Clinical: Pulmonary Neoplasm Flashcards
What does intracellular bridging seen on histology indicate?
Squamous cells
How can a pulmonary adenocarcinoma be identified on microscopy?
The tumor will contain glands.
What does a “school of fish” pattern with “salt and pepper” nuclei pattern on microscopy indicate?
Small Cell Lung Carcinoma
Risk factor for lung cancer
Smoking
What is the major occupational risk factor that can lead to lung cancer?
Asbestos inhalation
though this mostly causes mesothelioma rather than lung cancer
What causes clubbing in the fingers with lung cancer?
Chain of events
- tumors increase alveolar pressure in the lungs
- the increase in alveolar pressure causes an increase in vascular pressure
- the increase in vascular pressure results in vessel dilation and possible edema due to increased hydrostatic pressure
- the increased volume from the vessel distension and edema is minimal but is easily seen in the small vessels in the finger tips
What are the only OMM techniques approved for use in lung cancer?
Lymphatic drainage and soft tissue
Where in the lungs do most adenocarcinomas form and where do they commonly metastasize?
They form mostly in the lung periphery
They metastasize to the brain
Where do most squamous cell carcinomas form?
Endobronchial (airways)
What condition are small cell lung carcinomas associated with and what is a common lab finding because of this association?
Lambert Eaton syndrome
-hypercalcemia
What cancer is associated with Brachial plexus dysfunction and/or Horner Syndrome?
Pancoast Tumor
- found at lung apex
- non small cell type
Why is surgery not an option to treat small cell lung carcinoma?
If typically forms too close to the carina. Tumors must be at least 2cm away from the carina to consider surgery.
Describe bronchoalveolar cell cancer.
Presents like pneumonia
- very slow growing
- located peripherally
How is bronchoalveolar cell cancer monitored?
Once a growth is detected it is monitored by CXR for 2 years to determine if it needs to be removed.
(Watchful waiting: used for nodules less than 1 cm that are suspicious)
What size lung nodule requires intense radiologic monitoring for both high and low risk patients?
Greater than 8cm diameter
What size nodule only requires radiologic monitoring in high risk patients for a year?
Less than 4cm diameter
What are the 3 limitations for PET scans?
- False readings for nodules smaller than 1cm
- False negatives with uncontrolled diabetes
- False positives with inflammation or infection
What type of pulmonary lesions does bronchoscopy have the highest yield?
Central lesions
-easiest ones to “get to” with an endotracheal scope
What technique has improved yield on peripheral lesions with bronchoscopy?
Electromagnetic Navigational Bronchoscopy
What is endoscopic Bronchial Ultrasound mainly used for?
Sampling Lymph Node tissue
Which technique has the highest yield to identify lung cancers?
Surgical Intervention
When staging lung cancers, which ones are not resected with surgery?
Stage IIIB - Stage IV
