Neoplastic Disease

Question 1

Lung tumours

Answer 1

Benign and malignant

• vast majority are carcinomas (arising from lining epithelium)
• 5% are bronchial carinoids
• 2-5% are mesenchymal an other miscellaneous neoplasm including sarcomas and lymphomas

Question 2

Carcinomas

Answer 2

• arising from lining epithelium

Question 3

Bronchial carcinoids

Answer 3

• neuroendocrine

Question 4

Risk factors

Answer 4

Smoking
Family history
Immunodeficiency
Industrial hazards

Question 5

Clinical details

Answer 5

cough 
weight loss
chest pain
dyspnoea SOB
metastases

Question 6

some present with symptoms of metastases

Answer 6

• local extension of tuour within plural cavity to pericardium
• spread to tracheal, bronchial, and mediastinal nodes
• most common distant spread adrenals, liver, brain and bone

Question 7

Paraneoplastic syndromes

Answer 7

ectopic hormone secretion by tumour

Question 8

Lung carcinoma staging..

Answer 8

'T' = primary tumour size/degree of invasion
'N' = lymph nodes positive or not
'M' = distant metastases or not

Question 9

Small cell carcinoma has a strong relationship to

Answer 9

smoking

Question 10

where do small cell carcinoma occur

Answer 10

• in bronchi and at periphery

- invade bronchial wall and parenchyma, early lymphatic and blood borne spread

Question 11

treatment for small cell carcinoma

Answer 11

chemotherapy

incurable by surgery

Question 12

Squamous cell carcinomas is more common in

Answer 12

men

90% of cases are smokers

Question 13

squamous cell carcinoma usually arises from

Answer 13

bronchi

Question 14

well differentiated resembles stratified squamous epithelium characterised by keratin formation and intercellular bridges

Answer 14

squamous cell carcinomas

Question 15

Most common in women and non-smokers

Answer 15

adenocarcinomas

Question 16

Adenocarcinomas tend to be located

Answer 16

peripherally

Question 17

adenocarcinomas grow more slowly than squamous cell carcinomas but tend to..

Answer 17

metastasises widely and earlier

Question 18

peripheral adenocarcinomas are sometimes associated with

Answer 18

areas of scarring

eg TB

Question 19

Large cell carcinoma

Answer 19

malignant epithelial tumour

Question 20

Lung metastases

Answer 20

arrive by blood, lymphatics, direct continuity

multiply descrete nodules

Question 21

Common primary sites of lung metastases are

Answer 21

bowel
prostate
breast
kidney

Question 22

Malignant mesothelioma is common with people

Answer 22

who exposed to asbestos

Question 23

Malignant mesothelioma

Answer 23

diffuse lesion that spreads widely in the pleural space

Question 24

Malignant mesothelioma arses

Answer 24

in lung, peritoneum, pericardium and genital tract