Lung Cancer

Question 1

Name a somking related disease and the characteristic conditions that go along with this

Answer 1

COPD

• emphysema
• Chronic bronchitis

Question 2

Factors that can increase the chances of getting lung cancer

Answer 2

• pharmacogenomics and inter-individual susceptibility
• (passive) smoking
• e-cigarettes
• vitamin E acetate

Question 3

Types of acute intersitial lung disease

Answer 3

• hypersensitivity pneumonititis
  
  • Type II and IV
  • Bird fancier
  • Farmer’s lung
• Sarcoidosis
• Idiopathic pulmonary fibrosis

Question 4

Characterisitics of lung sarcoidosis

Answer 4

• cell mediated
• Granulomas
• Hilar lyphadenopathy
• raised angiotensin converting anzyme - macrophage activation
• minimal necrosis

Question 5

How would the lungs be described in idiopathic pulmonary fibrosis?

Answer 5

honeycomb lung

Question 6

What are the 3 main types of benign lung tumour?

Answer 6

• mesenchymoma
• papilloma
• inflammatory myoblastic tumour

Question 7

What are the main characterisitics of a benign tumour?

Answer 7

• defined margins
• uniform consistency
• no lymphadenopathy
• homogeneous
• cartilage with glands
• can be quite large

Question 8

Dysplasia =

Answer 8

normal to disordered tissue

Question 9

metaplasia =

Answer 9

change between mature cell types

Question 10

Where do primary malignant lung tumours usually occur?

Answer 10

• epithelium
• vessels
• muscle
• cartilage
• lymphoid
• pleura

Question 11

Where do secondary malignant lung tumours usually arise from?

Answer 11

• sarcoma - spread by blood
• renal carcinoma
• lymphoma
• etc.

**The lung is a common site for secodnary cancers

Question 12

Describe squamous epithelial lung cancer

Answer 12

Non small cell lung cancer

approx. 40% = COMMON

Caused by:

• smoking
• air pollution
• asbestos
• fibrosing lung disease

Question 13

What does EBUS stand for?

Answer 13

endobronchial ultrasound

Question 14

Describe adenocarcinoma lung cancer

Answer 14

Non small cell lung cancer

Approx 40% = COMMON

Caused by:

• smoking
• lung scar - TB related
• air pollution
• asbestos

Question 15

Name a variant of adenocarcinoma and describe its pattern of spread

Answer 15

bronchoalveolar

intrapulmonary dissemination

Question 16

Describe TNM staging of cancer

Answer 16

Question 17

describe small cell undifferentiated lung cancer

Answer 17

• neuroendocrine
• paraneoplastic effects
  
  • may produce bioactuve amines or peptides e.g. ADH, PTN-like peptides, ACHT
• Neurological e.g. demyelination

Question 18

Describe carcinoid lung cancer

Answer 18

Less maligant

• typical = towards the less aggressive end of spectrum
• atypical = smoking related, tends towards malignant end of the spectrum

Question 19

What are paraneoplastic syndromes?

Answer 19

• a set of signs and symptims not directly caused by the cancer
• may be related to factors produced
• many immunological

Question 20

What are the main genes affected in the cause of lung cancer?

Answer 20

• EGFR
• BRAF
• RAS
• ALK rearrangements

Question 21

current treatments of lung cancer

Answer 21

chemotherapy

targeted - small molecule

immuno-oncology and checkpoint inhibitors

Question 22

Describe mesothelioma lung cancer

Answer 22

• asbestos - crocidolite
• incidence rising
• long lag period
• male: female = 5:1
• signficance of fibrosis pleural plaques