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Respiratory 1 > Pathology 4 > Flashcards

Pathology 4 Flashcards

1
Q

lung tumors=

A

benign and primary malignant neoplasms

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2
Q

pleural tumors=

A

benign and malignant neoplasms

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3
Q

most malignant lesions in lung are:

A

-mets from other cancers = CANNON BALL LESIONS

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4
Q

most common benign lesons?

A
  • granulomas

- chronic pneumonia and abscess

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5
Q

pulmonary hamartoma

A
  • common BENIGN tumor
  • PERIPHERAL
  • asymptomatic and slow growing
  • can appear as a “coin lesion”
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6
Q
  • Majority of primary (bronchogenic) lung tumors are:

- peak incidence:

A
  • carcinomas
  • 50s and 60s

MALES=FEMALES

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7
Q

Lung cancer symptoms:

A
  • COUGH
  • WL
  • DYSPNEA
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8
Q

bloody pleural efusion in patient >40yrs… thikn?

A

cancer

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9
Q

non-inflam plueral effusions:

A
  • hydrothorax=serous fluid; usually caused by cardiac failure
  • hemothorax=blood in pleural space; usually ruptured aneurysm, vascular trauma, or cancer
  • chylothorax=lymphatic obstruction; thoracic duct injury
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10
Q

Paraneoplastic syndromes

A
  • common with lung cancers
  • ex) squamous cell carcinoma = hypercalcemia (PTH, prostaglandin E)
  • ex) small cell carcinoma - neuroendocrine cells so more syndromes (cushings, inappropriate ADH secretion, carcinoid…)
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11
Q

Other lung cancer systemic manifestations:

A

1) lambert-eaton myasthenic syndrome= muscle weakness due to autoantibodies
2) peripheral neuropathy=purely sensory
3) acanthosis nigricans=dermatologic
4) leukemoid reactions=hematologic
5) hypertrophic pulmonary osteoarthropathy = clubbing of fingers

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12
Q

Pancoast tumor

A
  • UPPER LOBES
  • grows directly into brachial plexus
  • arm pain
  • Horners syndrome (8th nerve screwed) possible
  • superior vena cava syndrome
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13
Q

Horners syndrome

A

(pancoast tumor)

  • enophthalmos
  • ptosis of upper eyelid
  • miosis
  • anhidrosis
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14
Q

most important factor in cancers?

A

-SMOKING

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15
Q

most common mutation in lung cancers?

A

-p53

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16
Q

precursor lesions to lung cancer:

A
  • squamous dysplasia and carcinoma in situ
  • atypical adenomatous hyperplasia
  • diffuse idiopathic neuroendocrine cell hyperplasia
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17
Q

TUmor classification -

A

1) adenocarcinoma - More females
2) squamous cel carcinoma -more males
3) small cell carcinoma - more females
4) large cell carcinoma - more males

18
Q

treatment of cancer is based on?

A

-classifications

so we have:

  • nonsmall cell carcinomas (adeno, squamous, large) 70-75%
  • small cell
  • some other combined patterns
19
Q

adenocarcinomas

A
  • most common
  • increasing incidence
  • gland formaton–> mucin production (MUCIN = MORE AGGRESSIVE)
  • frequent desmoplastic response

-MOST COMMON LUNG CANCER IN WOMEN, YOUNGER PATIENTS AND NON-SMOKERS (SMOKERS STILL COMMONLY GET THIS)

20
Q

adenocarcinomas - genes involved:

A

-KRAS and EGFR mutations

21
Q

Adenocarcinoma

A
  • PERIPHERAL with scars sometimes

- slow growing and mets early

22
Q

2 froms of adenocarcinoma

A
  • bronchial derived

- brochioloalveolar - origin=bronchioloalveolar stem cell; lepidic growth patter (no invasion- but grows along walls)

23
Q

Bronchioloalveolar -

-precursor lesions:

A

-atypical adenomatous hyperplasia (AAH) - monoclonal

24
Q

squamous cell carcinoma

A
  • CLOSE CORRELATION WITH SMOKING
  • CENTRAL ( IN OR NEAR HILUS)
  • MEN!!v
  • produced KERATIN!!!!!!

-grows rapid and mets slowly

25
Q

squamous cell carcinoma- genes

A

hgih frequency of p53 mutation and EGFR overexpression

26
Q

adeno vs squamous cell ca?

A
  • adeno grows more slowly but mets early

- squamous grows rapidly but mets slowly

27
Q

Squamous cell Ca - clinical features:

A
  • bloody sputum
  • cough
  • obstruction symptoms
  • pneumonia reccurent
  • atelectasis
28
Q

Squamous cell Ca- related syndromes:

A
  • superior vena cava syndrome

- pancoast tumor

29
Q

squamous cell Ca -histology==

A

intercellular bridges

keratin pearl formation!

30
Q

small cell ca-

A

MOST MALIGNANT

  • more males
  • SMOKING!!!!!!!
  • highly aggressive- rapid growing early mets
  • surgery not helpful - CHEMO IS CHOICE

-paraneoplastic syndromes!!!!!!

31
Q

small cell carcin - genes

A

c-MYC

-RB1

32
Q

small cell Ca- histology:

A
  • little cytoplasm

- OAT CELL CARCINOMA - round to oval cells

33
Q

LArge cell Ca-

A

DIAGNOSIS OF EXCLUSION

  • UNDIFFERENTIATED
  • poor prognosis
  • many variants - GIANT CELLS
34
Q

secondary patholgoy due to lung cancer:

A
  • changes occur distal to tumor!
  • partial obstruction= focal emphysema
  • complete obstruction = atelectasis
  • severe bronchitis, bronchiectasis, pulmoanry abscess
  • post obstructive pneumonia
35
Q

MOST AGGRESSIVE?

A

SMALL CELL

36
Q

MOST FAVORABLE?

A

-bronchioalveolar

37
Q

most common mets?

A
  • LN most!!
  • adrenal
  • liver
  • brain
  • bone
38
Q

lugn cancer causes of death:

A
  • PNEUMONIA
  • lung abscess
  • bleeding
  • esophago-pleural fistula
  • met effects on other organs
39
Q

neuroendocrine prognosis?

A

-pretty good - 90-95% curable via surgery

40
Q

carcinoid syndrome:

A
  • intermittent: diarrhea, flushing, bronchoconstriction, cyanosis
  • SEROTONIN PRODUCTION

-GREAT SURVIVAL for TYPICAL

Respiratory 1 (9 decks)

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