Heme/Onc

Question 1

Angiosarcoma

Answer 1

Metastatic disease to lungs results in multiple cystic lesions

Question 2

Lung CA Screening

Answer 2

• No need if diagnostic CT in past year
• 55-80 years
• 30 pack year hx
• Smoking in past 15 years
• Only screen if healthy enough for treatment
  
  • severe COPD not candidate
• 1.38 over diagnosed for every death averted
• 2.5% patients with nodules had biopsies
• 10x radiation of PA/Lat CXR

Question 3

Ground Glass Nodules

Answer 3

Should be followed for any size
Follow for 5 years
Unlikely to spread to nodes within first year
Likely adeno in situ 
PET not sensitive
Low yield from biopsy

Question 4

Pulmonary Tumor Thrombotic Microangiopathy

Answer 4

• Confirmed with lung biopsy
• Tumor emboli within pulmonary vasculature surrounded by fibrin
• most common malignancy if gastric adeno

Question 5

Bronchogenic Cyst

Answer 5

• Resect with VATS when found
• will likely enlarge
• ## most common cystic finding in mediastinum

Question 6

Malignant Pleural Effusion

Answer 6

• low pH
• low glucose
• both predict unsuccessful pleurodesis

Question 7

Diffuse Idiopathic Pulmonary Neuroendocrine Hyperplasia (DIPNECH)

Answer 7

• may be precursor to carcinoid
• nodules with air trapping
• chromogranin stain positive
• middle age, female, non smokers
• does not cause carcinoid syndrome
• does not metastasize
• observe