19 - Lung Cancer Path Flashcards
prevalence of major epithelial types of lung CA
small cell - 20% nonsmall cell - 80% [ squamous - 30% adeno 40% large cell 10%]
overall 5 yr survival for lung CA in US
15%
lung CA type w/ worst prognosis
small cell
best prognosis lung CA
bronchioloalveolar carcinoma
path of squamous cell lung CA
intercellular bridges - prickles keratin - can form keratin "pearls" usually central (hilar) - arise from bronchi commonly necrotic (cystic cavity on CXR)
key protein to look for w/ adenoCA
mucin
bronchioloalveolar CA
purely grows along alveolar septa - no destruction of parenchyma, no invasion
now classified as adenoCA in situ
may spread aerogenously through lung like PNA
ground glass appearance on imaging
what is most frequent type of lung CA in nonsmokers?
bronchioloalveolar CA
prognostic difference btwn mucinous and non mucinous bronchioloalveolar CA
mucinous - aerogenous spread> consolidation, not good surgical candidate
non mucinous - can be resected
large cell CA
may be poorly differentiated non small cell
large, polygonal cells, undifferentiated
often have some features of adenoCA by EM (not seen by LM)
usually peripheral, frequently necrotic
small cell lung CA is a ____ tumor
neuroendocrine
how do neuroendocrine tumors look?
organoid pattern of nests, ribbons, trabeculae, pseudorosettes
polygonal cells
stroma of delicate cap network
absence of pleomorphism, mitotic figs, tumor necrosis
type of lung CA most strongly assoc w/ smoking
small cell
p53 mutation in lung CA
linked to smoking induced CA
KRAS mutation in lung CA
if you have it, worse prognosis
