Lung Cancer Path 3 Flashcards
Do carcinoid tumors have a relationship to smoking?
no relationship to smoking
At what age can carcinoid tumors be see?
usually younger than 40
Describe how carcinoid tumors appear under microscopy.
Nests of Uniform cells with uniform round nuclei
No necrosis; no hemorrhage
Has a Definite capsule
What does this image represent?
dense core neurosecretory granules of carcinoid tumor under electron microscopy
What are the clinical features of carcinoid tumors?
cough
What are the signs and symptoms of carcinoid syndrome? (major ones)
- Diarrhoea ( VIP)
- Flushing ( histamine)
- Cyanosis ( pulmonary valve stenosis – by seratonin)
cough, could cause late atelaectasis
How to you treat a patient with carcinoid tumor/
Surgery is usually curative except in those with mets (then need chemo)
What is the prognosis for those with carcinoid tumor?
poor
Which substance is elevated In during in a patient with carcinoid syndrome?
5-HIAA
Why does primary GI carcinoid not cause right sided Valvular stenosis and carcinoid syndrome while the bronchial carcinoids do?
MAO the enzyme that breaks down the serotonin is present in the hepatocytes and pulmonary capillary endothelial cells.
Why does Primary GI carcinoid with liver metastasis ( atypical carcinoid cause right sided Valvular stenosis?
With liver metastasis, the serotonin produced by the metastatic tumor cells bypass the hepatocytes into the inferior vena-cava and to the right heart
Why doesn’t carcinoid heart disease affect the left side of the heart?
Pulmonary capillary endothelial cells produce MAO that breaks down the serotonin. Hence serotonin does not reach the left side of the heart from the right side.
In what circumstances will you also see mitral valve fibrosis in carcinoid syndrome?
septal defect
What are large cell carcinomas composed of? (what type of cells features)
large anapestic cells lacking features diagnostic of squamous cell or adenocarcinoma.
Describe prognosis of those with large cell carcioma
tendency to spread
