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Pulmonology > 21 - Tumors of the Lung > Flashcards

21 - Tumors of the Lung Flashcards

1
Q

How do asbestos exposure and smoking affect risk of lung cancer?

A
  • asbestos exposure alone increases risk
  • further increased risk is asbestosis occurs
  • asbestos and smoking significantly increase risk (multiplicative effect)
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2
Q

What oncogenes are associated with lung cancer?

A
  • K-RAS
  • EGFR
  • tyrosine kinase receptor
  • ALK
  • ROS-1
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3
Q

What are the diagnostic approaches to lung cancer?

A
  • sputum cytology
  • bronchoscopy
  • CT-guided transthoracic needle biopsy
  • open or VATS biopsy
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4
Q

Keratin pearls, intracellular bridges, an desmoplastic reactions suggest ___.

A

Squamous cell lung cancer (NSCLC)

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5
Q

Which types of lung cancer tends to occlude/obstruct central airways and can lead to post-obstructive pnemonia or bronchiectasis?

A
  • Squamous cell lung cancer (NSCLC)

- carcinoid

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6
Q

Which type of lung cancer is associated with ectopic production of PTH, leading to paraneoplastic hypercalcemia?

A

Squamous cell lung cancer (NSCLC)

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7
Q

What is the most common form of lung cancer?

A

Adenocarcinoma (NSCLC)

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8
Q

Which types of lung cancer can occur in non-smokers?

A
  • Adenocarcinoma (NSCLC) (occurs in both smokers and non-smokers)
  • mesothelioma (no connection to smoking)
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9
Q

Squamous cell lung cancer is a [central/peripheral] lung cancer.

A

central

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10
Q

Adenocarcinoma is a [central/peripheral] lung cancer.

A

peripheral

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11
Q

Gland formation, mucin, and papillary structures are suggestive of ___.

A

Adenocarcinoma

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12
Q

Immunohistochemistry staining positive for TTF-1 is suggestive of ___ or ___.

A
  • Adenocarcinoma

- small cell lung cancer

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13
Q

What is carcinoma in-situ?

A

A form of adenocarcinoma where the tumor grows along the alveolar septae without invasion through the basement membrane

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14
Q

What types of lung cancer are neuroendocrine?

A
  • small cell lung cancer
  • carcinoid
  • large cell carcinoma
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15
Q

Small cell lung cancer is a [central/peripheral] lung cancer.

A

central

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16
Q

What is the treatment for small cell lung cancer?

A

Chemotherapy and radiation (almost always metastatic at presentation –> can’t be treated surgically)

17
Q

Small cells with scant cytoplasm, powdery chromatin, nuclear molding, and a high mitotic rate suggest ___.

A

Small cell lung cancer

18
Q

What are some local symptoms of lung cancer?

A
  • 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)
19
Q

How does small cell lung cancer usually present?

A

large, bulky central tumors with extensive mediastinal adenopathy

20
Q

How does carcinoid lung cancer usually present?

A

endobronchial mass or peripheral solitary nodule

21
Q

Cells similar in size and appearance with powdery chromatin and some stroma between cells suggest ___.

A

carcinoid lung cancer

22
Q

What is a hamartoma? How does it appear histologically?

A

A benign, very well-circumscribed solitary nodule; histo - cartilage, fat, trapped respiratory epithelium

23
Q

What is the primary cause of pleural tumors?

A

metastasis from a different primary tumor

24
Q

What is the main cause of malignant mesothelioma?

A

Asbestos

25
Q

What is the differential diagnosis for mesothelioma? How do you differentiate?

A

Adenocarcinoma

Immunohistochemistry

  • Adenocarcinoma is positive for TTF-1 and CEA
  • Mesothelioma is positive for calretinin
26
Q

What type of cancer is common in the oral cavity?

A

Squamous cell

27
Q

What are the risk factors for oral cavity tumors?

A
  • tobacco
  • alcohol
  • HPV
  • sun exposure
28
Q

What type of cancer is common in the nasopharynx?

A

squamous cell keratinizing or non-keratinizing (very aggressive tumor)

29
Q

What type of cancer is common in the larynx?

A

squamous cell

30
Q

What are the risk factors for nasopharyngeal carcinoma?

A
  • EBV
  • smoking
  • formaldehyde
  • food preservatives
31
Q

What are the risk factors for laryngeal carcinoma?

A
  • alcohol
  • HPV
  • asbestos
32
Q

Which two lung cancers are most strongly associated with smoking?

A
  • small cell lung cancer

- squamous cell carcinoma

33
Q

What type of cancer has a strong association with Epstein-Barr virus?

A

nasopharyngeal carcinoma (usually nonkeratinizing, undifferentiated carcinoma)

Pulmonology (25 decks)

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