Lung Cancer Flashcards
Squamous Cell Carcinoma
p53 highest frequency of all lung cancers
Rb1
EGFR overexpression
deletions of 3p, 9p, 17p
Adenocarcinoma
produce TTF-1 and mucin
KRAS mutations = poorer outcome
EGFR (targeted therapy)
similar frequency as p53, Rb1, p16
Bronchoalveolar Carcinoma (Adenocarcinoma In Situ)
dysplastic cells growing along alveolar septa
lepidic growth, histologically looks like thickened alveolar walls
3 big papillary cancers?
bladder thyroid ovary
3 less common papillary cancers?
liver lung colon
Small Cell Carcinoma (Oat Cell)
SUBmucosal, central.
Squamous was central & mucosal.
mutations of p53, Rb1
HIGH LEVELS of ANTI-APOPTOTIC PROTEIN BCL2!
Adenocarcinoma Subtypes
2 subtypes:
Mucinous- spread aerogenously, satellite tumors form when patient coughs, WORSE. (mucinous is BETTER in colon)
Non-Mucinous- solitary
neuroendocrine markers
chromogranin, synaptophysin, CD57
oncogenes of lung cancer
C-MYC, KRAS, EGFR, c-MET, c-KIT
multiple loci on chromosome 3p
many candidate tumor repressor genes, FHIT, RASSF1A and others
tumor suppressor genes
p53, Rb1, p16 (INK4a)
field cancerization
loss of chromosome 3p material found in benign bronchial epithelium of individuals with lung cancer
synchronous primaries
2 primary cancers that occur at the same time
metachronous primaries
2 primary cancers that occur at separate times
lung cancer in NON-smokers
EGFR mutations
rare KRAS, p53 mutations
Locations?
Adeno = subpleural
Oat Cell = submucosal
Squamous Cell = mucosal
combined carcinoma
1 cell gave rise– NOT a collision carcinoma
systemic manifestatiosn
lambert eaton acanthosis nigricans peripheral neuropathies (sensory) hypertrophic osteoarthritis clubbing of fingers
Carcinoid tumors
well-behaved neuroendocrine tumors near MAINSTEM bronchus submucosal organoid with delicate fibrivascular stroma flushing, diarrhea, cyanosis
common in lungs, GI, appendix
Anterior Mediastinum
thymoma teratoma lymphoma thyroid/parathyroid mestastatic carcinoma
Posterior Mediastinum
neurogenic (Schwannoma, neurofibroma) lymphoma metastatic bronchogenic cyst hernia (gastroenteric)
Middle Mediastinum
bronchogenic cyst
pericardial cyst
lymphoma
Fibrinous exudations
reflect later, more severe exudative reaction that in an earlier development phase might have presented as a serous or serofibrinous exudate
Malignant Mesotheliomas
Acid mucopolysaccharide +
CEA -
CK +
