Neoplastic lung diseases

Question 1

Genetic mutations associated with SCC of the lungs

Answer 1

Deletions involving 3p, 9p, and 17p –> tumor suppressors

Question 2

Genetic mutations associated with small cell carcinomas of the lungs

Answer 2

MYC gene amplification
Inactivation of TP53 and RB
3p deletion

Question 3

Genetic mutations associated with adenocarcinoma of the lungs

Answer 3

EGFR, ALK, KRAS, ROS, MET, and RET

Question 4

Microscopic features of atypical adenomatous hyperplasia in the lungs

Answer 4

Dysplastic cuboidal epithelium and mild interstitial fibrosis

Question 5

Microscopic features of bronchioloalveolar carcinoma

Answer 5

Adenocarcinoma in situ –> dysplastic cells growing along alveolar septae, with or without IC mucin

Question 6

Prognosis in bronchioloalveolar carcinoma

Answer 6

Excellent

Question 7

Precursor lesions of lung cancers

Answer 7

Squamous dysplasia and carcinoma in situ

Atypical adenomatous hyperplasia

Adenocarcinoma in situ/bronchioloalveolar carcinoma

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

Question 8

Peripherally located lung tumor associated with scarring. CXR finding is a pneumonia like consolidation. Microscopy shows lepidic pattern and infiltrating glands with mucin.

Answer 8

Adenocarcinoma

Question 9

Lung cancer that expresses thyroid transcription factor 1 (TTF-1)

Answer 9

Adenocarcinoma

Question 10

Central lung tumor, near hilum in large bronchus. Grossly appears as a gray-white, firm to hard, fungating or infiltrating lesions, with areas of hemorrhage and necrosis.

Answer 10

Squamous cell carcinoma

Question 11

Lung cancer type that can produce PTHrP leading to hypercalcemia

Answer 11

Squamous cell carcinoma

Question 12

Lung tumor with a hilar or central location. It is derived from neuroendocrine progenitor cells of the lining bronchial epithelium

Answer 12

Small cell carcinoma

Question 13

Lung tumor positive for neuron specific enolase and neurosecretory granules on electron microscopy. Most commonly associated with ectopic hormone production.

Answer 13

Small cell carcinoma

Question 14

Microscopy of lung tumor show small, round, oval, or spindle shaped cell with scant cytoplasm and ill-defined borders. It has fine granular chromatin. Immunohistochemistry is positive for chromogranin, synaptophysin, neuron specific enolase, and neural cell adhesion molecule.

Answer 14

Small cell carcinoma

Question 15

Lung tumor that expresses high levels of anti-apoptotic protein BCL2

Answer 15

Small cell carcinoma

Question 16

Azzopardi effect of small cell carcinoma

Answer 16

Basophilic staining of vascular walls due to encrustation by DNA from necrotic tumor cells

Question 17

Lung cancer type that is a diagnosis of exclusion with absent markers for adenocarcinoma and SCC

Answer 17

Large cell carcinoma

Question 18

Finding in pleural effusion fluid when the effusion is caused by a malignancy

Answer 18

Malignant cells

Question 19

Symptoms of Cushing syndrome

Answer 19

Weight gain
Hypertension
Hypokalemia
Muscle weakness

Question 20

Lung cancer(s) associated with Cushing syndrome

Answer 20

Small cell lung cancer

Question 21

Symptoms of SIADH

Answer 21

Euvolemic hyponatremia and concentrated urine
HA
Weakness
Altered mental status
Seizures
Respiratory depression
Death

Question 22

Lung cancer(s) associated with SIADH

Answer 22

Small cell lung carcinoma

Question 23

Lung cancer(s) associated with hypercalcemia

Answer 23

SCC

Question 24

Lung cancer(s) associated with hypertrophic osteoarthropathy and digital clubbing

Answer 24

Non-small cell lung cancer, particularly adenocarcinoma

Question 25

Paraneoplastic syndrome characterized by auto-antibodies directed to the neuronal calcium channel causing muscle weakness

Answer 25

Lambert-Eaton myasthenic syndrome

Question 26

Lung cancer(s) associated with opsoclonus/myoclonus ataxia syndrome

Answer 26

SCC

Question 27

Lung cancer(s) associated with paraneoplastic encephalomyelitis and paraneoplastic cerebellar degeneration

Answer 27

Small cell carcinoma

Question 28

Microscopy of lung tumor shows small monomorphic cells with round nuclei and scant cytoplasm arranged in nests separated by a delicate fibrovascular stroma

Answer 28

Carcinoid tumor

Question 29

Low-grade malignant epithelium neoplasm. Neuroendocrine tumor of the lung. Appears as a spherical mass that projects into the lumen of the bronchus

Answer 29

Carcinoid lesion

Question 30

Symptoms of carcinoid syndrome

Answer 30

Intermittent diarrhea
Flushing
Cyanosis

Question 31

Disorderly growth of a tissue indigenous to site. Appear as a rounded radio-opacity in CXR when located in the lungs

Answer 31

Hamaroma

Question 32

Most common site of metastatic neoplasm

Answer 32

Lungs

Question 33

Genetic mutation in 80% of mesotheliomas

Answer 33

Homozygous deletion of tumor suppressor gene CDKN2A/INK4

Question 34

Lung is encased by a thick layer of soft, gelatinous, grayish-pink tumor tissue

Answer 34

Mesothelioma

Question 35

Microscopy types of mesothelioma

Answer 35

Epithelioid
Sarcomatoid
Biphasic

Question 36

Positive immunohistochemistry in mesothelioma

Answer 36

Calretinin
Cytokeratin
Wilms tumor 1
Podoplanin

Question 37

Negative immunohistochemistry in mesothelioma

Answer 37

Claudin 4

Question 38

Lung tumor cells show numerous long slender microvilli and abundant tonofilaments on electron microscopy

Answer 38

Mesothelioma

Question 39

Most common cause of death in mesothelioma

Answer 39

Cardiorespiratory failure caused by encasement of the heart and lungs by tumor