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CVPR > CVPR Week 5: Basics of lung cancer > Flashcards

CVPR Week 5: Basics of lung cancer Flashcards

1
Q

Histologic classifications of malignant epithelial lung tumors

A

Small cell or Non-small cell

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2
Q

Histological classifications of small cell lung cancer

3 listed

A
  • Classical small cell carcinoma
  • Large cell neuroendocrine
  • Combined
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3
Q

Histological classifications of Non-small cell lung cancer

3 listed

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell carcinoma
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4
Q

Types of adenocarcinoma

A

Bronchoalveolar carcinoma

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5
Q

Adenocarcinoma cancer type

A

Non-small cell lung

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6
Q

Combined cancer type

A

Small cell lung

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7
Q

Large cell neuroendocrine cancer type

A

Small cell lung

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8
Q

Squamous cell carcinoma cancer type

A

Non-small cell lung

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9
Q

Classical small cell carcinoma cancer type

A

Small cell lung cancer

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10
Q

Large cell carcinoma cancer type

A

Non-small cell lung cancer

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11
Q

Bronchoalveolar carcinoma cancer type

A

Adenocarcinoma of Non-small cell lung cancer

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12
Q

Why is this system no longer clinical significant?

A
  • No longer clinically sufficient to only distinguish small cell vs Non-small cell
  • Because a minority of adenocarcinomas will have treatable genetic alterations
  • Therefore it is necessary to know if a given tumor is adenocarcinoma, so molecular testing can be performed
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13
Q

More classifications of malignant epithelial lung tumors

A
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14
Q

Small cell carcinoma: Neuroendocrine differentiation

A

Neuroendocrine differentiation (cells that receive neuronal input and subsequently release hormones)

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15
Q

Non-Small cell carcinoma:

A
  • Squamous cell carcinoma
  • Adenocarcinoma
  • Combined adenosquamous
  • Large cell carcinoma
    • Large cell neuroendocrine carcinoma
    • Large cell non-neuroendocrine carcinoma
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16
Q

Mesothelioma

A

Epithelioid (not truly epithelial)

Derived from visceral/parietal pleura (mesothelial layer)

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17
Q

Small cell carcinoma synonyms

A
  • Small cell neuroendocrine carcinoma
  • “Oat cell” carcinoma (old terminology)
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18
Q

Small cell carcinoma risk factors

A

Highly associated with smoking (“if the patient never smoked, it’s not small cell)

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19
Q

Small cell carcinoma location

A

Usually occurs centrally near large airways

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20
Q

Small cell carcinoma: How is Neuroendocrine differentiation shown?

A
  • Cytoplasmic neurosecretory granules
  • these stain with synaptophysin, chromogranin (immunohistochemical stains)
  • This is how we “prove” the tumor has neuroendocrine differentiation
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21
Q

Small cell carcinoma properties of growth

A
  • grows fast
  • metastisizes early
  • usually late stage at the time of discovery
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22
Q

Small cell carcinoma treatment

A

Treated differently than Non-small cell carcinoma

  • Usually not resectable (can and do resect if low-stage, but usually not detected until late stage)
  • Different chemotherapy regimen (vs. non-small cell carcinoma)
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23
Q

Small cell carcinoma Histological features

6 listed

A

High nuclear:cytoplasmic ratio (scant cytoplasm)

frequent necrosis and mitoses

Crush artifact

+ for synaptophysin

+ for chromogranin (IHC)

  • for squamous cell markers
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24
Q

Identify cancer type and features

5 listed

A

Small cell carcinoma

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25
Q

Small

A
26
Q

Identify cancer type and histological features

6 listed

A

High nuclear:cytoplasmic ratio (scant cytoplasm)

frequent necrosis and mitoses

Crush artifact

+ for synaptophysin

+ for chromogranin (IHC)

  • for squamous cell markers
27
Q

Squamous cell carcinoma risk factors

A

Highly associated with smoking (similar to small cell CA, but association not quite as strong as small cell carcinoma

28
Q

Squamous cell carcinoma location

A

most commonly centrally located around large airways

29
Q

Squamous cell carcinoma histological features

6 listed

A
  • Keratinization (“pink stuff”, keratin “pearls”)
  • Intercellular bridges (can be difficult to see)
  • Abundant, dense cytoplasm
  • No gland formation (unless mixed subtype, e.g. “Adenosquamous carcinoma”)
    • for neuroendocrine markers (Chromo, synapto)
    • for squamous markers
30
Q

What is this?

A

squamous metaplasia

31
Q

Identify cancer type and histological features

6 listed

A

squamous cell carcinoma

  • Keratinization (“pink stuff”, keratin “pearls”)
  • Intercellular bridges (can be difficult to see)
  • Abundant, dense cytoplasm
  • No gland formation (unless mixed subtype, e.g. “Adenosquamous carcinoma”)
    • for neuroendocrine markers (Chromo, synapto)
    • for squamous markers
32
Q

Identify cancer type and histological features

6 listed

A

Squamous cell carcinoma

  • Keratinization (“pink stuff”, keratin “pearls”)
  • Intercellular bridges (can be difficult to see)
  • Abundant, dense cytoplasm
  • No gland formation (unless mixed subtype, e.g. “Adenosquamous carcinoma”)
    • for neuroendocrine markers (Chromo, synapto)
    • for squamous markers
33
Q

Adenocarcinoma Risk factors

3 listed

A
  • Most common cancer in never-smokers
  • Not highly associated with smoking (but smoking does increase risk)
  • Most common lung malignancy in women
34
Q

Adenocarcinoma location

A
  • Usually occurs peripherally (vs small cell and squamous cell which ten to occur centrally)
35
Q

Adenocarcinoma properties of growth

A

Grows slower than squamous cell but metastasizes earlier

36
Q

Adenocarcinoma histological features​

5 listed

A
  • Abundant cytoplasm that is foamy (vs the dense cytoplasm of squamous cell carcinoma) and often contains mucin
  • Will usually show Gland formation
  • Multiple histologic patterns: acinar (gland-forming), papillary, lepidic (bronchioloalveolar), solid
  • Can be challenging to distinguish from a metastasis
  • Primary lung is usually + for TTF-1 (IHC)
37
Q

Adenocarcinoma treatment

2 listed

A
  • Can have treatable molecular aberrations, therefore must distinguish from other non-small cell carcinomas
  • Most common alterations in the genes EGFR and ALK
38
Q

Identify cancer type and histological features

6 listed

A

adenocarcinoma

39
Q

Identify cancer type and histological features

6 listed

A

Adenocarcinoma

40
Q

Mesothelioma caveat

A
  • Not truly epithelial (“epithelioid”) so this is NOT a carcinoma
  • Is derived from the pleura of lung (visceral or parietal)
  • Pleura derived from embryonic mesoderm (epithelial surfaces are derived from embryonic ectoderm)
41
Q

Pleura of the lung embryological origin

A

Pleura derived from embryonic mesoderm (epithelial surfaces are derived from embryonic ectoderm)

42
Q

Mesothelioma derived from

A

Derived from pleura of lung (visceral or parietal)

43
Q

Mesothelioma risk factors

2 listed

A
  • Associated with asbestos exposure
  • Smoking exposure synergistic with asbestos exposure
44
Q

Mesothelioma histological features

A
  • The epithelioid variant can be difficult to distinguish from adenocarcinoma
  • Sarcomatoid variant mimics many types of sarcoma
45
Q

Identify cancer type and histological features

A
46
Q

Identify cancer type and histological features

A
47
Q

Question

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48
Q

Questions

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49
Q

Questions

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50
Q

Questions

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51
Q
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52
Q

Horner syndrome

A
53
Q

Question

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54
Q

Questions

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55
Q

Superior vena cava syndrome

A
56
Q

Question

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57
Q

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58
Q

Question

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59
Q

Question

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60
Q

Lung metastases

A
61
Q

Need to watch lecture cause this PDF sucked

A

CVPR (93 decks)

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