Lung Neoplasms Flashcards

1
Q

True or False: lung cancer is the most common cause of cancer mortality worldwide.

A

True

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2
Q

What is the most common cause of lung cancer?

A

Smoking

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3
Q

What % of lung carcinomas occur in active smokers or those who’ve stopped recently?

A

87%

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4
Q

Benzo[a]pyrene is a carcinogen that can cause a mutation in which protein, leading to lung cancer?

A

P53

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5
Q

Uranium miners have a ___x risk of cancer if theyre non-smokers and __x risk if they are smokers.

A

4x

10x

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6
Q

This is the chemical that can cause lung cancer in closed spaces and is inhaled when attached to environmental aerosols.

A

Radon

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7
Q

What can inhaled carcinogens do to oncogenes and tumor supressors to cause lung CA?

A

Activate oncogenes

Inhibit tumor supressors

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8
Q

What are the 3 precursor lesions that have a very good chance to progress to cancer?

A

Squamous dysplasia and carcinoma in situ
Atypical adenomatous hyperplasia
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.

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9
Q

What pt population is at risk for small cell carcinoma?

A

male smokers

(cancers starting with “S” are associated with “S”mokers, they’re “c”entral, and they are assocaited with paraneoplastic “S”yndromes)

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10
Q

Are small cell carcinomas benign or malignant?

A

Highly malignant

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11
Q

What are the histological features of small cell carcinoma?

A

Poorly differentiated cells, most show neurosecretory granules

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12
Q

Where in the lung are small cell carcinomas?

A

Central

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13
Q

What are the paraneoplastic syndromes assoacited with small cell carcinoma?

A

ADH
ACTH
Eaton-Lambert syndrome

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14
Q

What is the Tx for small cell carcinoma: Chemo, surgery, or both?

A

ONLY chemo

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15
Q

What is the most common tumor for male smokers?

A

Squamous cell carcinoma

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16
Q

What is happening during the years of asymptomatic Squamous cell carcinoma?

A

Squamous metaplasia

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17
Q

When do Sx start in Squamous cell carcinoma?

A

When the tumor obstructs, destroys, or grows within the tissue

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18
Q

What is the most common mutation for Squamous cell carcinoma?

A

p53 mutations

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19
Q

What are the 2 u see on histology for Squamous cell carcinoma?

A

ketatin pearls or intercellular bridges

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20
Q

Where in the lung are Squamous cell carcinoma?

A

Central

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21
Q

What is the 1 paraneoplastic syndrome associated with Squamous cell carcinoma?

A

Hypercalcemia from fromduction of PTHrP

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22
Q

What is the most common tumor in non-smokers and FEMALE smokers?

A

Adenocarcinoma

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23
Q

The majority of Adenocarcinoma tumors are + for which serum protein?

A

Thyroid transcription factor-1

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24
Q

What is the most common mutation to cause Adenocarcinoma?

A

KRAS mutations

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25
Q

What are the 2 thing seen in histology for Adenocarcinoma?

A

Glands or Mucin

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26
Q

Where in the lung are Adenocarcinomas?

A

Peripheral

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27
Q

How do u get large cell carcinomas?

A

Smoking

28
Q

What shows up on histology for large cell carcinomas?

A

Poorly differentiated large cells

29
Q

What DOES NOT show up on histology for large cell carcinomas?

A

anything from prev cancers- keratin pearls, interceullar bridges, glands, or mucus

30
Q

Where are large cell carcinomas located?

A

Central or Peripheral

31
Q

Do large cell carcinomas have a good or bad prognosis?

A

Poor prognosis

32
Q

Is bronchioloalveolar carcinoma related to smoking?

A

No

33
Q

How does bronchioloalveolar carcinomas grow in the lung?

A

Grow along pre-existing bronchioles and alveoli

34
Q

Which cells give rise to bronchioloalveolar carcinomas?

A

Clara cells

35
Q

Where in the lung is bronchioloalveolar carcinoma?

A

peripheral

36
Q

Bronchioloalveolar carcinomas present with PNA-like consolidation and have a poor or excellent prognosis?

A

Excellent prognosis

37
Q

True or False: Carcinoid tumors are not related to smoking.

A

True

38
Q

What shows up on histological exams for Carcinoid tumors?

A

Well differentiated neyroendocrine cells

39
Q

Carcinoid tumors are + for which marker?

A

Chromogranin +

40
Q

Carcinoid tumors can be central or peripheral and can form what in the bronchus?

A

Polyp-like mass

41
Q

True or Fase: Carcinoid tumors often cause carcinoid syndrome.

A

False. They rarely do.

42
Q

What is the most common location for metastasis to the lung?

A

Breast or colon

43
Q

What is seen on imaging for metastasis lesions in the lung?

A

“cannon-ball” nodules

44
Q

Are metastasis in the lung more or less common and primary tumors of the lung?

A

More common

45
Q

What are the major Sx to lung carcinoma?

A

Cough, weight loss, chest pain, and dyspnea

….not very specific here….

46
Q

If the tumor causes a pleural effusion, where is the tumor located?

A

Tumor spread into the pleura

47
Q

If the tumor causes hoarseness, where is the tumor pressing?

A

Recurrent laryngeal nerve

48
Q

If the tumor causes diaphragm paralysis, where is the tumor pressing?

A

Phrenic nerve

49
Q

If the tumor causes SVC syndrome, where is the tumor pressing?

A

SVC

50
Q

If the tumor causes Horner syndrome, where is the tumor pressing?

A

Sympathetic ganglia

51
Q

Which 2 cancers tend to remain localized longer and have a slightly better prognosis than do the undifferentiated cancers?

A

Adenocarcinoma and Squamous cell

52
Q

Hyponatremia, Cushing syndrome, and Eaton-Lambert are paraneoplastic syndromes from which type of tumor?

A

Small cell carcinomas

53
Q

Hypercalcemia is a paraneoplastic syndrome from which type of tumor?

A

Squamous cell tumors

54
Q

These are benign neuroendocrine neoplasms and often seen in areas of scarring or chronic inflammation.

A

Tumorlets

55
Q

What mutation distinguises typical and atypical carcinoid tumors?

A

p53 mutations (atypical have them)

56
Q

This is the name of the lesion from a carcinoid tumor where it has penetrated the bronchial wall.

A

Collar-button lesion

57
Q

Are carcinoid tumors well- or poorly-differentiated?

A

Well-differentiated

58
Q

What are the classic Sx to carcinoid tumors?

A

persistent cough, hemoptysis, 2o infections… blahblahblahbjsghsjgnsgmpksg

59
Q

This is a relatively common lesion that is usually discovered incidentally, and shows a coin lesion on CXR.

A

Harmatoma

60
Q

What are the harmatoma nodules made of?

A

connective tissue (usually cartilage) intersected by epithelial clefts and lined by ciliated columnar epithelium

61
Q

These are rare tumors in kids that present with a fever, cough, chest pain, and hemoptysis. They’re from proliferation of spindle-shaped fibroblasts and myofibroblasts.

A

Inflammatory Myofibroblastic tumor

62
Q

True or False: the lung is the most common site for metastatic neoplasms.

A

True!

63
Q

These are soft-tissue tumors in the pleura, often attached by a pedicle, and are rarely malignant.

A

Solitary fibrous tumor

64
Q

Solitary fibrous tumors have dense fibrous tissue with occasional cysts, and have spirals of what substance within them?

A

Collagen

65
Q

What are the 2 most common Sx of primary lung cancer?

A

Cough and Hemoptysis