21 - Tumors of the Lung Flashcards
How do asbestos exposure and smoking affect risk of lung cancer?
- asbestos exposure alone increases risk
- further increased risk is asbestosis occurs
- asbestos and smoking significantly increase risk (multiplicative effect)
What oncogenes are associated with lung cancer?
- K-RAS
- EGFR
- tyrosine kinase receptor
- ALK
- ROS-1
What are the diagnostic approaches to lung cancer?
- sputum cytology
- bronchoscopy
- CT-guided transthoracic needle biopsy
- open or VATS biopsy
Keratin pearls, intracellular bridges, an desmoplastic reactions suggest ___.
Squamous cell lung cancer (NSCLC)
Which types of lung cancer tends to occlude/obstruct central airways and can lead to post-obstructive pnemonia or bronchiectasis?
- Squamous cell lung cancer (NSCLC)
- carcinoid
Which type of lung cancer is associated with ectopic production of PTH, leading to paraneoplastic hypercalcemia?
Squamous cell lung cancer (NSCLC)
What is the most common form of lung cancer?
Adenocarcinoma (NSCLC)
Which types of lung cancer can occur in non-smokers?
- Adenocarcinoma (NSCLC) (occurs in both smokers and non-smokers)
- mesothelioma (no connection to smoking)
Squamous cell lung cancer is a [central/peripheral] lung cancer.
central
Adenocarcinoma is a [central/peripheral] lung cancer.
peripheral
Gland formation, mucin, and papillary structures are suggestive of ___.
Adenocarcinoma
Immunohistochemistry staining positive for TTF-1 is suggestive of ___ or ___.
- Adenocarcinoma
- small cell lung cancer
What is carcinoma in-situ?
A form of adenocarcinoma where the tumor grows along the alveolar septae without invasion through the basement membrane
What types of lung cancer are neuroendocrine?
- small cell lung cancer
- carcinoid
- large cell carcinoma
Small cell lung cancer is a [central/peripheral] lung cancer.
central
What is the treatment for small cell lung cancer?
Chemotherapy and radiation (almost always metastatic at presentation –> can’t be treated surgically)
Small cells with scant cytoplasm, powdery chromatin, nuclear molding, and a high mitotic rate suggest ___.
Small cell lung cancer
What are some local symptoms of lung cancer?
- cough/wheeze
- chest wall pain
- Horner’s syndrome
- Superior vena cava syndrome
- hoarseness (recurrent laryngeal compression)
- compression of phrenic nerve
- compression of brachial plexus or sympathetic chain
- fever (uncommon)
How does small cell lung cancer usually present?
large, bulky central tumors with extensive mediastinal adenopathy
How does carcinoid lung cancer usually present?
endobronchial mass or peripheral solitary nodule
Cells similar in size and appearance with powdery chromatin and some stroma between cells suggest ___.
carcinoid lung cancer
What is a hamartoma? How does it appear histologically?
A benign, very well-circumscribed solitary nodule; histo - cartilage, fat, trapped respiratory epithelium
What is the primary cause of pleural tumors?
metastasis from a different primary tumor
What is the main cause of malignant mesothelioma?
Asbestos
What is the differential diagnosis for mesothelioma? How do you differentiate?
Adenocarcinoma
Immunohistochemistry
- Adenocarcinoma is positive for TTF-1 and CEA
- Mesothelioma is positive for calretinin
What type of cancer is common in the oral cavity?
Squamous cell
What are the risk factors for oral cavity tumors?
- tobacco
- alcohol
- HPV
- sun exposure
What type of cancer is common in the nasopharynx?
squamous cell keratinizing or non-keratinizing (very aggressive tumor)
What type of cancer is common in the larynx?
squamous cell
What are the risk factors for nasopharyngeal carcinoma?
- EBV
- smoking
- formaldehyde
- food preservatives
What are the risk factors for laryngeal carcinoma?
- alcohol
- HPV
- asbestos
Which two lung cancers are most strongly associated with smoking?
- small cell lung cancer
- squamous cell carcinoma
What type of cancer has a strong association with Epstein-Barr virus?
nasopharyngeal carcinoma (usually nonkeratinizing, undifferentiated carcinoma)
