EXAM #2: PATHOLOGY OF THE LUNG Flashcards

1
Q

What are the most common malignant lesions of the lung?

A

Metastasis from a different organs to the lung

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2
Q

What is the most common BENIGN lesion of the lung?

A

Granuloma i.e.

  • TB
  • Fungus (Histoplasmosis)
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3
Q

What are the most common sites that metastesize to the lung?

A

1) Breast
2) Stomach
3) Pancreas
4) Colon

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4
Q

How do mets to the lung appear?

A

Multiple “cannonball” lesions

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5
Q

How does a pulmonary hamartoma appear on imaging?

A

“Coin lesion”

*This is a benign lesion of normal lung tissue (and cartilage) that is disorganized)

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6
Q

What are the vast majority of primary lung tumors?

A

Carcinoma i.e. neoplasia arising from the epithelium

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7
Q

What are the top four causes of pleural exudate?

A

1) Microbial invasion
2) Cancer*
3) Pulmonary infarction
4) Viral pleuritis

Especially if “blood-tinged exudate”

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8
Q

What is Lambert Eaton Syndrome?

A

Muscle weakness due to autoantibodies vs. Ca++ channels on motor end plates

Note that this is differentiated from myasthenia gravis in that it gets BETTER with activity

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9
Q

What type of lung cancer causes the majority of paraneoplastic sydromes?

A

Small cell lung cancer (neuroendocrine)

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10
Q

What lung cancer is hypercalcemia most commonly associated with?

A

Squamous cell carcinoma

*B/c is produces PTHrP

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11
Q

What are the sequelae of a Pancoast tumor?

A

1) Horner Syndrome
2) Brachial plexus dysfunction

*This is a tumor, typically of squamous cell etiology, that is located in the apex of the lung

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12
Q

Aside from smoking, what other exposures are associated with lung cancer?

A

1) Asbestos
2) Industrial hazards
3) Aromatic hydrocarbons

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13
Q

What are the four major types of lung cancer?

A

NSCLC:

1) Adenocarcinoma
2) Squamous cell carcinoma
3) Large cell carcinoma

4) Small cell carcinoma

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14
Q

What is never indicated for small cell lung cancer?

A

Surgery

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15
Q

What is the most common type of lung cancer?

A

Adenocarcinoma i.e. glandular

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16
Q

What gene mutations are associated with adenocarcinoma? What are these three mutations associated with?

A

1) KRAS in smokers
2) EGFR in individuals of Asian descent
3) ALK (anaplastic lymphoma kinase) in nonsmokers and younger patients

17
Q

Where does adenocarcinoma typically develop?

A

Periphery i.e. most common to involve the pleura

18
Q

What are the two forms of adenocarcinoma?

A

1) Bronchial

2) Bronchioalveolar

19
Q

What is unique about bronchioalveolar adenocarcinoma (BAC)?

A
  • Uncommon but best prognosis

- Cancer grows on walls of alveoli and bronchioles

20
Q

What does BAC arise from?

A

Bronchioalveolar stem cells

21
Q

Describe the progression of SCC.

A

1) Metaplasia
2) Dysplasia
3) CIS
4) Invasive carcinoma

22
Q

What genetic mutations are associated with SCC?

A
  • p53

- EGFR

23
Q

Histologically, what is pathognomonic for SCC?

A

Keratin pearls and intercellular bridges

24
Q

What mutations are associated small cell lung cancer?

A
  • c-MYC

- Rb1

25
What is the treatment of choice for small cell lung cancer?
Chemotherapy
26
What histological finding is pathognomonic for small cell carcinoma?
"Oat cell carcinoma"
27
Where does small cell carcinoma arise?
Centrally
28
How is the diagnosis of large cell carcinoma described?
Diagnosis of exclusion
29
How are the large cells in large cell carcinoma described?
Undifferentiated i.e. no mucin, no glands, no keratin pearls...etc.
30
What are the concerning staging elements for lung cancer?
1) Larger than 3cm 2) Invasion of adjacent structures 3) Contralateral lymph nodes *Also, note that Mets= stage 4
31
What are the most common sites of metastases of primary lung cancer?
1) LN 2) Adrenal gland 3) Liver 4) Brain 5) Bone
32
What causes carcinoid syndrome? What are the symptoms?
5-HT secretion from a carcinoid tumor causing: 1) Diarrhea 2) Flushing 3) Bronchoconstriction 4) Cyanosis
33
What are the major benign and malignant pleural tumors?
Benign= fibroma--most made up of collagen Malignant= mesothelioma