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Pathology > LUNG 3 2024 > Flashcards

LUNG 3 2024 Flashcards

1
Q

Recall that many chemicals (procarcinogens) are

converted into carcinogens via activation by

A

highly polymorphic P-450 monooxygenase

enzyme system

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2
Q

Asbestos

The latent period before the development
of lung cancer

A

10-30 yrs

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3
Q

Cancers in nonsmokers are more likely to have

_______ and almost never have_______;

A

EGFR mutations; KRAS

mutations

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4
Q

Preceded by atypical proliferation of terminal

bronchiolar epithelium

A

pulmonary fibrosis

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5
Q

Most common cause of granuloma

A

tuberculolus infection

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6
Q

Most occur in _____because of more air. M. tuberculosis thrive well in
aerated environment

A

upper lobe

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7
Q

o Stains that can tell us that the tumor is
epithelial in origin
o Carcinomas are generally positive for

A

keratins (adenocarcinomas, squamous cell carcinomas, small cell carcinomas)

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8
Q 
o Positive for MAJORITY of 
adenocarcinomas of the lungs
o Positive also in the thyroid tissue
normally
o Positive in obviously malignant lesion 
forming glands in the lungs
Most adenocarcinomas PRIMARY to the 
lungs is usually positive for \_\_\_\_\_\_\_\_
A

TTF-1

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9
Q

Sometimes since it can also be positive for thyroid tumors metastasizing to the
lungs, if you have history of thyroid cancer in the patient and you need to rule out metastasis coming from the thyroid, you have to do ________

A

NAPSIN A

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10
Q

o Markers for squamous differentiation

A

p63 and P40

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11
Q

dx where you

cannot really tell whether they are adenocarcinoma or squamous cell carcinoma;

A

Waste basket diagnosis

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12
Q

Other markers that could be used to differentiate
the different common histologic variants of
pulmonary carcinoma

A

TTF-1, CD56. CK5/6 34BE12

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13
Q

adenocarcinoma types:

A

Mucin secreting
Micropapillary pattern
Lepidic pattern

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14
Q

A positive TTF-1 and a negative CK5/6

A

most

likely an adenocarcinoma primary to the lungs

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15
Q

General marker for adenocarcinoma,
not automatically primary to the lungs, adjunct
marker if you do not have more specific TTF-1 or
napsin (not always available)

A

34βE12

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16
Q

o It is present in the cytoplasm of Type II
pneumocytes and alveolar macrophages
o Highly sensitive marker for
adenocarcinomas of the lungs (around 80%)
o It is also seen in other adenocarcinomas like
renal cell carcinomas and variants of
papillary thyroid carcinomas

A

Napsin A

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17
Q

 Less specific and can be seen staining
some of the adenocarcinomas
 Not usually strong and diffused
PATHO20: LUNG 3.1 (Pulmonary Tumors)
5
Group#14: CANONO, P.T., MULLA, S., TUMALA, R.J., UDARBE, K.M., VILLANUEVA, A.L., VILLARBA, A.L., VITAL, C.N.
LECTURE ¦ BOOK ¦ RECORDING ¦ TRIVIA/FACTS ¦ OLD TRANSES ¦ EMPHASIS
 If there is a problem with this, it is
combined with CK5/6

A

p63

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18
Q

markers for small cell carcinoma

A

TTF-1, CD56

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19
Q

OTHER MARKERS FOR NEUROENDOCRINE

DIFFERENTIATION

A

 SYNAPTOPHYSIN & CHROMOGRANIN

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20
Q

Grown significantly (bronchus obstruction) →
atelectatic lung/lobe (depends on the
involvement) → pneumonic process = pain,
sputum production → later stages =

A

weight loss

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21
Q

is a pain
experienced in the distribution in the
ulnar nerve

A

Pancoast tumor

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22
Q

tumor type of cushing syndrome

A

small cell, carcinoid

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23
Q

tumor type of hypercalcemia

A

squamous cell carcinoma

24
Q 
Antidiuretic hormone (ADH), inducing  \_\_\_\_\_\_\_\_due to inappropriate ADH 
secretion
A

hyponatremia

25
Q

Adrenocorticotropic hormone

(ACTH), producing

A

cushing syndrome

26
Q

Parathormone, parathyroid
hormone-related peptide,
prostaglandin E, and some
cytokines, all implicated in the

A

hypercalcemia often seen with lung

cancer

27
Q

muscle weakness is
caused by autoantibodies (possibly elicited by
tumor ionic channels) directed to the neuronal
calcium channel

A

LAMBERT-EATON MYASTHENIC

SYNDROME

28
Q

Dermatologic abnormalities, including

A

ACANTHOSIS NIGRICANS

29
Q

Hematologic abnormalities, such as

A

Leukemoid reactions

30
Q

Hypercoagulable states, such

A

s Trousseau
syndrome (deep vein thrombosis and
thromboembolism)

31
Q

A peculiar abnormality of connective tissue called

A

hypertrophic pulmonary osteoarthropathy,

associated with clubbing of the fingers

32
Q

tumor classification percentage:

adenocarcinoma

A

50%

33
Q

tumor classification percentage:

Squamous cell carcinoma

A

20%

34
Q

tumor classification percentage:

small cell carcinoma

A

15%

35
Q

tumor classification percentage:

large cell carcinoma

A

2% (outside the umbrella of neuroendocrine tumors

36
Q

very poorly
differentiated carcinoma that usually assume
a sarcomatoid feature

A

sarcomatoid carcinoma

37
Q

squamous + adenocarcinoma

A

14%

38
Q

small cell + squamous cell

A

5%

39
Q

are those that retain
basaloid features instead of producing
the squamous features

A

are those that retain
basaloid features instead of producing
the squamous features

40
Q

are difficult to
differentiate with small cell carcinoma
because they do not form the keratin.

A

nonkeratinizing

41
Q

For neuroendocrine tumors, there are

A 
o Small cell carcinomas
o Combination of small cell and medium 
cell and even the large cell type
o Large cell neuroendocrine carcinoma
o Carcinoid tumor (typical and atypical)
42
Q

Compared with squamous cell cancers, these lesions
are usually more peripherally located and tend to be
smaller.

A

adenocarcinoma

43
Q

Adenocarcinomas grow in various patterns, including

A

acinar, lepidic, papillary, micropapillary, and

solid.

44
Q

In the poorly differentiated forms, this is where

difficulty in differentiating ______________ occur

A

Squamous Cell

Carcinomas

45
Q

sometimes are
very well-differentiated that they assume/form
just like your alveoli which we call

A

Lepidic type

of Carcinoma.

46
Q

very typical adenocarcinoma wherein you
have irregular glandular structures and
angulations of the glands which means that we
have

A

invasion of the stroma.

47
Q

a protein first identified in the thyroid that

is required for normal lung development.

A

Thyroid Transcription Factor 1

48
Q

o To differentiate Primary Pulmonary
Adenocarcinoma from a Metastatic Colonic
Adenocarcinoma, we usually use

A

CDX2

49
Q

CDX2 (-) for

A

Primary pulmonary adenocarcinoma

50
Q

CDX2(+) for

A

metastatic colonic adenocarcinoma

51
Q

variant where the major tumor
component consists of solid sheets and lacks other
recognizable patterns of adenocarcinoma such as
lepidic, acinar, papillary, or micropapillary
growth.

A

solid

52
Q

solid adenocarcinoma are mostly positive for

A

TTF1 and Napsin

53
Q

commonly in the form of point
mutations and homozygous deletions are seen in
50% of cases.

A

TP53 Mutations

54
Q

KRAS and EGFR Mutations are also important in

A

atypical and adenomatous hyperplasia

55
Q

EGFR Mutations are mutually exclusive of KRAS

mutations and occur significantly higher in:

A

 Adenocarcinomas from east Asians rather
than non-Asians;
 In women than in men;
 In never-smokers than ever-smokers.

56
Q

occur in never-smokers or light-smokers, in younger
patients and in patients that lack mutations of EGFR,
KRAS and TP53.

A

ALK translocation

Pathology (31 decks)

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