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Respiratory Pathophys > lung cancer > Flashcards

lung cancer Flashcards

1
Q

Is nicotine a carcinogen?

A

no

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2
Q

What is the second most common cause of lung cancer?

A

radon! alpha particles damage tissue and induce cancer

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3
Q

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

A

female mortality is increasing where men is decreasing

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4
Q

What are the main features of small cell carcinoma?

A
  • CENTRAL
  • fast
  • don’t cavitate
  • most distal spread of cancers
  • good response to therapy but does not last
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5
Q

main features of squamous cell carcinoma

A
  • CENTRAl
  • cavitate often
  • spread to hilum
  • poor response to therapy
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6
Q

main features of adenocarcinoma?

A
  • peripheral
  • do not cavitate
  • spread pleural and chest wall
  • poor response to therapy
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7
Q

Main features of bronchoalveolar cell carcinoma?

A
  • SLOW growing
  • elderly
  • mistakenly diagnosed as pneumonia
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8
Q

Main features of large cell carcinoma?

A
  • very UNdifferentiated
  • present as large mass
  • worse prognosis of non-small cell cancer
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9
Q

What is pancoast syndrome?

A

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

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10
Q

What cancer has endocrinopathies most often?

A

oat/small cell

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11
Q

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

A

squamous

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12
Q

what cancer has neuromuscular symptoms most often?

A

oat cell

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13
Q

What type of cancer never gets surgery?

A

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

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14
Q

What percentage of lung cancer is considered resectable at diagnosis?

A

30%

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15
Q

What is the 5-year survival rate with surgery?

A

30%

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16
Q

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

A

13%

17
Q

what defines primary lung cancers?

A

malignant tumors of epithelial origin

18
Q

what is the most common histotype of lung cancer?

A

adenocarcinoma

19
Q

what histotypes of lung cancer highest association with cigarette smoking?

A

squamous and small cell

20
Q

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

A

adenocarcinoma (followed by large cell)

21
Q

Which lung cancers present centrally?

A

Squamous and Small cell

22
Q

Which cancers present peripherally?

A

Large cell and ACA

23
Q

SqCC and SCC predominantly arise from what cells?

A

respiratory mucosa of main or lobar bronchi

24
Q

Aca arises from what cell type?

A

bronchioles and terminal alveolar units

25
Q

which cancer has highest proliferative rate?

A

small cell… so, most responsive to chemotherapy

26
Q

How do you identify atypical adenomatous hyperplasia?

A

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

27
Q

How do you differentiate Adenocarcinoma In SItu from AAH?

A

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)

28
Q

What sets apart Aca from AIS and AAH?

A

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

29
Q

Whats the deal with molecular alterations in lung cancers?

A

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

30
Q

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

A

Aca in non-smokers

31
Q

what has the highest sensitivity for detecting peripheral lesions?

A

trans-thoracic aspiration

32
Q

what has the highest sensitivity for detecting central lesions?

A

sputum cytology

33
Q

what unique features define SqCC?

A

shows squamous differentiation with keratinization and intercellular bridges

34
Q

what features define small cell carcinoma?

A

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

35
Q

what is a carcinoid tumor?

A

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

36
Q

what are atypical carcinoids

A

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

Respiratory Pathophys (12 decks)

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