Pathoma - Lung Cancer Flashcards Preview

CPR Week 6 > Pathoma - Lung Cancer > Flashcards

Flashcards in Pathoma - Lung Cancer Deck (32)
1

Most common cause of cancer mortality in the United States and when it hits

Lung Cancer, usually in your 60s

2

Key risk factors for Lung CA

1. Cigarette smoke
2. Radon
3. Asbestos

3

What is the most dangerous part of smoking in regards to cancer?

Polycyclic Hydrocarbons - very oncogenic

4

"Coin Lesion" and what we do next

Solitary nodule 2 - 5cm that leads you to compare that Xray to other ones to see if there is change. Change indicates possible Lung CA, meaning biopsy next

5

Benign lesion examples

Granuloma - Often due to TB or a fungus

Bronchial hamartoma - Often calcified on imaging

6

What is a hamartoma?

Benign tumor made of tissue in that area that is just disorganized

7

Bronchial hamartoma made of what?

Lung tissue and cartilage

8

Division of cancer types within Lung CA

Small cell carcinoma (15%)

Non-small cell (85%)

9

Treatment for non-small cell vs. small cell

Small cell = Radiation therapy to treat

Non small cell = surgical resection that does not respond to radiation

10

Major subtypes of non-small cell carcinoma

Adenocarcinoma - 40%
Squamos cell carcinoma - 30%
Large cell carcinoma - 10%
Carcinoid tumor - 5%

11

Adenocarcinoma

Gland affected or mucous production from cancer cells

12

Squamos cell carcinoma

keratin involved or bridges intracellularly

13

What cells do we call large cell carcinomas?

Don't see glands, mucin, keratin pearls or bridges

14

Small cell carcinoma characteristic histology

Poorly differentiated small cells. Arises from neuroendocrine (Kultchitsky) cells

15

Bronchioalveolar carinoma histology

Columnar cells that grow along preexisting bronchioles and alveoli.

Arise from Clara cells

16

Histology for Carcinoid tumor

Well differentiated neuroendocrine cells, chromogranin positive

17

Most common cancers that metastasize to the lungs

Breast and colon

18

Most common tumor in male smokers

Squamos cell

19

These two cancers are not related to smoking!

Bronchiovalveolar carcinoma
Carcinoid tumor

20

These carcinomas are located strictly centrally

Small Cell
Squamos cell

21

These carcinomas are located strictly peripherally

Bronchioloalveolar
Adenocarcinoma

22

These carcinomas can be located centrally or peripherally

Large Cell
Carcinoid tumor

23

Multiple cannon ball nodules on imaging

Metastasis to the lungs

24

This carcinoma has rapid growth and early metastasis. Also produces ADH or ACTH and can cause _____ _____.

Small cell carcinoma and it can cause Eaton-Lambert Syndrome which is a paraneoplastic syndrome

25

This cancer produces PTHrP

Squamos Cell

26

This may present with pneumonia-like consolidation on imaging, excellent prognosis

Bronchioloalveolar carcinoma

27

This cancer is chromogranin positive

Carcinoid Tumor

28

This cancer has well differentiated neuroendocrine cells.

Which one has poorly differentiated neuroendocrine cells?

Carcinoid tumor

Poorly = Small Cell

29

Discuss TNM staging

Use it when discussing lung CA

T: Size and location of the tumor
N: Spread to regional lymph Nodes
M: Unique site of distant spread is the adrenal gland

30

How bad is the mortality rate for lung CA and why?

Pretty bad because we are so late in finding it

15% 5 year survival

31

Local complications of Lung CA

1. Pleural involvement
2. Obstruction of SVC
3. Involvement of recurrent laryngeal (hoarseness) or phrenic nerve (diaphragmatic paralysis)
4. Compression of sympathetic chains (ptosis, pinpoint pupil, anhidrosis)

32

Most common cancer in the pleura, in non smokers, and in females

Adenocarcinoma