Lung Cancer Pathology 1

Question 1

Describe what a hamartoma is?

Answer 1

not really a tumor but a mass with all the components from the same organ but misplaced and accumulated in the same place.

Question 2

Which is more common metastatic lung cancer or primary lung cancer?

Answer 2

Metastatic lung cancer

Question 3

What is the most common cause of metastatic lung cancer?

Answer 3

breast cancer

Question 4

On X rays how do metastatic lung cancers typically appear?

Answer 4

as “canon balls” on X-ray

Question 5

What is the most common presenting symptom of bronchogenic carcinomas?

Answer 5

cough

Question 6

Name some etiologies os lung cancer.

Answer 6

1. cigarette smoking
2. radon gas (uranium mining)
3. Asbestosis and smoking
4. Heavy metals (Arsenic, Ni, and beryllium

Question 7

Scarring of the lung predisposes one to what type of cancer of the lungs?

Answer 7

adenocarcionoma (scar cancers)

Question 8

Be able to reproduce slide on the cellular and molecular events in carcinogenesis from tobacco exposure.

Answer 8

Question 8

Be able to reproduce slide on the cellular and molecular events in carcinogenesis from tobacco exposure.

Answer 8

Question 9

What are the 2 broad groups which bronchogenic carcinomas are classified as?

Answer 9

SCLC and NSCLC (small cell lung cancers and non-small cell lung cancers respectively)

Question 10

Which type of bronchogenic carcinomas response poorly to chemo?

Answer 10

NSCLC

Question 11

Which type of bronchogenic carcinomas are more suited to be treated by surgery?

Answer 11

NSCLC

Question 12

Which type of bronchogenic carcinomas are more aggressive and metastasize early?

Answer 12

SCLC

Question 13

Which type of bronchogenic carcinomas are not amenable to curative surgery?

Answer 13

SCLC

Question 14

Name the types of NSCLC’s.

Answer 14

1. squamous cell Ca
2. adenocarcinoma - bronchial and bronchioalveolar Ca (most common lung Ca)
3. Large cell Ca

Question 15

Adenocarcinoma has replaced what type of nsclc as the most common primary lung tumor in recent years?

Answer 15

squamous cell carcinoma

Question 16

What is the most common primary lung cancer in smokers and nonsmokers, women and in the region of scar tissue?

Answer 16

adenocarcionma

Question 17

Which type of lung carcinomas have the strongest relationship to smoking?

Answer 17

squamous cell carcinoma and small cell caricnoma

Question 18

Which type of bronchogenic carcinomas are typically located centrally in the lungs?

Answer 18

sq cell carcinomas
small cell carcinomas

Question 19

What type of bronchogenic carcinomas are located more peripherally in the lungs?

Answer 19

adenocarcinomas

Question 20

What are the most common symptoms of centrally located tumors?

Answer 20

cough and hemoptysis

Question 21

Partial obstruction with a centrally located tumor can lead to what complications?

Answer 21

infections/bronchectasis

Question 22

Complete obstruction due to a centrally located primary tumor can lead to what complication?

Answer 22

atelectasis

Question 23

What are the major symptoms of a peripherally located tumor?

Answer 23

Dyspnea , Chest Pain ( adeno ca which is peripheral in location)

Question 24

What is cachexia most likely mediated by in lung cancer?

Answer 24

TNF-a, IFN-y, IL-1, and IL-6

Question 25

What are some clinical presentations of intra-thoracic spread of bronchogenic carcinomas?

Answer 25

1. Lymphnodes – lymphadenopathy – mediastinal, cervical
2. Pleural involvement > pleural effusion - bronchiloalveolar

3.Esophageal obstruction > Dysphagia

4.Reccurent laryngeal nerve involvement > hoarseness

5.Phrenic nerve > (hiccups, diaphragm paralysis)

3. Spread from Pancoasts tumor (tumor in upper lobe) Superior vena cava syndrome
   Horner’s syndrome
   -Invasion of cervical sympathetic plexus and brachial plexus

Question 26

Describe location of Pancoast’s tumor.

Answer 26

Usually a primary SCC located at the extreme apex of lung.

Involves the lower trunk (T1-T2) of the brachial plexus and superior cervical sympathetic ganglion in post mediastinum.

Destruction of superior cervical sympathetic ganglion causes Horner’s syndrome

Question 27

What are Pancoast’s Tumors characterized by?

Answer 27

ptosis

miosis

anhidrosis

enophthalmos (recession of eye balls within orbits)