Flashcards in Pulmonary Neoplasms Deck (80)
How many mutations are induced for every 15 cigarettes smoked?
RISK FACTORS FOR LUNG CANCER
1. Smoking and second-hand smoke
2. Asbestos – mesothelioma
3. Radon – uranium mining
4. Can develop lung cancer even after stopping smoking years ago
5. Other family members who have had smoking-related cancers
6. Prior lung diseases such as
7. Air pollution:
Cigarette smokers have risk related to what factors of smoking?
1. Age at onset of smoking
2. Amount smoked
3. Gender (women)
4. Product smoked
5. Depth of inhalation
Stopping tobacco use before middle age avoids more than ____of the lung cancer risk attributable to tobacco.
We can treat smoking cessation with what drugs?
1. Zyban (buproprion),
2. Chantix (varenicline) or
3. nicotine replacement therapy
4. Clonidine and nortriptyline are recommended as second- line treatments
5. hypnosis can work for some motivated smokers
What is a neoplasm?
What are the two kinds?
Neoplasia is uncontrolled cell growth
Growth that is not needed for normal development or replacement of dead or damaged tissues
Can be benign or malignant
What are the types of benign neoplasms?
Malignant? (two kinds)
Benign neoplasms – tumors
Hamartomas and granulomas
Malignant neoplasms– cancers
Primary: Bronchogenic carcinomas and others
small cell and non-small cell
What are the kind of metastatic neoplasms? 4
breast, colon, prostate, bladder
Bronchogenic carcinomas and others small cell and non-small cell
BENIGN PULMONARY NEOPLASMS:
How do the cells grow? 3
Describe the borders? 2
Cells grow in fairly
1. orderly manner,
2. stick together,
3. don’t migrate
Seem to be
2. smooth borders
What are hamartomas?
What is often associated with these? 2
local tissues growing in disorganized manner
1. bronchial tissue and
2. calcifications (popcorn calcification)
What are granulomas?
chronic inflammatory lesions with macrophages
1. Describe the rate of cell division?
2. What do they look like?
3. How do the cells function? 2
4. How do the masses themselves look?
1. Rapid, even continuous division (occasionally in hours)
Cells are geared up for dividing
2. Show de-differentiation
Look less and less like parent cells or tissues
3. Lose some or all of their normal cell functions
Have no useful function for the body
Parasitize the host’s body
Steal nutrients, energy, blood supply – space occupying masses
4. Masses have irregular, invasive borders
Will travel in search of new lands to conquer
What are the different routes of spread for metastatic lung cancer?
Define the following routes of spread:
Transcoelomic: along the surface of an organ - mesothelioma
Lymphatic: most common route for carcinomas
Hematogenous: most common route for sarcomas
Iatrogenic: transplantation or implantation
What are the other most common places for cancer caused by smoking besides the lungs?
breast, colon, prostate, bladder
What is the most common type of lung cancer?
There are two types of this cancer. What are they? 2
1. Small cell lung cancer – primitive neuroendocrine cells
2. Non-small cell lung cancer
What are the types of non-small cell lung cancer?
-Broncheoalveolar carcinoma (subtype of adenocarcinoma)
2. Squamous cell carcinoma of the lung
3. Large cell lung carcinoma
Name some other types of lung cancers?
2. Kaposi’s sarcoma,
5. head and neck
These four histologies account for approximately 90% of all epithelial lung cancers.
1.Small Cell Lung Cancer (SCLC)
3.Squamous Cell Carcinoma
4.Large Cell Carcinoma
SMALL CELL LUNG CARCINOMA
1. Also known as what?
2. What does it arise from?
3. This is what percent of patients with lung cancer?
5. 90% of pts with SCLC develop what?
1. Also known as “oat cell” lung cancer
2. Arises from primitive, small
3. 14% of patients with lung cancer
-Bad disease, early metastases
-Very aggressive cancer, rapidly fatal
-Only a small percentage of patients are curable
-Even with limited stage disease
5. 90% of patients with SCLS develop brain metastases
Describe the tumor in small cell carcinomas.
1. Poorly differentiated neuroendocrine tumor.
2. Central mass with endobronchial growth.
What might a SCLC produce?
What are these associated with?
May produce specific peptide hormones such as:
1. adrenocorticotrophic hormone (ACTH),
2. arginine vasopressin (AVP),
3. atrial natriuretic factor (ANF), and
4. gastrin-releasing peptide (GRP).
These hormones may be associated with distinctive
Differential diagnosis for SCLC?
1. Poorly differentiated non-small cell carcinomas
2. Neuroendocrine carcinomas,
poorly differentiated squamous cell carcinoma
3. Nonepithelial tumors lymphoma,
4. small round blue cell tumors,
5. sarcomas (e.g., synovial sarcoma).
1. Among women and young adults (less than 60 years), ____________ tends also to be the most common form of lung cancer.
2. In lifetime never smokers, all histologic forms of lung cancer can be found, although ___________ tends to predominate.
3. The incidence of small cell carcinoma is also on the ______.
NON-SMALL CELL LUNG CARCINOMA
1. Is what percent of lung cancer?
2. What are the three most common kinds?
3. What do they have in common (2) and what makes them different (2) from each other?
4. What are signs and symtpoms related to?
5. What makes bronchoalveolar carcinomas different?
1. 80% of lung cancers. Rare before age 35, peaks at 65-80
-Adenocarcinoma of the lung 54%
-Squamous cell carcinoma of the lung 35%
-Large cell lung carcinoma 11%
3. All have similar prognosis and are treated the same, but have different locations and patterns of spread
4. Signs/symptoms are related to the location of the tumor, may have associated paraneoplastic syndromes.
5. Bronchoalveolar carcinoma is different, more aggressive
Subcategory of adenocarcinoma, found more peripherally
NSCLC - ADENOCARCINOMA
1. Where does this cancer arise from?
2. Found near which structures often? 3
3. What may you see before primary symtpoms?
4. What two findings will you find on tissue biopsy?
Associated with smoking
1. Peripheral - arise from surface epithelium, peripheral scars
2. Gland formation, papillary structures or mucin production
3. May see metastatic disease before primary symptoms
4. Hypertrophic osteoarthropathy and Trousseau’s syndrome
Peripheral lung locations.
Associated with a history of smoking.
It is the most common type of lung cancer occurring in never smokers
NSCLC: BRONCHOALVEOLAR ADNEOCARCINOMA is a subtype of adenocarcimona. How can it present?
It can occcur as early as when?
Can present as solitary or multicentric nodules, rapidly progressive
Can occur in 2nd decade of life – multiple pulmonary nodules
NSCLC: BRONCHOALVEOLAR ADNEOCARCINOMA
1. Symtpoms present as?
2. Nodal enlargement?
4. Tends to occur is what tissues?
5. Grows where?
6. How can it present radiographically? 3
7. How can it present on CT scans?
1. Non-resolving focal or bilateral “pneumonia”
2. Nodal enlargement uncommon
3. Distant spread uncommon
4. Tends to be more peripheral
5. grows along the alveoli without invasion.
6. present radiographically as a
-single mass, as a
-diffuse multinodular lesion, as a -fluffy infiltrate.
7. on CT scans as a "ground-glass" opacity (GGO).
Also seen in nonsmokers