Pathoma - Lung Cancer Flashcards Preview

CRRAB II Week 8/9 - WLB > Pathoma - Lung Cancer > Flashcards

Flashcards in Pathoma - Lung Cancer Deck (21)
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1
Q

What are the key risk factors for lung cancer?

A
  1. Cigarette smoke (85%) - polycyclic aromatic hydrocarbons
  2. Radon (uranium)
  3. Asbestos
2
Q

What is the average age of presentation for lung cancer?

A

60 yoa

3
Q

What is the typically presentation of lung cancer?

A
  • Symptoms are nonspecific (cough, weight loss, hemoptysis, pneumonia)
  • Imaging often reveals a solitary nodule (“coin lesion”)
  • Biopsy is necessary for diagnosis of cancer
4
Q

What are the two benign lesions that may present like “coin lesions” or solitary nodules?

A

***More common in patients

5
Q

What are the two classic divisions of lung carcinoma?

A

Small cell carcinoma (15%)

Non-small cell carcinoma (85%)

6
Q

Why is important to distinguish small cell from non-small cell carcinoma?

A

Treatment: small cell has to be treat with chemotherapy and cannot be removed by surgery, non-small cell can be treated with surgery and does not respond to chemotherapy.

7
Q

What are the major sub-types of non-small cell carcinoma?

A
  • Adenocarcinoma (40%) - glands/mucin
  • Squamous cell carcinoma (30%) - keratin pearls
  • Large cell carcinoma (10%)
  • Carcinoid tumor (5%)
8
Q

What is the characteristic histology of small cell carcinoma?

A
  • poorly differentiated small cells
  • arises from neuroendocrine cells (Kultchitsky)
  • central location
9
Q

What paraneoplastic syndromes are common in small cell carcinoma?

A

-Production of ADH or ACTH (cushing)
-Cause Eaton-Lambert Syndrome
(Mnemonic: SSS’s: Small Cell Central Smoking paraneoplastic Syndrome)

10
Q

What are the two classic histological findings in Squamous Cell Carcinoma?

A

Keratin pearls & Intercellular bridges

11
Q

What paraneoplastic syndrome is common in Squamous Cell Carcinoma?

A

PTHrP = Parathyroid Hormone related Peptide

12
Q

What is the most common tumor in male smokers?

A

Squamous cell carcinoma (central)

13
Q

What is the most common tumor in nonsmokers and female smokers?

A

Adenocarcinoma (peripheral)

-see glands or mucin

14
Q

What do you call a lung neoplasm with no keratin pearls, no intercellular bridges, no glandular tissue, and no mucin?

A

Large cell carcinoma - poorly differentiated large cells

(can be central or peripheral)

15
Q

What is Bronchioloalveolar carcinoma?

A
  • Columnar cells that grow along preexisting bronchioles and alveoli
  • arises from Clara cells
  • **Not related to smoking
16
Q

How does Bronchioloalveolar carcinoma present?

A
  • May present with pneumonia-like consolidation on imaging
  • Peripheral
  • Good prognosis!
17
Q

What is a carcinoid tumor?

A
  • Well differentiated neuroendocrine cells
  • Low grade malignancy, rarely causes carcinoid syndrome
  • **Chromogranin POSITIVE!
  • **Not related to smoking
18
Q

Where does a carcinoid tumor grow?

A

Central or peripheral:

-classically forms a polyp-like mass in the bronchus

19
Q

What are the most common sources of metastases to the lung?

A

Breast and colon carcinoma

20
Q

How common are metastases to the lung from another primary cancer?

A

More common than primary tumors of the lung!

21
Q

What are local complications of lung cancer?

A
  • Pleural involvement (usually adenocarcinoma)
  • Obstruction of superior vena cava
  • Involvement of recurrent laryngeal nerve (hoarseness) or phrenic nerve (diaphragmatic paralysis)
  • Compression of sympathetic chain - pancoast tumor (ptosis, pin-point pupil, and anhidrosis)