lung cancer

Question 1

Is nicotine a carcinogen?

Answer 1

no

Question 2

What is the second most common cause of lung cancer?

Answer 2

radon! alpha particles damage tissue and induce cancer

Question 3

Whats the difference between male and female lung cancer mortality rates?

Answer 3

female mortality is increasing where men is decreasing

Question 4

What are the main features of small cell carcinoma?

Answer 4

• CENTRAL
• fast
• don’t cavitate
• most distal spread of cancers
• good response to therapy but does not last

Question 5

main features of squamous cell carcinoma

Answer 5

• CENTRAl
• cavitate often
• spread to hilum
• poor response to therapy

Question 6

main features of adenocarcinoma?

Answer 6

• peripheral
• do not cavitate
• spread pleural and chest wall
• poor response to therapy

Question 7

Main features of bronchoalveolar cell carcinoma?

Answer 7

• SLOW growing
• elderly
• mistakenly diagnosed as pneumonia

Question 8

Main features of large cell carcinoma?

Answer 8

• very UNdifferentiated
• present as large mass
• worse prognosis of non-small cell cancer

Question 9

What is pancoast syndrome?

Answer 9

apical lung tumor invades pleural, chest wall, destroys bone, brachial plexus (shoulder and back pain, ipsilateral horners syndrome)

Question 10

What cancer has endocrinopathies most often?

Answer 10

oat/small cell

Question 11

what type of cancer causes excess PTH secretion leading to hypercalcemia?

Answer 11

squamous

Question 12

what cancer has neuromuscular symptoms most often?

Answer 12

oat cell

Question 13

What type of cancer never gets surgery?

Answer 13

small cell because most often has distant spread at diagnosis so surgery is not curative

Question 14

What percentage of lung cancer is considered resectable at diagnosis?

Answer 14

30%

Question 15

What is the 5-year survival rate with surgery?

Answer 15

30%

Question 16

What is the overall 5-year survival rate for lung cancer?

Answer 16

13%

Question 17

what defines primary lung cancers?

Answer 17

malignant tumors of epithelial origin

Question 18

what is the most common histotype of lung cancer?

Answer 18

adenocarcinoma

Question 19

what histotypes of lung cancer highest association with cigarette smoking?

Answer 19

squamous and small cell

Question 20

What is the most common histotype of lung cancer in non smokers?

Answer 20

adenocarcinoma (followed by large cell)

Question 21

Which lung cancers present centrally?

Answer 21

Squamous and Small cell

Question 22

Which cancers present peripherally?

Answer 22

Large cell and ACA

Question 23

SqCC and SCC predominantly arise from what cells?

Answer 23

respiratory mucosa of main or lobar bronchi

Question 24

Aca arises from what cell type?

Answer 24

bronchioles and terminal alveolar units

Question 25

which cancer has highest proliferative rate?

Answer 25

small cell... so, most responsive to chemotherapy

Question 26

How do you identify atypical adenomatous hyperplasia?

Answer 26

increase in number and cytological grade of alveolar lining pneumocytes, alveolar septa thickens second to fibrosis

Question 27

How do you differentiate Adenocarcinoma In SItu from AAH?

Answer 27

FURTHER increase in septal fibrosis and cytological atypia | AND extent of lung involvement is by definition between 5 mm and 3 cm (rather than only microscopic foci)

Question 28

What sets apart Aca from AIS and AAH?

Answer 28

progressive destruction and remodeling of alveolar outline AND invasion of the speta

Question 29

Whats the deal with molecular alterations in lung cancers?

Answer 29

different lung cancer histotypes and molecular signatures further characterize smoking related vs non smoking related cancers. groupings exist!!

Question 30

in what type of cancer are EGFR mutations most commonly seen?

Answer 30

Aca in non-smokers

Question 31

what has the highest sensitivity for detecting peripheral lesions?

Answer 31

trans-thoracic aspiration

Question 32

what has the highest sensitivity for detecting central lesions?

Answer 32

sputum cytology

Question 33

what unique features define SqCC?

Answer 33

shows squamous differentiation with keratinization and intercellular bridges

Question 34

what features define small cell carcinoma?

Answer 34

small sized cells with higher proliferative and apoptotic rates, high N/C ratio, fine chromatin, crush artifact, NESTS!!

Question 35

what is a carcinoid tumor?

Answer 35

tumor with neuroendocrine features by histological (nested pattern, high vascularity), cytological (finely dispersed chromatin). low proliferative rate, no necrosis. very good prognosis

Question 36

what are atypical carcinoids

Answer 36

tumors with carcinoid morphology but with either increased mitotic rate OR necrosis. higher incidence of lymph node metastases.