Histopath - lung Flashcards
top 3 cancers in women
Breast, bowel, lung
List 4 types of lung cancer in order of most to least common
Squamous cell
Adenocarcinoma
Small cell
Large cell
SqCC
- Which part of the lung is affected?
- 2 Histological Fx?
- what electrolyte imbalance is often seen?
- Proximal bronchi affected
- Histo: Keratinisation + Intracellular prickles
- Hypercalcemia
Lung adenocarcinoma
- Most common in whom?
- 2 histological Fx?
- Which part of the lung is affected?
- Molecular analysis results?
- Women and non-smokers
- Mucin production + gland formation
- Starts peripherally, early spread
- EGFR mutations seen in molecular analysis
Small cell lung carcinoma
- what cells does it arise from?
- Prognosis? why?
- 2 common mutations seen?
- which weird neuro thing is it associated with?
- Arises from NEUROENDOCRINE cells
- POOR prognosis, due to early mets
- RB1 and p53 mutations
- Assoc with Lambert Eaton syndrome = autoimmune, muscle weakness which improves with testing
What do the cells look like in large cell lung carcinoma/
Large nuclei, prominent nucleoli
Wtf is carcinoid syndrome? Cause?
Flushing + diarrhoea + bronchoconstrictin
Serotonin excess in paraneoplastic syndrome
Which molecular finding indicates a poorer response to cisplatin
ERCC1
Which two molecular findings indicate a poor response to Tyrosine kinase inhibitors in lung cancer?
Kras mutation
EML4-ALK mutation
staging of lung carcinoma?
TNM
T = 1-4, depends on size and invasion
N = 0-2
M = metastases, 0-1
Pneumoconiosis includes 3 different disease.. which ones?
Coal worker’s lung
Asbestosis
Silicosis
Which part of the lung is affected in Coalworker’s lung and asbestosis?
Upper lobe
idiopathic pulmonary fibrosis
- who does it affect?
- what changes are seen in the lung?
- Sx?
- Tends to affect old men
- Fibrosis followed by cyst formation. aka honeycomb change. This starts at the periphery of the lobule, usually in lower lobes
- SOB and dry cough, progressively worsening
What is extrinsic allergic alveolitis?
Immune mediated response to inhaled antigens –> alveolar inflammation
Extrinsic allergic alveoli’s - legs of triggers?
Pigeons, hay, mould
How does EAA present? Both acute and chronic presentation
Acutely - sudden SOB, fever, chills, cough after exposure to antigen
Chronic - only symptomatic at work, improves on the weekends
Coal worker’s lung - which part of lung is affect?
Histology in mild and severe disease?
Upper lobes
Mild = macrophages containing pigment accumulate around airways Severe = Large fibrotic nodules
spirometry findings in restrictive lung disease
Decreased lung volume
Decreased compliance
Both FEV1 and FVC are reduced to same degree
1 major sign on examination in interstitial lung disease
end inspiratory crackles
Pathophysiology of bronchiectasis
Chronic mucus accumulation –> inflammation –> breakdown of elastin in bronchi –.> bronchus dilatation
5 Causes of bronchiectasis
CF Asthma Aspiration Obstruction - eg tumour Secondary to fibrosis - sarcoidosis
3 histological features of asthma
Whorls of shed epithelium
- Curschmann spirals
- Eosinophils
- Leyden crystals
Granulomatous lung infection
- 2 cells seen?
- 2 main causes?
Histiocytes + macrophages
- TB
- Fungal - cryptococcus, aspergillus
4 stages of lobar pneumonia
- Consolidation
- Red hepatisation
- Grey hepatisation
- Resolution
Lobar vs bronchial pneumonia
- affected people?
Lobar = younger Bronchopneumonia = elderly
3 causes of emphysema
Marfan’s
IVDU
a1 antitrypsin deficiency
