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respiratory > Lung cancer > Flashcards

Lung cancer Flashcards

1
Q

leading cause of cancer death

A

lung cancer

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2
Q

MC lung cancer

A

metastasis

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3
Q

lung metastasis is most often from

A
  1. breast 2. colon 3. prostate 4. bladder cancer
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4
Q

sites of metastasis from lung cancer

A
  1. adrenals 2. Brain 3. bone 4. liver
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5
Q

lung cancer metastasis to bone - manifestation

A

pathologic fracture

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6
Q

lung cancer metastasis to liver - manifestation

A
  1. jaundice

2. hepatomegaly

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7
Q

lung cancer - presentation

A
  1. cough 2. hemoptysis 3. bronchial obstruction
  2. wheezing 5. loss of weight 6. anorexia
  3. noncalcified nodule on CT
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8
Q

Lung cancer - complication

A

mnemonic: SPHERE + dysphagia + phrenic nerve paresis - heart or pericardial invasion +pleural invasion
1. Superior vena cava syndrome 2. Pancoast tumor
3. Horner syndrome 4. Endocrine (paraneoplastic)
5. Recurrent laryngeal nerve compression (hoarseness)
6. Effusions (pleural or pericardial)

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9
Q

Lung cancer - risk factors

A
  1. smoking 2. secondhand smoking 3. radon 4. asbestos 5. family history 6. Asbestosis 7. Silicosis
  2. Coal
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10
Q

primary lung cancer - divided to

A
  1. small cell carcinoma

2. Non-small cell

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11
Q

primary lung cancer - types (small or non small?)

A
  1. small cell (oat cell) carcinoma
  2. adenocarcinoma (non-small)
  3. Squamous cell carcinoma (non-small)
  4. Large cell carcinoma (non-small)
  5. Bronchial carcinoid tumor (non-small)
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12
Q

lung small cell (oat cell) carcinoma - location

A

central

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13
Q

lung adenocarcinoma - location

A

peripheral

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14
Q

lung Squamous cell carcinoma - location

A

central

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15
Q

lung Large cell carcinoma - location

A

peripheral

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16
Q

lung metastasis on image

A

usually multiple lesions

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17
Q

bronchial carcinoid tumor - location

A

central or peripheral

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18
Q

lung small cell (oat cell) carcinoma may cause/produce

A
  1. Cushing syndrome (ACTH) 2. SIADH
  2. antibodies against presynapitc Ca2+ channels (Lambert-Eaton myasthenic syndrome)
  3. or neurons (paraneoplastic myelitis/encephalitis, sabacute cerebellar degeneration)
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19
Q

lung small cell (oat cell) carcinoma - manegment

A

inoperable

treat with chemotherapy +/- radiation

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20
Q

lung small cell (oat cell) carcinoma - gene amplification

A

myc oncogenes common

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21
Q

lung small cell (oat cell) carcinoma - aggressiveness

A

very aggressive

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22
Q

lung small cell carcinoma is also called

A

oat cell

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23
Q

lung small cell (oat cell) carcinoma - histology

A
  1. neoplasm of neuroendocrine Kulchitsky cells (small dark blue cells)
  2. chromogranin A positive
  3. undifferentiated (very aggressive)
  4. Neuron specific enolase positive
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24
Q

lung small cell (oat cell) carcinoma - histology positive to

A

chromogranin A

Neuron specific enolase

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25
Q

Kulchitsky cells appearance

A

small dark blue cells

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26
Q

lung squamous cell carcinoma - histology

A

keratin pearls and intercellular bridges

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27
Q

lung squamous cell carcinoma - may cause/produce

A
  1. cavitation

2. hypercalcemia (produce PTHrP

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28
Q

lung squamous cell carcinoma - CXR

A

Hillar mass arising from bronchus

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29
Q

bronchial carcinoid tumor - histology

A

nests of neuroendocrine cells

chromogranin A positive

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30
Q

chromogranin A positive lung tumors

A
  1. bronchial carcinoid tumor

2. lung small cell (oat cell) carcinoma

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31
Q

bronchial carcinoid tumor - prognosis

A

excellent

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32
Q

bronchial carcinoid tumor - metastasis

A

rare

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33
Q

bronchial carcinoid tumor - presentation/symptoms

A
  1. symptoms due to mass effect

2. carcinoid syndrome (flashing, diarrhea, wheezing)

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34
Q

lung Large cell carcinoma can secrete

35
Q

lung Large cell carcinoma - histology

A
  1. β-hCG secretion
  2. pleomorphic giant cells
  3. highly anaplastic undifferentiated tumor
36
Q

lung Large cell carcinoma - prognosis

37
Q

lung Large cell carcinoma - treatment

A
  1. less responsive to chemotherapy

2. remove surgically

38
Q

MC primary lung cancer

A

adenocarcinoma

39
Q

MC lung cancer in non smokers

A

adenocarcinoma

40
Q

lung adenocarcinoma activating mutations

A
  1. KRAS 2. EGFR 3. ALK
41
Q

lung adenocarcinoma is associated with (paraneoplastic)

A

hypertrophic osteorarthropathy (clubbing)

42
Q

lung adenocarcinoma - histology

A
  1. glandular pattern

2. often stains mucin (+)

43
Q

adenocarcinoma in siitu

A

bronchioarveolar subtype

44
Q

bronchioarveolar subtype - CXR

A

hazy infiltrates similar pneumonia

45
Q

bronchioarveolar subtype - prognosis

46
Q

bronchioarveolar subtype - histology

A

grows allong alveoral septa –> apparent thickening of alveolar wall –> Tall columnar cells containing mucus

47
Q

excellent prognosis lung tumors

A
  1. bronchioarveolar subtype

2. Bronchial carcinoid tumor

48
Q

lung tumor - c myc

A

small cell carcinoma

49
Q

lung tumor - clubbing

A

adenocarcinoma

50
Q

lung tumor less responsive to chemotherapy

A

Large cell carcinoma

51
Q

Small cell carcinoma - effects on nervous system

A

antibodies against presynapitc Ca2+ channels (Lambert-Eaton myasthenic syndrome) or neurons (paraneoplastic myelitis/encephalitis, sabacute cerebellar degeneration)

52
Q

lung tumor - similar to pneumonia CXR

A

bronchioarveolar subtype

53
Q

lung tumor - β-hCG secretion

A

Large cell carcinoma

54
Q

lung tumor - nests od neuroendocrine cells

A

Bronchial carcinoid tumor

55
Q

MC tumor in male smokers

A

squamous cell lung

56
Q

lung small cell carcinoma epidemiology

A

male smokers

57
Q

lung squamous cell carcinoma epidemiology

A

male smokers

58
Q

MC tumor in female smokers

A

lung adenocarcinoma

59
Q

large cell carcinoma -epidimiology

60
Q

bronchioarveolar subtype - smoking

A

no relationship

61
Q

Bronchial carcinoid tumor - smoking

A

no relationship

62
Q

mesothelioma

A

malignancy of the pleura

63
Q

mesothelioma is associated with

A

asbestosis

64
Q

mesothelioma may result in

A
  1. hemorrhagic pleural effusion (exudative)

2. pleural thickening

65
Q

mesothelioma - risk factors

A

asbestosis

smoking is not a risk factor

66
Q

mesothelioma - histology

A
  • psammoma bodies

- calretinin and cytokeratin (+) in almost all mesotheliomas, ((-) in most carcinomas)

67
Q

A psammoma body is a

A

A psammoma body is a round collection of calcium

68
Q

pancoast tumor is also called

A

superior sulcus tumor

69
Q

Pancoast syndrome?

A

pancoast lung cancer that invade cervical sympathetic chain

70
Q

pancoast tumor (superior sulcus tumor) may cause

A

Compression of locoregional structures:

  1. Horner syndrome
  2. Superior vena cava syndrome
  3. hoarseness
  4. sensorimotor deficits
71
Q

pancoast tumor - horner - why

A

invades cervical sympathetic chain

72
Q

Horner syndrome clinical findings

A
  1. ipsilateral ptosis 2. miosis 3. anhidrosis
73
Q

superior vena cava syndrome - caused by

A
  1. malignancy (pancoast tumor)

2. thrombosis from indwelling catheter

74
Q

superior vena cava syndrome - medical emergency because

A

it can raise intracranial pressure (if obstruction is severe)
–> headaches, dizziness, increased risk of aneurysm/rupture of intracranial arteries

75
Q

superior vena cava syndrome - pathophysiology

A

an obstruction of the SVC that impairs blood drainage from head, neck, and upper extremitires

76
Q

superior vena cava syndrome - clinical characteristics

A
  1. facial plethora
  2. bleaching after fingertip
  3. jugular venous distension
  4. upper extremities edema
77
Q

Lung Ca - MC symptom

A

cough (75%)

78
Q

Lung Ca - proportion of cough/hemotpysis/dyspnea

A

cough –>75%
hemoptysis –> 35%
dyspnea –> 60%

79
Q

Lung Ca - single most common area of metastasis

80
Q

lung ca - metastasis to bone - labs

A
  1. increased ALP

2. hypercalcemia

81
Q

lung Ca in CXR

A

pneumonic coin lesion

82
Q

lung Ca in CT

A

noncalcified nodule

83
Q

Lung cancer - effusions

A
  1. Pleural

2. Pericardial

84
Q

primary lung cancers that have lesser association with smoking

A
  1. Bronchial carcinoid

2. Bronchioalveolar

respiratory (27 decks)

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