Seen in periphery and poor prognosis (metastasizes early).

Question 18

Where do carcinoid tumors of the lung arise from?

Answer 18

Neuroendocrine cells within the airways.

Question 19

What is carcinoid syndrome and when does it occur?

Answer 19

• right heart failure
• chronic diarrhea
• respiratory distress
• flushing & cyanosis of skin

Occurs when there is hepatic metastatic disease.

Question 20

Which of the two subtypes of carcinoid tumor is associated with smoking?

Answer 20

Atypical carcinoid

Question 21

Which of the two subtypes of carcinoid tumor is more aggressive?

Answer 21

Atypical carcinoid (typical carcinoid is the best differentiated neuroectodermal carcinoma)

Question 22

Which of the two subtypes of carcinoid tumor is associated with higher presence of calcification?

Answer 22

Typical carcinoid (40%)

Question 23

What is a radiographic sign for the presentation for a typical carcinoid tumor?

Answer 23

Iceberg tumor = presence of small intraluminal & large extraluminal soft tissue component.

Question 24

Are malignant or benign tumors M/C for the trachea?

Answer 24

Malignant (80%)

Question 25

What is M/C benign neoplasm of the tracheobronchial glands in kids?

Answer 25

squamous papillomas

Question 26

What is the 2nd M/C benign tumor of the trachea?

Answer 26

Hemangiomas

Question 27

What is the M/C malignant tumor of the trachea?

Answer 27

Invasion from an adjacent neoplasm (notably lung).

Question 28

What are the top 3 M/C primary malignant tracheal tumors?

Answer 28

a) Adenoid cystic carcinoma (M/C bronchial gland tumor) b) Squamous cell carcinoma c) Mucoepidermoid tumor

Question 29

True or false: adenoid cystic carcinoma is not associated with smoking.

Answer 29

True. ACC is not associated with smoking (unlike squamous cell).

Question 30

What is the most frequently affected area in Hodgkin's lymphoma on initial presentation and what is the 2nd M/C area?

Answer 30

Cervical nodes followed by groin nodes.

Question 31

In 30% of cases, what gland is involved in Hodgkin's lymphoma?

Answer 31

Thymus

Question 32

Metastasis to the lungs usually occurs via which route?

Answer 32

Hematogenous (veins >> arteries) | Especially inferior or superior vena cava.

Question 33

What is Carney's triad?

Answer 33

a) pulmonary chondromas b) gastric epithelioid leiomyosarcoma (GIST) c) extra-adrenal paraganglioma (pheochromocytoma)

Question 34

Pulmonary hamaratoms are more commonly seen where in location?

Answer 34

Periphery

Question 35

Hamartomas present with what type of calcification pattern?

Answer 35

popcorn calcification

Question 36

What is the M/C benign pleural neoplasm?

Answer 36

Fibroma

Question 37

Most intrathoracic neurofibromas arise from which structure(s)?

Answer 37

Intercostal nerves OR sympathic nerves

Question 38

What is Reckling-Hausen's disease?

Answer 38

a) kyphoscoliosis b) scalloped vertebrae c) lateral meningocele