Lecture 16 - Lung Cancers

Question 1

Pathogenesis?

Answer 1

progressive transformation of benign bronchial epithelium into neoplasm, molecular changes e.g. 3p deletions, p53 mutations and K-ras mutations

Question 2

Histological classification of primary lung cancer?

Answer 2

cell of origin in lung, molecular differences, clinical and therapeutic implications

Question 3

Clinicopathologic effects of lung cancer?

Answer 3

local effects (cough, dyspnea), local spread (pleural effusion, Horner’s syndrome), mediastinal spread (SVC obstruction, nerve entrapment syndromes), metastatic spread (nodal/extranodal)

Question 4

Paraneoplastic syndromes?

Answer 4

small cell: cushing’s syndrome; non-small cell: hypercalcaemia; finger clubbing

Question 5

Adenocarcinoma vs squamous cell?

Answer 5

typical peripheral origin, non-smoking correlation, gland tissue, often in pleural fibrosis or scars

Question 6

Small cell carcinoma?

Answer 6

smoking link, highly malignant, paraneoplastic syndromes common, haemorrhage and necrosis on cut sheet, highly mitotic

Question 7

Malignant Mesothelioma?

Answer 7

mesothelial cell tumour, asbestos exposure, encases and compresses lung