pathoma - cancer lung

Question 1

benign lesions

Answer 1

• granuloma - due to TB or fungus or histoplasma in midwest
• bronchial hamartoma; often calcified on imaging
  
  • hamartoma - benign lesion of tissue native to the region but it is disorganized - in lung = lung tissue + cart

Question 2

subtypes of non small cell carcinoma

Answer 2

adenocarcinoma (40%) - glands or mucous prodution

squamous cell carcinoma (30%) - keratin perarls or intercellular bridges

large cell carcinoma (10%) - dont see the abouve things

carcinoid tumor (5%)

Question 3

Small cell carcinoma

Answer 3

• poorly differntiated small cells; arises from neuroendocrine (kulchitsky) cells
• male smokers
• central location
• rapid growht and early metastasis, may produce ADH or ACTH or cuase eaton-lambert syndrome (paraneoplastic syndromes)
• not treated with surgury - only chemo
• cancers that start with S = smokers, central, paraneoplastic syndromes

Question 4

squamous cell carcinoma

Answer 4

• keratin perals or intercellular bridges
• most common tumor in male smokers
• central location
• may produce PTHrP = hypercalcemia

Question 5

adenocarcinoma

Answer 5

• glands or mucin
• most common tumor in nonsmokers and female smokers
• peripheral location

Question 6

large cell carcinoma

Answer 6

• poorly differentiated large cells (no keratin peraly, intracellular bridges, glands, or mucin)
• smoking
• central or peripheral
• poor prognosis

Question 7

bronchoalveolar carcinoma

Answer 7

• columnar cells that grow along preexisting bronchioles and alveoli, arises from clara cells
• not related to smoking
• peripheral location
• may present with pneumonia-like consolidation on imaging
• excelent prognosis

Question 8

carcinoid tumor

Answer 8

• well differntiated neuroendocrine cells; chromogranin positive (means it neuroendocrine)
• not related to smoking
• central or peripheral; calssically forms a polyp-like mass in the bronchus
• low-grade malignancy; rarely, can cause carcinoid syndrome
• small cell carcinoma is a poorly differnetiated neuroendocrine tumor
• histologically look like nests of cells (common for neuroendocrine tumors)

Question 9

metastasis to lung and from lung

Answer 9

• most common sources are breast and colon carcinoma
• multiple “cannon ball” nodules on imaging
• more common than primary tumors
• the lung likes to metastasize to the adrenal gland

Question 10

local complications

Answer 10

• pleural involvement: adenocarcinoma usually becuase it is peripheral
• obstruction of SVC - SVC syndrome - head and neck pains with edema with blue discoloration of arms and face
• invovlement of recurrent laryngeal (create hoarsness) or phrenic nerve (diaphramatic paralysis)
• compression of sympathetic chain (ptosis, pintpoint pubil and anhidrosis)

Question 11

mesothelioma

Answer 11

• malignant neoplasm of mesotheilal cells
• highly associated with occupation exposure to asbestos
• presents with recurrent pleural effusions dyspnea and chest pain
• tumor encases the lung