Lung Cancer

ahmadsadaka's version from 2015-06-03 06:47


Question Answer
centrally located tumorssquamous cell, small cell
peripherally located tumorsadenocarcinoma, large cell carcinoma
tumors associated with paraneoplastic syndromessmall cell carcinoma (mainly), but squamous cell related to hypercalcemia
hypercalcemia productionsquamous cell
most common in nonsmokersadenocarcinoma
strongest association with smokingsmall cell
small dark blue round cells with minimal cytoplasm (Kulchitsky cells) and Nuclear moldingsmall cell
associated with lambert-eaton syndromesmall cell
glands and mucus production seen on histologyadenocarcinoma
presents with pneumonia like symptoms and infiltrates on CXRadenocarcinoma in situ (lepidic growth)--> formerly known as bronchioalveolar carcinoma
presents with consolidation(s) with air bronchogram on CXR & CT and associated with k-RAS mutations in 100%Invasive mucinous adenocarcinoma
cavitated lesions on CXR or CTsquamous cell
keratin pearlssquamous cell
secretes PTHsquamous cell
secretes ACTH and ADHsmall cell
intercellular bridgessquamous cell
lots of undifferentiated cellslarge cell
generate seratonincarcinoid tumors
this tumor can cause flushing, diarrhea, wheezing, salivationthis is carcinoid syndrome, which can happen with a carcinoid tumor
chromogranin + cellscarcinoid
this causes ptosis, miosis, and anhydrosis. What else often accompanies these symptoms?horner's syndrome caused by pancoast tumor. Also often accompanied by arm pain because of brachial plexus involvement
confluent pleural rindmesothelioma
not associated with smoking at allmesothelioma
where can mesothelioma arise from?pleura, peritoneum, pericardium, tunica vaginalis testis
which cancer has a very long latency period?mesothelioma--often showing up 20-40 years after exposure
what are the staging levels and what do they represent?T-->size and extension. N--> spread to lymph nodes and location M-->metastasis
what is often found on CXR for lung cancer? how can you tell if it is benign or malignant?solitary coin lesions! Usually primary benign if just one nodule alone. Most likely (secondary) malignant metastatic if see multiple discrete nodules.
what are the most common location for lung metastasis to spread?bone, brain, liver, adrenals
what increases your risk of lung cancer?cigarettes, radon exposure, silica exposure, arsenic, agent orange, biomass cooking, cadmium, chromium, other lung conditions
what are symptoms of lung cancer?bone pain, decreased weight, seizures, fatigue, abdominal pain, cough, hemoptysis, pleural/chest pain, hoarseness or diaphragm paralysis, SVC syndrome, clubbing
what cures lung cancer and what are the questions you should be thinking about?SURGERY! is this resectable? is this person operable?
what is staging good for?predicting outcome!
which cancer is associated with having mutations that may be good for targeted therapy?adenocarcinoma
which cancer arises from type II pneumocytes and or clara cellsatypical adenomatous hyperplasia
stroma and papillary growthadenocarcinoma
associated with pleural puckering on gross lungadenocarcinoma
found at superior sulcus of lung?Pancoast tumor (apex of lung)
associated with chronic asbestos exposure?mesothelioma
3 histological sub-types of mesothelioma?epithelial (cuboidal cells invading pleura), sarcomatoid (spindle cells), biphasic (both!)
symptoms of pancoast tumor?horner's (cervical sympathetic plexus involvement-->ptosis, anhydrosis, miosis), hoarseness (recurrent laryngeal nerve paralysis) & arm pain bc of brachial plexus compression
what is SVC syndrome?superior vena cava syndrome. Gradual obstruction of the SVC can be a clinical emergency bc blocking blood up into the head and causing puffy red head. Poor prognosis. Radiate immediately!
Patient presents with puffy red head?SVC syndrome
2 types of carcinoid tumors--what's the difference?typical has less than 2 mitotic cells and NO NECROSIS and a much better prognosis. Atypical has more than 2 mitotic cells and some necrosis and a much poorer prognosis.
what do carcinoid tumors show on histology?organoid, trabecular, palisading, riboon-like arrangement of cells with moderate amount of eosinophilic cytoplasm, nucleus with granular chromatin.
Cells with dense core granules on histocarcinoid tumor
salt and pepper nuclear arrangement of cellscarcinoid tumor
cells separated into nested patterncarcinoid tumor
may be associated with Cushing's syndrome?carcinoid and small cell
neuroendocrine tumors of the lung (what is the difference between them?)carcinoid is low grade, small cell is high grade
what is the evolution of adenocarcinoma?atypical adenomatous hyperplasia (precursor lesion) --> bronchioloalveolar carcinoma (adenocarcinoma in situ with characteristic ground glass appearance on CXR) --> minimally invasive adenocarcinoma --> full blown invasive adenocarcinoma
what is WHO classification most common category of lung tumorsepithelial tumors (90-95%)