Carcinoma of the Lung Flashcards
What is the most common cause of cancer mortality worldwide?
Lung cancer
What type of cancers are associated with mutations of the K-ras gene?
- 25% adenocarcinomas
- 20% large cell carcinomas
- 5% squamous cell carcinomas
In what cancers is overexpression of the Myc gene found?
10-40% of small cell carcinomas
What cancers are mutations in the p53 gene found?
- 80% of small cell carcinomas
- 50% of non-small cell carcinomas
What cancers are mutations in the Rb gene found?
- 80% of small cell cancers
- 25% of non-small cell carcinomas
What determines the histologic subtyping of lung cancer?
Best differentiated component (unless an area of small cell carcinoma is present)
What determines the degree of differentiation grading of lung cancer?
Worst-differentiated component
Histology shows a cancer with a keratin pearl composed of cells with brightly eosinophilic cytoplasm. The pearl is surrounded by concetric layers of cells (“onion skin”). What is the Dx?
Squamous Cell Carcinoma
Shown is a gross specimen of Squamous Cell Carcinoma. Describe the pathogenesis leading from cigarette smoking to cancer. Where are these tumors generally found?
- Smoking
- Cellular Damage
- Regeneration from the pluripotent basal layer
- Squamous metaplasia
- Dysplasia
- Carcinoma in situ
- Invasive tumor
Central portion of the lung
A gross lung specimen reveals a tumor with an irregular border with a tan/gray cut surface and it causes puckering of the overlying pleura. Furthermore, pleural fibrosis was observed. What is the Dx? Where are these tumors generally found?
Adenocarcinoma of the lung; In the periphery
What is the precursor lesion to adenocarcinoma of the lung?
Atypical adenomatous hyperplasia
What are the 4 types of adenocarcinoma of the lung?
- Acinar
- Papillary
- Solid with mucus formation
- Bronchioalveolar
What type of adenocarcinoma is this?
Acinar
Epithelial cells grow along thin fibrovascular cores. What type of adenocarcinoma is this?
Papillary
Several intracytoplasmic droplicts are shown within this adenocarcinoma. What is it?
Solid adenocarcinoma with mucus
A diffusely infiltrating tumor appears solid, glistening and mucoid. What type of adenocarcinoma is it?
Bronchiolalveolar
What is the most common type of adenocarcinoma?
Acinar
What are the two subtypes of bronchiolalveolar carcinoma?
Nonmucinous and mucinous
A lung biopsy reveals atypical cuboidal to low columnar cells proliferating along th existing alveolar wall. What is the growth called? What is the Dx?
Lepidic growth; Nonmucinous bronchioloalveolar carcinoma
A lung biopsy reveals tall columnar cells that grow along the existing alveolar walls. Goblet cells are featured throughout the sample. What is within the columnar cells? What is the Dx?
Mucin; Mucinous bronchioloalveolar carcinoma
Lung biopsy shows poorly differentiated tumors growing in sheets. The cells do not show squamous or glandular differentiation. The cells show prominent nucleoli and ample cytoplasm. What is the Dx? What is unique about the Dx?
Large Cell Carcinoma of the Lung; It is a Dx of exclusion
Histology reveals sheets of small, round, oval, and spindle-shaped cells with scant cytoplasmm. The nuclei are very distinctive and nuceloli are absent. Necrosis is evident. Mitotic rate is very high. What is the Dx? What is the clinical Px? What markers are seen in this sample? What is this cancer associated with?
Small Cell Lung Carcinoma; This cancer has a high rate of metastasis; CD56, synaptophysin, chromogranin; SMOKING
What are some paraneoplastic syndromes associated with small cell lung carcinoma?
Diabetes insipidus, Ectopic adrenocortioctropic hormone syndrome, Eaton-Lambert Syndrome
What is the Rule of Thumb in SCLC measurements in histology?
Diameter of three small resting lymphocytes
