Lung Cancer Flashcards
What are the risk factors for lung cancer?
- male
- tobacco
- alcohol
- HPV
- hygiene
- repeated trauma
What are the most common cancers of the lung and what are the possible consequences?
- squamous carcinoma
- lymph node spread
- local recurrence
What are the 2 conditions that encompass COPD?
- emphysema
- chronic bronchitis
What is emphysema, the different types and the consequences of this?
- enlargement of air spaces by destroying tissue, results in less surface area for gas exchange
- capillary space around the alveoli decreases resulting in shunting of blood that does not get oxygenated
- centriobular emphysema
- panacinar emphysema (associated with host defect in protection against reactive oxygen species)
What are some examples of interstitial lung disease with their features?
- hypersensitivity pneumonitis (type III/IV, bird fancier, farmer’s lung)
- sarcoidosis (granulomas)
- idiopathic pulmonary fibrosis (honeycomb lung around the base of the lung)
What is interstitial lung disease?
- spectrum of changes where interstitium between alveoli become inflamed and over time become fibrotic
- restrictive lung disease
What is the most common type of benign lung tumour and its features?
- mesenchymoma
- big nodule of cartilage
- due to maldevelopment of mesenchyme elements in the lung
Where can primary malignant lung tumours arise?
- epithelium (metaplasia and dysplasia)
- vessels
- muscles
- cartilage
- lymphoid
- pleura
What is metaplasia?
change from one differentiated cell type to another
What is dysplasia?
- disordered proliferation and maturation of cells
- pre-malignant
What are some key secondary lung tumours?
- sarcoma
- renal carcinoma
- lymphoma
What are the different types of primary epithelial tumours of the lung?
- squamous
- adeno
- small cell undifferentiated
- carcinoid
- large cell undifferentiated
What are the causes of squamous NSCLC?
- smoking
- air pollution
- asbestos
- fibrosing lung disease
What are the causes for adenocarcinoma?
- smoking
- lung scar
- air pollution
- asbestos
Describe the important consequences/paraneoplastic effects of small cell undifferentiated (SCLC)
- neuroendocrine (neurological consequences)
- paraneoplastic effects:may produce bioactive amines or peptides
Describe the key features of carcinoid lung tumours
- malignant spectrum
- typical: towards less aggressive end of spectrum
- atypical: smoking realted, towards malignant end of spectrum
What are paraneoplastic syndromes?
- a set of signs and symptoms not caused directly by the cancer
- may be related to the factors produced by the cancer
- may be immunological
What are the different manifestations of the paraneoplastic syndromes?
- neurological
- endocrine
- skin (acanthosis nigricans EGF)
- connective tissue/bone: finger clubbing
- haematological (EPO)
- kidney disease (immune complex GN)
What does molecular pathology look for?
- EGFR amplification
- BRAF mutation
- RAS mutation
- ALK rearrangements
Describe PD1 and PDL1 checkpoint inhibition
PD1 and PDL1 bind to lymphocytes inhibiting the immune response so inhibiting it would prevent the inactivation of the immune response
What are the current treatments of lung cancer?
- conventional chemotherapy
- immuno-oncology and checkpoint inhibitors
- targeted small molecule
