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Pulmonary Neoplasms Flashcards

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1
Q

List the epidemiological factors of lung carcinoma

A

95% of lung cancers are carcinomas; most frequently diagnosed cancer in the world; most common cause of cancer mortality from ages 40 to 70; Most common causes are cigarette smoking, radiation, and asbestosis

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2
Q

Carcinomas almost always have mutations of which gene

A

EGFR

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3
Q

Carcinoma is commonly metastasized to these organs

A

liver, brain, bone, adrenal glands

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4
Q

Which two lung cancers have the highest correlation to smoking

A

squamous and small cell

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5
Q

Squamous cell carcinoma is associated with mutations of What genes

A

CDKN 2, p53, Fgrf 1

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6
Q

Small cell carcinoma Is associated with mutations of what genes

A

P53, RB loss of function, amplification of MYC jeans

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7
Q

Adino carcinomas have gain of function mutations on multiple genes and coding for receptor tyrosine kinases. What are the most common ones?

A

EGFR, ALK, ROS 1, MET, RET

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8
Q

Adino carcinoma is also have gain in function mutations and serene theorem and kinases. what are they?

A

BRAF, PIK3

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9
Q

What are precursor lesions for lung cancer

A

Atypical Adenomatis hyperplasia; squamous dyspleisia: idiopathic pulmonary neuroendocrine cell hyperplasia

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10
Q

What is the most common pulmonary neoplasm in women and nonsmokers?

A

lung adenocarcinoma

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11
Q

If a patient with lung adenocarcinoma is a smoker, what mutation are they most likely to have And what does this mean clinically?

A

KRAS; Associated with worse prognosis

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12
Q

Lung Adino carcinoma is positive for what stain

A

TTF one

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13
Q

What can be seen under the microscope for long adenocarcinoma

A

glandular differentiation with mucin encased in papillary structures

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14
Q

What would you expect to see under the microscope for atypical adenomatous hyperplasia

A

Pneumonocyte dysplasia; mild fibrosis of the alveolar lining

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15
Q

Describe the Appearance of Adino carcinoma in situ

A

I have a normal tissue encased in a circular margin

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16
Q

Adina carcinoma comes from preexisting lepidic cells. What are these?

A

cells that line the alveolar septa

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17
Q

Squamous cell carcinoma of the lung is most commonly seen in what population

A

Male smokers

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18
Q

Squamous cell carcinoma starts out where and extends to where

A

Center To right main bronchus

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19
Q

Describe the gross appearance of squamous cell carcinoma

A

Very firm pale white mass and sometimes necrotic folk eye in the center that appear black

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20
Q

The name squamous implies what can be seen histologically And squamous cell carcinoma

A

Keratinization

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21
Q

what lab findings indicate Squamous cell carcinoma

A

Hypercalcemia and elevation of PTH related peptide

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22
Q

What genes are frequently mutated in small cell carcinoma

A

P53 and RB1

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23
Q

Small cell carcinoma stains positive for what

A

chromogranin; synaptopysin

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24
Q

What are histologic characteristics of small cell carcinoma

A

Staining a vascular walls; High mitotic rate; Inconspicuous nucleoli; poorly defined cell borders

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25
Small cell carcinoma Is associated with what other diseases
cushing syndrome; syndrome of inappropriate adh associated with hyponatremia
26
Describe the histologic features of large cell carcinoma of the lung
Undifferentiated malignant epithelial tumor That lacks psychology of small cell and squamous differentiation; large nucleus and cytoplasm
27
Superior Vena cava syndrome is a secondary pathology of lung cancer. Describe the pathogenesis
Circular compromise leading to edema in the head and arm
28
Can happen if the tumors spread to nearby cervical sympathetic plexus
Horner syndrome: Tosas, meiosis, anhydrosis
29
Pancoast tumors are found in which layer of the lungs
superior pulmonary silk is
30
What are secondary complications that can arise from lung tumors
Focal emphysema due to partial obstruction; total obstruction causes atelectasis; pulmonary abscesses; pleuritis
31
SIADH is most commonly associated with wood lung cancer
small cell carcinoma
32
What's the criteria for A T1 Lung tumor
Tumor is less than three centimeters in diameter without plural or main stem bronchus involvement
33
List the criteria for a T3 lung tumor
chimer is between 5 and seven centimeters in diameter with involvement of the parietal plura, chess wall diaphragm and fernic nerves; also can extend to mediastinal plura parietal pericardium
34
List the criteria for AT 2 lung tumor
Tumor is three to five centimeters in diameter with involvement of main stem bronchus but not the visceral plura
35
list the criteria for a T4 lung tumor
tumor is greater than seven centimeters with invasion of the Mediastinum Heart vessels trachea nerves esophagus for tibral bodies
36
What is a carcinoid tumor of the lung assoc. w//
Low grade malignant neoplasm of neuroendocrine cells
37
Describe the morphology of a carcinoid tumor
Finger like spherical polypoid mass that often projects into the main stem bronchus; also called a collar button lesion; Cells are separated by a delicate fibrovascular stroma
38
what is associated with carcinoid syndrome
Intermittent diarrhea, flushing, and Cyanosis
39
Harmatomas of the lung are commonly found in which regions of the lungs?
Benign, well circumcised, coin like lesion found in the lung typically along the margins
40
What are the histologic characteristics of lung harmatomas
Nodules of connective tissues (most commonly cartilage) Called epithelial clefts aligned by cilated Columnar epithelium
41
Describe the gross appearance of metastatic nodules to the lung tissue
Tan white cannonball lesions
42
What do solitary fibre's tumors in the lung look like On a chest X-ray
Solitary gray mass attachment to the plura
43
what do solitary fibers tumors look like under the microscope
Worlds of articulate and collagen; spindle cells Resembling fiber blasts; CD34 positive And also stat 6 positive; negative for keratin which distinguishes it from mesothelioma
44
Plural plaques are common manifestations of what lung condition
asbestosis
45
Grossly what do plural plaques look like
Circumcised plaques of dense calcified collagen
46
What do asbestos bodies look like under the microscope
Golden Brown translucent rods Surrounded by macrophages attempting to phagocytose; iron deposits are Assumed to come from Phagocytes
47
Metrodelema is a plural neoplasm that arises from what
either the visceral or paratoplura; the lesions are typically diffuse and spread over large amounts of the plural surface as a thick tumor
48
Describe the morphology of epithelioid type mesothelioma
Can be cubodial or columnar Pepillary structures; Positive for keratin proteins; negative for Claudin 4 Which distinguishes it from adenocarcinoma
49
Describe the morphology of sacramentoid type mesothelioma
Derived from the mesencyma; Appearance of fibrosarcoma
50
Describe the morphology of biphasic type mesothelioma
Mixture of epithelioid type and sacramactoid type; Former derived from epithelial lining; ladder derived from Mesenchymal Stromo cells
51
Mesothelioma can become malignant and 80% of cases have a deletion of this tumor suppressor gene
Cdk N2 a
52
list the Typical clinical presentations of lung cancer
cough, hemoptysis, dyspnea, chest pain, pulmonary embolism
53
Bronchio alveolar carcinoma is associated with what clinical manifestations
bronchorrhea; persistent infection; obstruction of major Airways indicated by Wheezing and Striders
54
Besides Smoking, what are other risk factors for lung cancer
Radiation therapy for other malignancy such as Hodgkin's lymphoma or breast cancer; environmental toxin exposure: second hand smoke, asbestos, radon, arsenic, nickel, beryllium; pulmonary fibrosis; hiv
55
lung cancer should always be suspected in a current or former smoker if they present with what Symptoms
New onset of cough or hemoptysis
56
Solitary pulmonary nodules are commonly associated with what diseases
granulomatis diseases such as microbacteria or fungi, Current malignancy
57
You should order a chest x-ray before you order a CT scan. What findings on a chest X-ray would Qualify for a CT scan
Yeah cool Like Donald Trump there in December on the trade settings option
58
What does a pet scan Assess
Can provide insight on how metabolically active a tumor is and if Metastasis has occurred
59
pancoast tumor is what kind of cancer?
non-small cell carcinoma
60
What is the most common initial symptom of a pancoast tumor
shoulder pain: invasion extends to brachial plexus, ribs, & vetebra
61
What symptoms occur if a pan coast tumor spreads to the pair of vertebral sympathetic chain
horner's syndrome
62
What are symptoms associated with pancos tumor invasion to the C8 and T1 nerve roots
Pain, weakness, hand atrophy; similar to klumpke palsy
63
What are pARAneoplastic syndromes associated with squamous cell carcinoma
Hypercalcemia
64
What are perineoplastic syndromes associated with adenocarcinoma
Hypertrophic osteoarthropathy: associated with clubbing and periostal proliferation of tubular bones
65
What perineoplastic syndromes are associated with small cell carcinoma
SIADH; Cushing syndrome; neurologic syndromes such as Lambert Eaton
66
What autoimmune conditions are associated with perineoplastic syndromes
Dermatomyocitus and polymyositis
67
Compare and contrast the differences between small cell and non small cell lung Carcinoma
Small cell: Smokers only fast growing; early metastasis Central poorer prognosis: not amendable to surgery Non small cell: includes both smokers and non smokers Can be resected Better prognosis
68
What metastatic cancers are common in the lungs
Breast,:, kidney, colon
69
What stage is non small cell lung cancer categorized as if it's metastasized to distal tissues
Stage 4: M1
70
Small cell lung cancers diagnosed and categorized
Limited and very limited disease are confined to one hemi thorax: T1-T4 extensive disease extends beyond 1 hemithorax: m1
71
What general three things are assessed on a Connecticut scan to determine the stage of lung cancer
Nodules present: location, size, margins, calcifications evidence of regional spread: such as Hyler lymph nodes, metastonal invasion, plural effusions signs of distal metastasis: Notably in hepatic, adrenal, brain, and bone regions
72
In suspension of lung cancer, what do elevated serum levels of alanine amino transferase in aspartate amino ttransferase Indicate
That the cancer has likely metastasized to the liver or the bones
73
How can you tell if the lung cancer has metastasized to the bone or the liver
Assess serum levels of GGT If GGT is normal then it is bone metastasis and if GGT is abnormal then it is hepatic metastasis
74
What are antineoplastic agents used in the treatment of small cell lung cancer
Cisplatin and etoposide; also EGFR & ALK inhibitors

Pulmonic Diseases (3 decks)

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