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KK RESPII Exam 1 > Gomez - Lung Neoplasia > Flashcards

Gomez - Lung Neoplasia Flashcards

1
Q

What are pulmonary hamartomas?

A

Benign masses in the lung

Composed of disorganized lung tissue and cartilage

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2
Q

Describe pulmonary lymphangioleiomyomatosis (LAM)

A

Proliferation of perivascular epitheliod cells

Usually in young women

Leads to a cystic emphesematous appearance of lung

Often accompanied by uterine neoplasia

Can be associated with tuberous sclerosis

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3
Q

Describe inflammatory myofibroblastic tumors

A

Proliferation of spindle-shaped fibroblasts

Rarely metastasizing

Occurs throughout body

Difficult to surgically resect, and keeps recurring

Associated with anaplastic lymphoma kinase (ALK) gene mutation

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4
Q

What are two important, strong initiators of lung cancer?

A

Polycyclic aromatic hydrocarbons

Nitrosamine

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5
Q

What is a good promotor of lung cancer?

A

Phenol

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6
Q

What populations are at risk for developing lung CA from radon gas?

A

Uranium miners

It has not been conclusively demonstrated that radon accumulation in basements can cause lung CA

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7
Q

Which type of lung CA is least associated with smoking?

A

Adenocarcinoma in situ, aka bronchioloalveolar carcinoma

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8
Q

What is the most common type of lung CA in female smokers?

A

Adenocarcinoma

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9
Q

What is the most common type of lung CA in all smokers?

A

Small cell carcinoma

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10
Q

What is the mnemonic for association between lung CA, location, smoking status, and related symptoms?

A

S sounds:

Small cell/Squamous, Smoker, Central, (paraneoplastic) Syndrome

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11
Q

What is the relationship between mutations in EGFR and KRAS?

A

They are mutually exclusive

Tumor cells that are EGFR(+) will be KRAS(-)

Tumor cells that are EGFR(-) will be KRAS(+)

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12
Q

What mutations are commonly present in squamous cell carcinoma of the lung?

A

del3p

p16 (not mutated in small cell carcinoma)

p53

RB

EGFR

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13
Q

What is true of using EGFR inhibitors to treat lung CA?

A

Can use EGFR inhibitor to treat EGFR(+) adenocarcinoma

Cannot successfully treat squamous cell carcinoma with EGFR inhibitors

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14
Q

Describe the pathogenesis of Pancoast tumors

A

Apical lung tumor

Causes pain in distribution of the ulnar nerve

Affects sympathetic ganglia, resulting in Horner syndrome (ptosis, miosis, anhydrosis)

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15
Q

What paraneoplastic syndrome is most commonly associated with squamous cell carcinoma?

A

Release of parathyroid hormone releasing peptide (PTHrP)

Causes hypercalcemia

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16
Q

What is Trousseau syndrome?

A

Hypercoagulability and thrombophlebits secondary to carcinoma

17
Q

What do adenocarcinomas look like?

A

Glandular tissue

FIbrous hyperplasia surrounding glands

18
Q

What does squamous cell carcinoma look like?

A

Keratinization of cytoplasm

Appearance of intracellular desmosomal bridges

19
Q

What is the precursor lesion for adenocarcinoma?

A

atypical adenomatous hyperplasia

20
Q

What are the characteristics of adenocarcinoma?

A

Tends to be more peripheral

Increased mucin production due to glandular nature of cancer

Positive thyroid transcription factor 1 (TTF1)

21
Q

What are zellballen?

A

Balls of cells with mucious vacuoles

can be found in pts with adenocarcinoma

22
Q

What is the problem with classifying large cell carcinomas?

A

They are so poorly differentiated

Probably a form of squamous cell or adenocarcinoma

Some have neuroendocrine origin

23
Q

Carcinoids and atypical carcinoids are associated with mutation of which tumor suppressor gene?

A

MEN 1

24
Q

What is the typical progression of lung CA metastasis?

A

Mass→regional lymph nodes→hilar lymph nodes→adrenals, liver, brain, bone

25
Q

What is the composition of transudate?

A

Low LDH, low protein, low cholesterol fluid

Seen in CHF, cirrhosis, or nephrotic syndrome

26
Q

What is the composition of exudate?

A

High LDH, high protein, or high cholesterol

Seen with pneumonia, pneumonitis, CA, infarct, autoimmune disorders, lymphatic blockage

27
Q

What types of cancer commonly metastasize to the pleura?

A

Lung and breast

28
Q

What markers are typically expressed by malignant mesotheliomas?

A

Calretenin

Mesothelin

WT-1

29
Q
A

KK RESPII Exam 1 (9 decks)

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