Bronchogenic Carcinoma

Question 1

What are the two types of bronchogenic carcinomas

Answer 1

1. Non-small cell lung cancer (NSCLC)
2. Small cell lung cancer (SCLC)

Question 2

What falls under the non-small cell lung cancers (NSCLC)

Answer 2

1. Squamous cells
2. Adenocarcinoma / adenocarcinoma in situ (MC)
3. Large cell (anaplastic)

Question 3

What fall under the small cell lung cancer (SCLC)

Answer 3

Less common
1. Adenosquamous carcinoma
2. Carcinoid tumors
3. Bronchial gland tumors
4. Sarcomas
5. Pulmonary blastomas

Question 4

What is the pathogenesis of bronchogenic carcinoma

Answer 4

1. Smoking (40+ carcinogens)
   *causes the lost expected cellular growth

Question 5

What are the mechanism of cancer cellular growth

Answer 5

1. Oncogenes
2. Tumor suppressor genes
3. Growth factors

Question 6

What happens when oncogenes are expressed

Answer 6

They will turn a healthy cell into a tumor cell
1. Abnormal cells will survive and proliferate
*need an additional activation step to evolve to cancer

Question 7

What are tumor suppressor genes

Answer 7

1. Anti-oncogene
   *protect cell from (potential) path to cancer

Question 8

What happens if tumor suppressor genes or lost or their is a reduction in their function

Answer 8

1. The cell can progress to become a cancer cell

Question 9

What are growth factors

Answer 9

1. Naturally occurring substance capable of stimulating cellular growth, proliferation and cellular differentiation
   *will stimulate the cancer cells

Question 10

What are the characteristics of small cell lung carcinoma (SCLC)

Answer 10

Oat cell
1. Prone to early hematogenous spread
*most aggressive in growth, spread and most likely has already metastasized
2. Cannot do surgical resection

Question 11

Where do small cell lung carcinoma start

Answer 11

1. Beings centrally
2. Spread via infiltrates sub-mucosal
   *causes narrowing of bronchi

Question 12

Where does SCLC metastasize to?

Answer 12

Metastasizes early
1. Brain, liver bone
2. Pleural effusion

Question 13

What is the doubling time of SCLC

Answer 13

Aggressive
*doubles in 2 months

Question 14

How fast do non-small cell lung cancer spread compared to SCLC

Answer 14

Grow more slowly
*brain metastases
*can be curable in early stages and treatable in advanced

Question 15

What is the most common type of NSCLC

Answer 15

Adenocarcinoma

Question 16

Where does adenocarcinoma spread to?

Answer 16

1. Peripheral location
   *mucous glands or epithelial cells within terminal bronchioles

Question 17

Who does adenocarcinoma affect?

Answer 17

1. Non-smokers
2. Smokers

Question 18

What was adenocarcinoma in situ once called

Answer 18

Bronchioloalveolar cell carcinoma

Question 19

Where does adenocarcinoma in situ spread to

Answer 19

1. Alveolar spread along pre-existing structures without invasion
   *Rare

Question 20

What are the components of squamous cell (NSCLC)

Answer 20

1. Centrally located and arise fro bronchial epithelium
   *presents as an intraluminal mass
   *higher association with cavitary lesions

Question 21

What is the doubling time for squamous cell (NSCLC)

Answer 21

3 months