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ELM2 - pathology > lecture 8/tutorial 10 - lung cancer > Flashcards

lecture 8/tutorial 10 - lung cancer Flashcards

1
Q

What are some of the risk factors for lung cancer?

A

Cigarette smoking/second hand smoke, radon gas, asbestos, genetics

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2
Q

What are the 2 key types of lung cancer?

A

Small cell carcinoma, non-small cell carcinoma

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3
Q

What type of lung cancer accounts for 15 % of cases but is highly malignant?

A

Small cell carcinoma

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4
Q

What type of lung cancer accounts for 85% of cases but is only moderately malignant?

A

Non-small cell carcinoma

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5
Q

What are the 3 sub-types of non-small cell lung carcinoma?

A

Large cell carcinoma, adenocarcinoma, squamous cell carcinoma

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6
Q

What is transformation, in terms of cancer development?

A

A genetic mutation or epigenetic event that alters mechanisms that control cell growth, proliferation or survival.

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7
Q

What are some of the mechanisms that malignant cells must evade/adapt to to survive?

A

become insensitive to growth-inhibitory signals, evade apoptosis, sustain angiogenesis, avoid immune cell destruction

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8
Q

What is the term for a benign mesenchymal tumor of fibroblasts?

A

Fibroma

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9
Q

What is the term for a benign mesenchymal tumor of cartilage cells?

A

Chondroma

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10
Q

What is the term for a benign mesenchymal tumor of fat cells?

A

lipoma

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11
Q

What is the term for a benign mesenchymal tumor of osteoblasts?

A

Osteoma

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12
Q

What is the term for a benign epithelial tumor of glands?

A

Adenoma

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13
Q

What is the term for a benign epithelial tumor forming a projection on a mucosal surface?

A

Polyp

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14
Q

What is the term for a benign epithelial tumor with finger-like projections from the epithelial surface?

A

Papilloma

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15
Q

What is the term for a malignant mesenchymal tumor?

A

Sarcoma

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16
Q

What is the term for a malignant epithelial tumor?

A

Carcinoma

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17
Q

What is a teratoma?

A

A tumor that contains tissues from multiple embryonic germ cell types and arises in the ovaries or testes.

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18
Q

How can differentiation be used to determine the difference between a benign and malignant tumor?

A

Benign tumors are well differentiation and malignant tumors are anaplastic/poorly differentiated.

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19
Q

What are some of the morphological hallmarks of cellular anaplasia?

A
  • pleomorphism (cells all have different shapes)
  • hyperchromatic nuclei
  • prominent nucleoli
  • mitoses (actively proliferating cells)
  • tumor giant cells
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20
Q

What is a low grade tumor?

A

A well differentiated, less aggressive tumor

21
Q

What is a high grade tumour?

A

A poorly differentiated, aggressive tumor

22
Q

What is a carcinoma insitu?

A

When there is high grade dysplasia affected the entire thickness of an area of epithelium, but the invasion has not yet invaded through the basement membrane

23
Q

What is the difference between benign and malignant tumors in terms of their rate of growth?

A

Benign tumors grow more slowly that malignant tumors.

24
Q

What process will immediately mark a tumor as malignant not benign?

A

Metastasis

25
Q

What are the components of the TNM staging system for cancer?

A
  • T: size/extentof tumour
  • N: spread to regional lymphnodes
  • M: presence/absence of metastasis
26
Q

What are the possible classifications of the primary tumor (T) in TNM staging?

A

T1, T2, T3, T4

27
Q

What are the possible classifications of regional lymphnodes (N) in TNM staging?

A

Nx, N0, N1, N2, N3

28
Q

What are the possible classification of metastasis (M) in TNM staging?

A

Mx, M0, M1

29
Q

What is the gross morphology of a lung carcinoma?

A

grey-white, firm tumor, often speckled with anthracosis if patient was a smoker.

30
Q

What type of lung cancers are typically related to the main or lobar bronchi?

A

Squamous or small cell carinomas

31
Q

What lung cancer is typically found peripheral to the bronchi, under the pleura?

A

Adenocarinoma, large cell carcinoma (though can be hilar too)

32
Q

What is the growth pattern of a small cell lung carcinoma?

A

Grows along the bronchial wall and infiltrate hilar lymphnodes - overall hilar location

33
Q

What is the growth pattern of squamous cell lung carcinoma?

A

Arises from the main bronchi and infiltrates adjacent lung tissue

34
Q

What is the growth pattern of large cell lung carcinoma?

A

Variable -can grow peripherally or centrally

35
Q

What are histological features of a lung adenocarcinoma?

A

Glandular appearance, often with mucus secretion. May be a central region with a collagenous scar Found in the periphery so may invade the pleura.

36
Q

What structures can lung cancer invade locally?

A

Chest wall, pleura, nerves, mediastinum, intrapulmonary lymphnodes

37
Q

What are paraneoplastic syndromes?

A

A syndrome that occurs when a tumour produces chemical signalling molecules that act on different parts of the body. Can be endocrine, neurological, skeletal, etc.

38
Q

What are some examples of paraneoplastic syndromes?

A

Hypercalcaemia, Cushing’s syndrome, peripheral neuropathy.

39
Q

What is the size and/or location of a T1 lung carcinoma?

A

Smaller than 3cm across

40
Q

What is the size and/or location of a T2 lung carcinoma?

A

Larger than 3 cm across, but not T3 or T4

41
Q

What is the size and/or location of a T3 lung carcinoma?

A

Within 2 cm of the carina of the tracheal bifurcation

42
Q

What is the size and/or location of a T4 lung carcinoma?

A

Invades into the mediastinum or vertebrae

43
Q

What is the key histological feature of a well differentiated squamous cell lung carcinoma?

A

Keratin pearls, cell nests

44
Q

What is the key histological feature of small cell lung carcinoma?

A

Dark hyper-chromatic nuclei that mould to one another.

45
Q

What are the symptoms of lung cancer?

A

Chest pain, cough, dyspnoea, weight loss

46
Q

What investigations are used in the diagnosis of lung cancer?

A

Chest xray, sputum cytology, MRI/CT, bronchoscopy with biospy.

47
Q

What paraneoplastic syndromes are commonly causes by lung carcinoma?

A

hyponatremia, cushing syndrome, hypercalcemia

48
Q

Which paraneoplastic syndrome is most commonly caused by squamous cell carcinoma?

A

Hypercalcemia

49
Q

Which 2 paraneoplastic syndrome are most commonly caused by small cell carcinoma?

A

Cushing Disease (excess cortisol production), Hyponatremia

ELM2 - pathology (19 decks)

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