CP8 malignant lung pathology Flashcards
What is the definition of lung malignancies?
Tumours within the lung that possess potentially lethal abnormal characteristics that enable them to invade and metastasise to other tissues.
What are the two types of malignant lung tumour?
Primary and secondary
What is the most common primary lung malignancy?
Carcinomas (<90%)
What are the two types of primary malignant lung carcinomas?
Small cell carcinomas (15-20%) and non-small cell carcinomas (80-85%)
What are the 3 non-small cell lung carcinomas?
Squamous cell undifferentiated (20-30%)
Adenocarcinoma (30-40%)
Large cell carcinoma (10-15%)
How do small cell and non-small cell carcinomas differ?
Different nuclear characteristics
Different amount of cytoplasm
Different pathogenesis, treatment and prognosis
Where do carcinomas arise from?
The epithelium
How is a tumour classed as squamous cell carcinoma under a microscope?
Presence of keratinisation +/- intracellular bridges or have a squamous immunoprofile
How is a tumour classed as a adenocarcinoma under the microscope?
Mucin production +/- gland formation or have a specific immunoprofile
How is a tumour classed as a small cell carcinoma under the microscope?
A typical morphology and a specific immunoprofile
What is a common risk factor in almost all patients with a small cell carcinoma?
Smoking
What are 3 uncommon primary malignant tumours?
Carcinoid tumours (low grade)
Malignant mesenchymal tumours e.g. synovial sarcoma
Lung lymphomas (can be seen in HIV/AIDS patients)
What is the most common type of secondary tumours?
What other types form secondary lung tumours?
Carcinomas
Sarcomas, melanomas and lymphomas
Fill in the blanks.
Secondary lung tumours are ______ common than primary lung tumours
More
What is the epidemiological of lung cancer?
49,000 new cases every year in the UK and >35,000 deaths usually within individuals aged between 40 and 70.
What are 4 risk factors of lung cancer?
Tobacco smoking
Occupational hazards e.g. asbestos, uranium, arsenic, nickel
Radiation e.g. radon in mines, survivors of atomic bombs
Genetics
What is an example of a condition that increases risk of lung cancer (other than other cancers)?
Lung fibrosis
What is an example of a condition that increases risk of lung cancer (other than other cancers)?
Lung fibrosis
What are the 3 major components of cigarette smoke?
Tar - carcinogenic
CO - prevent blood carrying O2
Nicotine
What are a 3 examples of asbestos related respiratory disease?
Lung fibrosis
Mesothelioma
Malignant lung carcinomas
What is the average latent period between asbestos exposure and pathogenesis of asbestos related disease?
20 years
What is a pathway of pathogenesis of malignant lung tumours?
Squamous metaplasia —> dysplasia —> carcinoma in situ —> frank squamous carcinoma
What are common complications of lung metastases?
Symptomatic complications: Haemoptysis, breathlessness, chest pain, dysphagia, seizures, weight loss, lethargy
Clinical signs as a complication: enlarged lymph nodes, finger clubbing
Disease complications: pneumonia, pleural effusion, damage to the recurrent laryngeal nerve, Horner’s syndrome
What is lymphangitis carcinomatosa?
When the lymphatics within the lungs are diffusely involved with the tumour
What are some treatments for lung cancer?
Targeted therapies (based on tumour genomics)
Using immune checkpoint inhibitors
Neo-adjuvant therapy (chemo +/- Immuno therapy before surgery)
Adjuvant therapy (chemo +/- targeted treatments after surgery)
