L8 – Pulmonary–Lung Pathology Flashcards
What is the significance of lung cancer in terms of cancer mortality?
Lung cancer is one of the most common malignancies and accounts for one third of all cancer deaths in males.
What is the general 5-year survival rate for lung cancer in England?
The overall 5-year survival rate is around 16%, with significant differences between subtypes.
How does survival differ between NSCLC and small cell lung cancer?
NSCLC has a 5-year survival rate of approximately 26%, while small cell lung cancer is around 7%.
Which age group is most commonly affected by lung cancer?
Lung cancer most often occurs in individuals aged between 55 and 84 years, peaking between 65 and 74 years.
What are the main subtypes of non-small cell lung cancer (NSCLC)?
NSCLC includes squamous cell carcinoma, adenocarcinoma, large cell undifferentiated carcinoma, and adeno-squamous carcinoma.
How are lung carcinomas classified based on in situ versus invasive disease?
In situ lesions (e.g. adenocarcinoma in situ, squamous cell carcinoma in situ) are confined, while invasive carcinomas breach the basement membrane.
What are the recognised neuroendocrine tumours of the lung?
These include carcinoid tumours, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma.
How does tumour histology influence treatment decisions in lung cancer?
Histological subtype determines the choice of chemotherapy, targeted therapy, and eligibility for immunotherapy.
What is the role of cigarette smoking in lung cancer?
Smoking increases lung cancer risk dramatically, with heavy smokers facing a 20-fold increased risk.
How does asbestos exposure interact with smoking in lung cancer risk?
Asbestos exposure alone increases risk fivefold, but in combination with smoking, the risk can increase 50–90 times.
Which molecular genetic alterations are commonly found in adenocarcinomas?
Common alterations include mutations in EGFR, KRAS, ALK fusions, ROS1 rearrangements, and BRAF mutations.
Why are tumour suppressor gene mutations important in squamous cell carcinoma?
Mutations in TP53 and CDKN2A, along with amplification of FGFR1, are frequently observed and influence tumour behaviour.
What are common presenting symptoms of lung cancer?
Symptoms include cough, weight loss, haemoptysis, and sometimes paraneoplastic syndromes.
What local effects can lung tumours cause?
They may cause airway obstruction leading to pneumonia or lobar collapse, pleural effusions, and invasion of surrounding structures.
How do paraneoplastic syndromes manifest in lung cancer?
They can include ectopic hormone production (e.g. ACTH, ADH) leading to Cushing syndrome or hyponatraemia.
What is the clinical significance of lymph node metastasis in lung cancer?
Lymph node involvement is the strongest predictor of poor survival and guides the staging and treatment approach.
What is the role of tumour mutational burden (TMB) in lung cancer therapy?
A high TMB can predict better responses to immunotherapy by indicating a higher neoantigen load.
How do environmental exposures like radon contribute to lung cancer risk in non-smokers?
Radon gas induces DNA damage, thereby increasing lung cancer risk even in the absence of smoking.
What characteristic imaging features are associated with small cell lung carcinoma?
It often appears as a central mass with mediastinal involvement and may be accompanied by signs of paraneoplastic syndromes.
How is liquid biopsy transforming the management of lung cancer?
It offers a non-invasive method to detect circulating tumour DNA, monitor mutations, and assess treatment response.
What challenges exist in differentiating lung cancer subtypes histologically?
Overlapping morphological features and tumour heterogeneity can complicate the accurate classification of lung carcinomas.
How do targeted therapies revolutionise treatment for NSCLC?
Agents targeting specific mutations (e.g. EGFR, ALK) have significantly improved outcomes for patients with identifiable genetic alterations.
How does the expression of neuroendocrine markers help classify lung cancers?
They differentiate neuroendocrine tumours from other subtypes, aiding in precise diagnosis and appropriate therapy selection.
What is the significance of lung cancer in terms of cancer mortality?
Lung cancer is one of the most common malignancies and accounts for one third of all cancer deaths in males.
What is the general 5-year survival rate for lung cancer in England?
The overall 5-year survival rate is around 16%, with significant differences between subtypes.
How does survival differ between NSCLC and small cell lung cancer?
NSCLC has a 5-year survival rate of approximately 26%, while small cell lung cancer is around 7%.
Which age group is most commonly affected by lung cancer?
Lung cancer most often occurs in individuals aged between 55 and 84 years, peaking between 65 and 74 years.
What are the main subtypes of non-small cell lung cancer (NSCLC)?
NSCLC includes squamous cell carcinoma, adenocarcinoma, large cell undifferentiated carcinoma, and adeno-squamous carcinoma.
How are lung carcinomas classified based on in situ versus invasive disease?
In situ lesions (e.g. adenocarcinoma in situ, squamous cell carcinoma in situ) are confined, while invasive carcinomas breach the basement membrane.
What are the recognised neuroendocrine tumours of the lung?
These include carcinoid tumours, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma.
How does tumour histology influence treatment decisions in lung cancer?
Histological subtype determines the choice of chemotherapy, targeted therapy, and eligibility for immunotherapy.
What is the role of cigarette smoking in lung cancer?
Smoking increases lung cancer risk dramatically, with heavy smokers facing a 20-fold increased risk.
How does asbestos exposure interact with smoking in lung cancer risk?
Asbestos exposure alone increases risk fivefold, but in combination with smoking, the risk can increase 50–90 times.
Which molecular genetic alterations are commonly found in adenocarcinomas?
Common alterations include mutations in EGFR, KRAS, ALK fusions, ROS1 rearrangements, and BRAF mutations.
Why are tumour suppressor gene mutations important in squamous cell carcinoma?
Mutations in TP53 and CDKN2A, along with amplification of FGFR1, are frequently observed and influence tumour behaviour.
What are common presenting symptoms of lung cancer?
Symptoms include cough, weight loss, haemoptysis, and sometimes paraneoplastic syndromes.
What local effects can lung tumours cause?
They may cause airway obstruction leading to pneumonia or lobar collapse, pleural effusions, and invasion of surrounding structures.
How do paraneoplastic syndromes manifest in lung cancer?
They can include ectopic hormone production (e.g. ACTH, ADH) leading to Cushing syndrome or hyponatraemia.
What is the clinical significance of lymph node metastasis in lung cancer?
Lymph node involvement is the strongest predictor of poor survival and guides the staging and treatment approach.
What is the role of tumour mutational burden (TMB) in lung cancer therapy?
A high TMB can predict better responses to immunotherapy by indicating a higher neoantigen load.
How do environmental exposures like radon contribute to lung cancer risk in non-smokers?
Radon gas induces DNA damage, thereby increasing lung cancer risk even in the absence of smoking.
What characteristic imaging features are associated with small cell lung carcinoma?
It often appears as a central mass with mediastinal involvement and may be accompanied by signs of paraneoplastic syndromes.
How is liquid biopsy transforming the management of lung cancer?
It offers a non-invasive method to detect circulating tumour DNA, monitor mutations, and assess treatment response.
What challenges exist in differentiating lung cancer subtypes histologically?
Overlapping morphological features and tumour heterogeneity can complicate the accurate classification of lung carcinomas.
How do targeted therapies revolutionise treatment for NSCLC?
Agents targeting specific mutations (e.g. EGFR, ALK) have significantly improved outcomes for patients with identifiable genetic alterations.
How does the expression of neuroendocrine markers help classify lung cancers?
They differentiate neuroendocrine tumours from other subtypes, aiding in precise diagnosis and appropriate therapy selection.
