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Pathology 2 - Block 2 - Part 5

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davidwurbel7's version from 2016-06-30 16:27

Respiratory Tumors

Question Answer
Benign tumors of the lungHamartoma
The most common lung cancerMetastatic Cancer
A spherical, small (3 to 4 cm), discrete glistening mass. On X ray: shows up as a so-called coin lesionHamartoma
Tumor consists mainly of mature cartilage, admixed with fat, fibrous tissue, and blood vessels in various proportionsHamartoma
The shiny appearance on gross examination of a hamartoma is due to thisMature Cartilage
A coin lesion of the lung 75% of the time is a hamartoma or thisGranuloma
Granuloma in the lung could be due to TB or thisHistoplasma
A coin lesion of the lung 25% of the time is thisAdenocarcinoma or Squamous Cell Carcinoma
The most common metastatic cancer of the lung is thisBreast Cancer
95% of lung cancers arise from hereBronchial Epithelium
Malignant tumor arising from the neuroendocrine cells of the lungCarcinoid of the Lung
Malignant tumors of the lung arising from the epithelium of the bronchusBronchogenic Carcinoma
2nd most common cancer in men and womenBronchogenic Carcinoma
The most common cause of death due to cancer in men and womenBronchogenic Carcinoma
The carcinogen in cigarette smoke is thisPolycylic Hydrocarbons
Exposure to this enhanced risk of cancer when combined with smokingAsbestos
Scarring of the lung is likely due to thisTuberculosis
Cancer arising from the tissue of a TB scar is this type of cancerAdenocarcinoma
Aggressive & metastasize early. Not amenable to curative surgery. Therefore, best treated by chemotherapySmall Cell Lung Cancers (SCLC)
Usually respond poorly to chemotherapy and are better treated by surgeryNon-Small Cell Lung Cancers (NSCLC)
Small Cell Lung Cancers (SCLC) is best treated with thisChemotherapy
Non-Small Cell Lung Cancers (NSCLC) is best treated with thisSurgery
Squamous cell carcinoma, Adenocarcinoma - including bronchioloalveolar Carcinoma, Large cell Carcinoma are examples of these cancers of the lungNon-Small Cell Lung Carcinoma (NSCLC)
The most common bronchogenic carcinoma type of cancer is thisAdenocarcinoma of the Lung
This cancer of the lung has the best prognosisBronchial Carcinoid
This cancer of the lung is the least commonBronchial Carcinoid
Squamous cell and small cell carcinoma is usually located hereCentrally
Adenocarcinoma is usually located herePeripheral
This event must occur in the lining of the respiratory tract in order to get squamous cell carcinomasSquamous Metaplasia
Arise centrally in major bronchi. Appear as gray white bronchial mass. Can cause obstruction leading to atelectasis, infection and bronchiectasis. Central area of tumor may cavitate due to necrosis. Can ectopically secrete PTHrP leading to hypercalcemiaSquamous Cell Carcinomas
Squamous cell carcinoma can cause this due to the release of PTHrPHypercalcemia
Squamous cell carcinoma can release this leading to the development of hypercalcemiaPTHrP
Tumor composed of Large polygonal cells with keratinization (keratin–pearls) and intercellular bridgesSquamous Cell Carcinoma
Sputum cytology stained with Papanicolau stain that shows squamous cell that stain bright orange to red indictsSquamous Cell Carcinoma
Lung cancer less linked to smokingAdenocarcinoma
The most common overall primary lung cancerAdenocarcinoma
The most common lung cancer in womenAdenocarcinoma
The most common lung cancer in nonsmokersAdenocarcinoma
A lung cancer that may arise from scar tissue in the lungAdenocarcinoma
Adenocarcinoma tend to be in this location in the lungPeripherally
Adenocarcinoma is identified by the production of thisMucin
This cancer arises peripherally from clara cells of small airways (respiratory / terminal bronchioles or alveolar walls). Spread: along the wall of terminal and respiratory bronchiole, alveolar ducts and alveoli in a hobnail (picket fence) patternBronchiolo-Aveolar Carcinoma
The pattern of spread seen on x-ray for Bronchiolo-alveolar carcinoma is called thisHobnail (Picket Fence) Pattern
Bronchiolo-alveolar carcinoma grossly and on X ray may present as consolidation and can be confused with this conditionPneumonia
Small cell Carcinoma is also known as thisOat Cell Carcinoma
Derived from Kulchitsky’s cell (neuroendocrine cells). Strongly linked to smoking. Undifferentiated and highly malignant. Most would have metastasized at the time of diagnosis. Not cured by surgery, responds to chemo and radiation therapy. Located centrallySmall Cell Carcinoma
The treatment for small cell carcinoma is thisChemotherapy and/or Radiation
A small cell carcinoma can produce ectopic hormone producing this conditionParn-Neoplastic Syndromes
A small cell carcinoma that produces ACTH, the patient will develop thisEctopic Cushing's Sydrome
A small cell carcinoma that produces ADH, the patient will develop thisSiADH
A complication of SiADH is dilutional hyponatremia which can lead to thisCerebral Edema
The reason for cerebral edema seen with SiADH is due to thisDilutional Hyponatremia
On microscopy, this cancer shows small round blue cells with crush artifact. Cells have scant amount of cytoplasm. Nuclear molding is a characteristic feature ( better seen in cytology specimens). On EM, cytoplasmic neurosecretory granulesSmall Cell Carcinoma
Clinical presentation include Cough, Dyspnea ,Hemoptysis, Weight loss and Chest PainLung Cancer
Suspect lung cancer in any smoker who presents with thisRecurrent Pneumonia
Primary lung cancer in extra-thoracic metastasis tend to spread hereAdrenal Gland
Intra-thoracic spread of a lung cancer to the pleura may lead to thisPleural Effusion
Intra-thoracic spread of a lung cancer to the esophagus causing esophageal obstruction may lead to thisSolid Dysphagia
Intra-thoracic spread of a lung cancer to the recurrent laryngeal nerve may lead to thisVocal Hoarseness
Intra-thoracic spread of a lung cancer to the phrenic nerve may lead to thisHiccups or Diaphragm Paralysis
Lung cancer complications due to obstruction of the bronchial tree may lead to thisAtelectasis or Bronchiectasis
Intra-thoracic lung cancer invasion of cervical sympathetic plexus and brachial plexus may lead to thisHorner's Syndrome
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Question Answer
Cancers that arise from structures in the midline of the body tend to metastasis hereBone Metastasis
Lung cancer paraneoplastic syndrome characterized by muscle weakness due to autoantibodies produced by the cancer cell directed against neuronal calcium channelsLambert - Eaton Myasthenic Syndrome
Lambert – Eaton myasthenic syndrome is usually seen with this type of lung cancerSmall Cell Carcinoma
Lung cancer paraneoplastic syndrome due to mucus production may cause Migratory thrombophlebitis and Non-bacterial thrombotic endocarditisHypercoagulability Syndromes
Hypercoagulability Syndromes are usually seen with this type of lung cancerAdenocarcinoma
Lung cancer paraneoplastic syndrome characterized by proliferative periostitis of digital bone leading to new bone formation plus growth of connective tissue which leads to finger clubbing and arthritis (synovits) of the adjacent jointHypertrophic Pulmonary Osteoarthropathy
Hypertrophic Pulmonary Osteoarthropathy is usually seen with these types of lung cancerSquamous Cell Carcinoma and Adenocarcinoma
These discreet, polypoid masses can occur in young to middle-aged adults. Their appearance is not related to smoking. They are not commonCarcinoid Tumor
Low grade, well differentiated malignant tumor of neuroendocrine origin. Rarely (5-10%) metastasize to distant sites. No relationship to smoking. Location: large bronchiCarcinoid Tumor
Histology shows nests of uniform cells with uniform round nuclei. Electron microscopy: dense-core neurosecretory granulesCarcinoid Tumor
The treatment of carcinoid tumor is thisSurgical Resection
A patient presenting with diarrhea, flushing, cyanosis, TIPS, wheezing may have thisCarcinoid Syndrome
Carcinoid Syndrome occurs because of secretion of this by a carcinoidSerotonin
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