Lecture 7 - Respiratory Neoplasms

Question 1

what cancer is the leading cause of death?

Answer 1

lung carcinomas

Question 2

what is the most common cause of lung carcinoma?

Answer 2

cigarette smoking - 90% lung cancer patients are smokers

Question 3

what is the survival rate of lung carcinoma?

Answer 3

5 years in 10-15% - often incurable

Question 4

what are the probable primary carcinogen of lung carcinomas? and why?

Answer 4

various tobacco chemical in cigarette smoke because they may activate the oncogenes or inhibit/mutate tumor suppressor genes

Question 5

what can carcinogens do to normal cells in vitro?

Answer 5

initiate malignant transformation (increased predisposition in families)

Question 6

what part of the lungs do more tumors originate from?

Answer 6

bronchi

Question 7

what happens to columnar epithelium cells of normal bronchial epithelium as one continues to smoke?

Answer 7

columnar cells undergo squamous metaplasia (chronic exposure), which can progress to carcinoma in situ and invasive squamous cell carcinoma (persistent exposure)

Question 8

name the 2 macroscopic classifications of lung cancers based on location:

Answer 8

hilar (central) - attached to bronchi, into lumen

peripheral (sub pleural) - consolidation of parenchyma

Question 9

what are 2 ways you can see a hilar tumor?

Answer 9

xrays show nodules

bronchoscopy

Question 10

name the 5 microscopic classifications of lung cancer based on histology:

Answer 10

adenocarcinoma (40%)
squamous cell carcinoma (30%)
large-cell undifferentiated carcinoma (10%)
small-cell carcinoma (15%)
carcinoids (5%)

Question 11

what is the survival rate of small-cell carcinoma if not surgically treated?

Answer 11

5%

Question 12

what type of lung cancer involves rare, slow growing tumors with low-grade malignancy?

Answer 12

carcinoid (87% cure rate)

Question 13

what are 3 major clinical features of lung cancer?

Answer 13

bronchial irritation
local extension
systemic symptoms

Question 14

how does bronchial irritation present in terms of lung cancer?

Answer 14

cough (most often)
wheezing
dyspnea
hemoptysis (30%)

Question 15

what does local extension present like in terms of lung cancer?

Answer 15

bronchial obstructions/atelectasis
lung infection
pleural effusion
pain, paralysis of vocal cords and/or diaphragm

Question 16

what are systemic symptoms seen in relation to lung cancer?

Answer 16

weight loss
cachexia (body wasting)
anorexia
asthenia (abnormal weakness/lack of energy)

Question 17

what is more common primary lung tumors or lung metastases from other areas?

Answer 17

lung metastases from other areas

Question 18

what 2 lung regions present with highly malignant lung cancer that tends to metastasize early?

Answer 18

mediastinum

pleural cavity

Question 19

what are 5 areas that primary lung cancers will metastasis to?

Answer 19

liver
brain
bone
kidney
adrenal glands

Question 20

how can metastases to the lung present?

Answer 20

solitary, multiple or diffuse lesions

Question 21

what are the two most important neoplasms of the respiratory tract?

Answer 21

lung cancers and carcinomas of the larynx

Question 22

what are two things that carcinoma of the larynx is pathologically linked to?

Answer 22

smoking

chronic alcohol abuse

Question 23

how many more times are males affected by carcinoma of the larynx than females?

Answer 23

7 times

Question 24

how does carcinoma of the larynx physically present as?

Answer 24

nodules or ulcerations

Question 25

does carcinoma of the larynx metastasize?

Answer 25

yes - initially locally and then later on can go distantly

Question 26

what is the histological classification of carcinomas of the larynx?

Answer 26

squamous cell carcinomas

Question 27

what are 3 symptoms that appear early in carcinoma of the larynx?

Answer 27

hoarseness
loss of voice
stridorous respirations (high-pitched wheezing due to disrupted airflow)

Question 28

what is the 5 year survival rate of someone who receives surgery and radiation for carcinoma of the larynx?

Answer 28

75%