Lung Cancer

Question 1

Squamous Cell Carcinoma

Answer 1

p53 highest frequency of all lung cancers
Rb1
EGFR overexpression
deletions of 3p, 9p, 17p

Question 2

Adenocarcinoma

Answer 2

produce TTF-1 and mucin
KRAS mutations = poorer outcome
EGFR (targeted therapy)
similar frequency as p53, Rb1, p16

Question 3

Bronchoalveolar Carcinoma (Adenocarcinoma In Situ)

Answer 3

dysplastic cells growing along alveolar septa

lepidic growth, histologically looks like thickened alveolar walls

Question 4

3 big papillary cancers?

Answer 4

bladder thyroid ovary

Question 5

3 less common papillary cancers?

Answer 5

liver lung colon

Question 6

Small Cell Carcinoma (Oat Cell)

Answer 6

SUBmucosal, central.
Squamous was central & mucosal.
mutations of p53, Rb1
HIGH LEVELS of ANTI-APOPTOTIC PROTEIN BCL2!

Question 7

Adenocarcinoma Subtypes

Answer 7

2 subtypes:
Mucinous- spread aerogenously, satellite tumors form when patient coughs, WORSE. (mucinous is BETTER in colon)
Non-Mucinous- solitary

Question 8

neuroendocrine markers

Answer 8

chromogranin, synaptophysin, CD57

Question 9

oncogenes of lung cancer

Answer 9

C-MYC, KRAS, EGFR, c-MET, c-KIT

Question 10

multiple loci on chromosome 3p

Answer 10

many candidate tumor repressor genes, FHIT, RASSF1A and others

Question 11

tumor suppressor genes

Answer 11

p53, Rb1, p16 (INK4a)

Question 12

field cancerization

Answer 12

loss of chromosome 3p material found in benign bronchial epithelium of individuals with lung cancer

Question 13

synchronous primaries

Answer 13

2 primary cancers that occur at the same time

Question 14

metachronous primaries

Answer 14

2 primary cancers that occur at separate times

Question 15

lung cancer in NON-smokers

Answer 15

EGFR mutations

rare KRAS, p53 mutations

Question 16

Locations?

Answer 16

Adeno = subpleural
Oat Cell = submucosal
Squamous Cell = mucosal

Question 17

combined carcinoma

Answer 17

1 cell gave rise– NOT a collision carcinoma

Question 18

systemic manifestatiosn

Answer 18

lambert eaton
acanthosis nigricans
peripheral neuropathies (sensory)
hypertrophic osteoarthritis
clubbing of fingers

Question 19

Carcinoid tumors

Answer 19

well-behaved neuroendocrine tumors 
near MAINSTEM bronchus
submucosal
organoid with delicate fibrivascular stroma
flushing, diarrhea, cyanosis

common in lungs, GI, appendix

Question 20

Anterior Mediastinum

Answer 20

thymoma
teratoma
lymphoma
thyroid/parathyroid
mestastatic carcinoma

Question 21

Posterior Mediastinum

Answer 21

neurogenic (Schwannoma, neurofibroma)
lymphoma
metastatic
bronchogenic cyst
hernia (gastroenteric)

Question 22

Middle Mediastinum

Answer 22

bronchogenic cyst
pericardial cyst
lymphoma

Question 23

Fibrinous exudations

Answer 23

reflect later, more severe exudative reaction that in an earlier development phase might have presented as a serous or serofibrinous exudate

Question 24

Malignant Mesotheliomas

Answer 24

Acid mucopolysaccharide +
CEA -
CK +