Pathology: Lung Cancer genetic/immunostain Markers

Question 1

targetted therapy for EGFR

Answer 1

erlotinib

Question 2

targeted therapy for ALK

Answer 2

crizotinib

Question 3

egfr-dependent pathway is found in

Answer 3

non-smokers

Question 4

KRAS dependent pathway found in

Answer 4

smokers

Question 5

name the five types of adenocarcinoma

Answer 5

acinar--> most common
papillary
micropapillary bad prognisis
lepidic (AIS--> good )
solid (bad prognosis)

Question 6

cancer most likely to cavitate

Answer 6

Squamous cell carcinoma

Question 7

profile of adeno carcinoma

Answer 7

CK 7+
Napsin A+
TTFi +

Question 8

profile of squamous cell carcinoma

Answer 8

CD 5/6 +
p40+
p63+

Question 9

contraindicated in squamous cell carcinoma

Answer 9

bevacizumab

Question 10

most likely cancer to cause paraneoplastic syndrom

Answer 10

small cell

1. cushing’s
2. SIADH
3. eaton-lambert syndrome

Question 11

most likley to cause hypercalcemia

Answer 11

squamous cell

PTHRp

Question 12

syndrome seen with carcinoid tumors

Answer 12

carcinoid syndrome

1. flushing
2. diarrhea
3. cyanosis

Question 13

pembertons sign seen with

Answer 13

small cell

facial flushingand distended head/nek veins upon raising both arms

Question 14

cancer most associated with smoking

Answer 14

small cell carcinoma

Question 15

medastinal lympahdenopathy out of proportion to lung lesion

Answer 15

SMall cell

Question 16

cavitation more likley to be

Answer 16

squamous cell

Question 17

non-smoker most likley to be

Answer 17

adenocarcinoma

Question 18

“lepidic” growth pattern

Answer 18

adenocacinoma in situ
“formerly bronchioloalveolar carcinoma”
–> not invasive and great prognosis

Question 19

two types of adenocarcinoma in situ of lung

Answer 19

1. mucinoud and 2. non mucinous

Question 20

NON-Mucinous AIS prominent in

Answer 20

smokers

Question 21

mucinous AIS promenent in

Answer 21

smokers

Question 22

stage I and 2

Answer 22

small enough to be removed

Question 23

stage 3

Answer 23

involvement of structure unable to be surgically removed wihtout distant mets

Question 24

stage 4

Answer 24

structures unable to be surgically removed and with distant mets

Question 25

non-mucinous more likley to arise from ____ cells

Answer 25

terminal respiratory unit cells CLARA cells and TIIP's

Question 26

radiographic sign for non-mucinous

Answer 26

groud glass--> Single Nodule

Question 27

better prognosis AIS subtype

Answer 27

NON-mucinous--> more often Sxlly resectable

Question 28

Non-mucinous profile

Answer 28

EGFR + TTFI+ CK 20- TTFI -

Question 29

Mucinous more promient in

Answer 29

non-smokers

Question 30

radiographic signs of

Answer 30

pneumonia pattern--> multifocal nodules

Question 31

AIS with worse prognosis

Answer 31

Mucinous sub type--> usually not surgically resctable

Question 32

mucinous profile

Answer 32

CK 20+ KRAS + TTFI - EGFR -

Question 33

chromogrammin + types

Answer 33

Small cell carcinoma | Carcinoid

Question 34

centrally located lesaions that cause cough and or hemoptysis

Answer 34

SCLC | Squamous cell

Question 35

most common to cause hemoptysis

Answer 35

Squamous cell--> because most likely to cavittate

Question 36

brain mets wiht unidentified source

Answer 36

1. Lung-- unidentified lesion | 2. breast second most common

Question 37

tx of small cell lung carcinoma

Answer 37

never surgically resectable--> go directly to cytotoxic chemotherapy

Question 38

markers for primary lung tumor

Answer 38

CK 7+ TTF1 + CK 20- cdx2-

Question 39

Colon primary markers

Answer 39

ck 20+ | cdx2+

Question 40

breast primary markers

Answer 40

ck7+ only

Question 41

kidneys markers

Answer 41

negative for all four | ck7 cdx2 ttf1, ck20

Question 42

mesothelioma marker

Answer 42

p67

Question 43

smoking and asbestos exposure increase risk of ____ x 5 fold

Answer 43

bronchogenic lung cancer only

Question 44

pt's with asbestos exposure more likely to get_____

Answer 44

lung cancer over mesothelioma

Question 45

profile of mesothelioma

Answer 45

WT1 CK 5/6 d2-40 calretin

Question 46

genetic mishap in mesothelioma

Answer 46

homozygous deltion of CDKn2A/INK4a