Respiratory Tumors (nowacki)

Question 1

what indoor pollutant increases risk of lung cancer

Answer 1

radon

Question 2

what broad group of neoplasias are amenable to surgery

Answer 2

non-small cell carcinomas

Question 3

Lung carcinomas are all M > F except which carcinoma

Answer 3

adenocarcinoma

Question 4

What cell cuases malignancy in bronchioloavleolar carcinoma

Answer 4

Clara cells

Question 5

Which lung carcinomas present in pts <40

Answer 5

Bronchial carcinoid tumor only

Question 6

Which lung carcinomas present in pts > 40

Answer 6

SqCC, adeno, small cell, and large cell

Question 7

Which lung carcinoma is the most likely to present with papneoplastic syndrome?

Answer 7

Small cell

Question 8

Where to most lung carcinomas metastasize to?

Answer 8

Adrenal Gland

Question 9

Wht is the most aggressive/ metastatic carcinoma?

Answer 9

Small cell carcinoma is very aggressive- metastasizes early and wide

Question 10

which two carcinomas have the best prognosis

Answer 10

Adeno and SqCC

Question 11

5 year survival for all lung cancers

Answer 11

15%

Question 12

Which cancer is the most likely to have hypercalcemia?

Answer 12

SqCC

Question 13

What syndromes is SCC associated with (3)?

Answer 13

Cushings
SIADH
Lambert-Eaton myasthennic syndrome

Question 14

Cushings syndrome is caused by what deviation in what hormone

Answer 14

too much ACTH

Question 15

What casues Lambert-Eaton myasthennic syndrome

Answer 15

(Abs against Ca channels)

Question 16

What causes SIADH and what electrolyte disturbance results?

Answer 16

• too much ADH

- -> reduced Na

Question 17

carcinoid syndrome is caused by what 2 hormones

Answer 17

serotonin and bradykinin

Question 18

What syndrome is SqCC associated with

Answer 18

PTHrP–> hypercalcemia

Question 19

What 2 cytologic features is SqCC associated with

Answer 19

keratin pearls, intracellular bridges

Question 20

What is the most common lung carcinoma

Answer 20

Adenocarcinoma

Question 21

Where do adenocarcinomas present

Answer 21

in the periphery

Question 22

what is the stain associated with adenocarcinoma

Answer 22

mucin+

Question 23

bronchioloalveolar carcinoma (aka? asociated with what type of growth?)

Answer 23

aka Adenocarcinoma in-situ. grows along alveolar septa.

Question 24

What 3 gene mutations are associated with adenocarcinoma

Answer 24

ALK, EGFR, KRAS

Question 25

What is important about the treatment of adenocarcinoma with certain mutations

Answer 25

KRAS mutations are not senstivie to EGFR tx

Question 26

if a patient is a non-smoker you should treat them with what type of drug and why?

Answer 26

a tyrosine kinase inhibitor (EGFR-inhibitor) because most non-smokers have an EGFR mutation and not a KRAS mutation

Question 27

what cancer is granules in cells associated with?

Answer 27

SCC

Question 28

what are the neuroendocrine cells in SCC called

Answer 28

kulchitsky cells

Question 29

what stain do kultchitsky cells respond to

Answer 29

chromogranin A

Question 30

SCC stain with what 3 stains/markers

Answer 30

Stains with synaptophysin, CD56, and chromogranin A

Question 31

how does one identify Large cell carcinoma microscopically

Answer 31

undifferentiated- no glands, no squamous differentiation

Question 32

WHat is defining finding of Brochial Carcinoid tumors?

Answer 32

Polyp in a young person = bronchial carcinoid tumor

Question 33

Metastatic tumors that spread to the lungs through the blood are more often what type

Answer 33

sarcomas > carcinomas | which makes sense bc sarcomas are non-epithelial by definition

Question 34

Metastatic tumors that spread to the lungs through the lymph are more often what type

Answer 34

carcinomas > sarcomas

Question 35

What is light's criteria for determining if pleural effusion is exudate

Answer 35

satisfying only one = exudate: a. Pleural protein/Serum protein > 0.5 b. Pleural LDH/Serum LDH > 0.6 Pleural LDH >2/3 normal serum LDH

Question 36

Stat 6+, CD34 + test indicates what neoplasm

Answer 36

benign, soltary fibrous tumor (of pleura)

Question 37

soltary fibrous tumor is mc at what age

Answer 37

6th decade

Question 38

How long after asbestos exposure does mesothelioma present

Answer 38

Presents 25-45 years after asbestos exposure

Question 39

What is the Immunohistochemistry for mesotheliomas (2)

Answer 39

Calretin+, cytokeratin +

Question 40

TTF1 = what cancer?

Answer 40

Adenocarcinoma ***he said this a billion times

Question 41

What is the classic stain for adenocarcinoma

Answer 41

mucicarmine +

Question 42

posterior mediastinal tumors are what broad type and what 2 specific types

Answer 42

Neurogenic: shwannoma, neurofibroma, | also lymphoma

Question 43

Thymomas classically present with what on exams? (2)

Answer 43

Myasthenia Gravis also- pressure sx

Question 44

Nasopharyngeal Angiofibroma presents with what classic pattern

Answer 44

15 year old males with a nosebleed

Question 45

wood/leather-working and their wives get what type of cancer

Answer 45

Intestinal type adenocarcinoma

Question 46

Sinonasal undifferentiated carcinoma (SNUC) is positive for what on stain?

Answer 46

pankeratin

Question 47

Olfactory Neuroblastoma: looks like what? what stain defines it

Answer 47

looks like SCC of lung | negative for keratin

Question 48

Which cancer is Associated with EBV

Answer 48

nasopharyngeal carcinoma

Question 49

What is the cornerstone of nasopharyngeal carcinoma tx?

Answer 49

Radiation

Question 50

Squamous papilloma of larynx is associated with what virus

Answer 50

HPV

Question 51

oropharyngeal squamous cell carcinoma stain

Answer 51

p16 +

Question 52

What does an increase in p16 lead to?

Answer 52

cell proliferation