What are the two types of primary lung neoplasms?
malignant (very common)
What is the second type of lung neoplasm?
Metastatic (very common)
What is this?
What in tobacco smoke causes cancer?(5)
- polycyclic hydrocarbons
- aromatic amines
What are other risk factors?(6)
- atmospheric pollution
What will the patient have if they present with pain?
Invasion of Chest Wall
What is the cause of haemoptysis?
What will cause the obstruction of the airway?
What is the distal area of yellow discolouration?
How will the patient present with metastases?
- lymph nodes
Where are the three most common areas of metastases?
What are the systemic effects of cancer?
- weight loss
- "ectopic" hormone production
What hormone will be produced if cance is squamous cancer?
What hormone will be produced if cancer is small cell?
Are lung cancers heterogenous or homogenous ?
What are the 4 most commone smoking-associated types of lung tumours?
- adenocarcinoma (35%)
- sqaumous carcinoma (30%)
- small call carcinoma (25%)
- large cell carcinoma (10%)
What are two other types of lung tumour?
- neuroendocrine tumours
- bronchial gland tumours
How would you diagnose a tumour?
- bronchoscopy and biopsy of the tumour if seen
- biopsy or needle aspiration of metastases (especially mediastinal or supraclavicular lymph nodes)
Why do we classify cancer?
What is the order of survival time with classification (longest to shortest)?
- squamous or adenocarcinoma
- large cell
- small cell
What is the treatment for small cell cancer?
It is known to be chemosensitive but has rapidly emerging resistance
What is the surgery of choice for NSCLC?
chemotherapy/radiotherapy are also options
What oncogenes are present in SCLC?
What oncogenes are present in NSCLC?
myc, K-ras, her2(neu)
What tumour supressor genes are mutated in SCLC?
p53, Rb, 3p
What tumour supressor genes are supressed in NSCLC? (6)
p53, 1q, 3p, 9p, 11p, Rb
What causes the activation of the EGFR gene?
Specific point mutations render the EGFR gene active in the absence of ligand (epidermal growth factor) binding
How would you identify a mutation in the DNA?
By DNA in biopsy or cytology samples
What kind of tumours respond to tyrosine kinase inhibitors? (erlotinib)
Adenocarcinoma (especially in asian population and non-smokers)
What does EML4-ALK fusion oncogene do?
It identifies a target for specific drug treatment (crizotinib)
What are four kinds of bronchial (large airway tumours)?
- squamous metaplasia
- carcinoma in situ
- invasive malignancy
What are peripheral carcinomas?
Atypical adenomatous hyperplasia
What happens in atypical adenomatous hyperplasia?
Spread of neoplastic cells along alveolar walls (bronchioloalveolar carcinoma), these are true invasive adenocarcinoma
What are the prognostic indicators in lung cancer? (2)
- tumour stage
- tumour histological subtype
What is a carcinoid neoplasm?
Neuroendocrine neoplasms of low grade malignancies
What are two types of bronchial gland neoplasms
- adenoid cystic carcinoma
- mucoepidermoid carcinoma
What is the name of the cancer associated with pleural neoplasia?
Adenocarcinoma (gland forming)
Atypical adenomatous hyperplasia
Basal Cell Hyperplasia
Dyplasia Carcinoma in Situ
Large Cell Carcinoma
Small cell carcinoma
Squamous Carcinoma Keratinising
What is the tumour obstructing?
White tumour obstructing bronchus