5. Lung Tumours Flashcards
Classify malignant lung tumours
Primary
-epithelial
-non-epithelial
Metastatic
What tumours commonly metastasise to the lung
Colon Breast Renal cell carcinoma Prostate Melanoma
What are the types of benign lung tumour?
Hamartoma most common Papilloma (upper airway) Adenoma (lower) Chondroma Haemangioma
How do benign tumours appear on PET?
Cold
Classify primary epithelial tumours
Non-small cell
Neuroendocrine
Classify non small cell tumours
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
Non Small cell lung cancer not otherwise specified
Classify neuroendocrine tumours
Small cell carcinoma
Large cell neuroendocrine carcinoma
Carcinoid tumour
What tumour can arise from fibrosis?
Adenocarcinoma
How do adenocarcinomas appear on CT?
Ground glass opacity
What marker is positive in adenocarcinomas?
TTF-1
Where are squamous cell carcinomas and carcinoid tumours usually found in the lung?
Centrally in major bronchi
What process can cause squamous cell carcinomas?
Metaplasia
What marker is present in squamous cell carcinomas?
p63
Describe the appearance of a small cell carcinoma under the microscope
Small to medium sized cells
Nuclei stick together
Little cytoplasm
Evidence of necrosis and mitosis
What markers are present in neuroendocrine tumours?
Synaptophysin
Chromogranin
How can a carcinoid tumour present?
Recurrent pneumonia
Carcinoid syndrome
How do carcinoid tumours appear under the microscope?
lots of ‘Salt and pepper’ cytoplasm
Nested or in trabeculae
What are the 5 main causes of malignant lung neoplasms?
Smoking Radon gas Asbestos Air pollution Genetic
What is an ECOG status?
Used to assess patient’s co-morbidities and whether they will survive treatment
What are the local effects of lung tumours?
Cough, haemoptysis, pneumothorax, pleural effusion, recurrent pneumonia
Which lung tumours are associated with paraneoplastic syndrome?
Small cell
Squamous cell
Adenocarcinoma
How do paraneoplastic syndromes occur?
Cross-reacting antibodies interfere with normal metabolic pathways
Which paraneoplastic syndromes are associated with small cell carcinomas?
Cushings syndrome
Hyponatraemia
Which paraneoplastic symptom is associated with squamous cell carcinoma?
Hypercalcaemia
Which paraneoplastic symptom is associated with adenocarcinoma?
Hypertrophic osteoarthropathy
What are the symptoms of Pancoast’s tumour?
Horner’s syndrome: ptosis, meiosis and anhidrosis
Weakness in small muscles of the hand
What mutations have been seen in adenocarcinomas?
EGFR ALK ROS-1 RET B-RAF
What mutations have been seen in non-small cell lung cancers?
KRAS p53 EGFR EML4 ALK
