Lung Cancer Flashcards
1
Q
Small Cell Carcinoma
A
Central
Male smokers
- From neuroendocrine cell (Kulchitsky)
- Very little cyto; mainly just blue nuclei
- Since neuroendo you can stain for granules (chromogranin pos)
- Very invasive, rapid growth and early mets (liver, brain, skeletal)
- Some paraneoplastic syndromes include endocrine (ADH, ACTH - Cushings) or CNS (Lambert Eaton)
- Often hilar lymphadenopathy
- Poor prognosis
Usually cannot surgically resect
2
Q
Squamous Cell Carcinoma
A
Central
Most common tumor in male smokers (squamous metaplasia 1st)
- Keratin pearls OR
- Intercellular bridges
- SHEETS not glands
- May see squamous metaplasia –> dysplasia –> in situ –> invades BM
- Can obstruct –> distal atelectasis or pneumonia
- Often invades chest wall
- Paraneoplastic syndrome = PTH related peptide –> hypercalcemia
3
Q
Adenocarcinoma
A
Peripheral
Most common in non-smokers and female smokers
- Glands (looks like necklace)
- Mucin prod (b/c glands) so mucin stain pos
- Can also have papillary pattern (finger-like)
- Slow growing so may be asymptomatic for awhile but early mets
- Often looks like consolidation on imaging
- May invade pleura b/c peripheral
4
Q
Large Cell Carcinoma
A
Central or peripheral
Smoking
- Poorly differentiated (not sheets)
- No keratin pearls, no mucin, no intercellular bridges
- Also poor prognosis and invasive (not quite as bad as small cell)
5
Q
SVC Syndrome
A
SVC blocked –> SVC Syndrome –> enlarged head and neck veins and blue arms and face w/ edema
6
Q
Pancoast Tumor
A
- at apex
- Symp chain involvement (stellate gang) - Horner’s (ptosis, anhydrosis, pinpoint pupil)
- Brachial plexus involvement - shoulder pain and hand weakness
- Recurrent laryngeal involvement - hoarseness
7
Q
Driver Mutations (5)
A
- EGFR - adenocarcinoma; esp in Asian female non-smokers (erlotinib)
- ALK - adenocarcinoma (crixotinib)
- PDL-1 - any non small cell disease (pembrolizumab)
- Myc oncogenes (small cell)
- KRAS (adenocarcinoma)
