Intrathoracic Malignancy Flashcards
State some risk factors for Lung Malignancy
- Smoking tobacco
- Radon gas
- Asbestos
- Air pollution
- CXR and CT scans
What are the five main types of Lung Malignancy and how are they categorised?
- Small cell carcinomas
- Non-small call carcinomas
2a. Adenocarcinomas
2b. Squamous cell carcinomas
2c. Carcinoid tumours
2d. Large cell carcinomas
Which are more common; Small cell carcinomas or Non-small cell carcinomas?
Non-small cell carcinomas
In Small cell carcinomas, what genes are inactivated?
RB1 and TP53
In Non-small cell adenocarcinomas, what genes are inactivated?
EGFR, KRAS, BRAF, ALK etc.
Small cell carcinomas are derived from what cell type?
Immature neuro-endocrine cells
What are some secondary sites of primary tumour metastasis
- Mediastinum & Hilar lymph nodes
- Lung pleura
- Heart
- Breasts
- Liver
- Adrenal glands
- Brains
- Bones
Cancers which cause a patient to develop a hoarse voice are due to damage to what structure?
Recurrent Laryngeal Nerve
Cancers which cause a patient to have difficulty breathing are due to damage of what structure?
Phrenic Nerve
Cancers which cause a patient to exhibit facial swelling is due to the cancer pressing on what structure?
Superior Vena Cava
Most Pancoast tumours are what lung cancer type?
Non-small cell type (Adenocarcinomas and Squamous cell carcinomas)
Where are Pancoast tumours located?
Apex of lung
Which non-small cell lung cancer is derived from mature neuroendocrine cells?
Carcinoid tumours
Para-neoplastic syndrome is common in what lung cancer types?
- Small cell cancer
- Squamous cell cancer (non-small)
Outline the effects of Cortisol Para-neoplastic syndrome
Increased production of Cortisol, leading to Cushing’s syndrome. Causes increased blood glucose and blood pressure
Outline the effects of ADH Para-neoplastic syndrome
Increased production of ADH, leading to increased water retention, increased blood pressure and increased oedema
Outline the Lambert-Eaton Myesthenic Para-neoplastic syndrome
Production of auto-antibodies against Voltage gated Calcium channels
Outline the PTH Para-neopastic Syndrome
Increased release of PTH, causing bone resorption and release of calcium into the blood (Hypercalcaemia)
What is the treatment plan for Small cell carcinomas?
Chemotherapy
What is the treatment plan for Non-small cell carcinomas?
Surgery first, followed by Radiotherapy or Chemotherapy
In Adenocarcinomas non-small cell carcinomas, histologically what do they look like?
Glandular differentiation, producing mucin
What is the normal histology of the Normal respiratory epithelium?
Psuedostratified cilitated columnar
The production of keratin material is associated with which type of lung cancer?
Non-small cell, squamous cell carcinomas
> 90% of Malignant Mesothelioma is associated with what exposure?
Asbestos
Incidence of Malignant Mesothelioma is expected to peak when?
2020
