Lung Cancer Pathology 2

Question 1

What does SIADH stand for?

Answer 1

Syndrome of inappropriate ADH secretion

Question 2

How does excess ADH affect your body?

Answer 2

resorption of excessive water

Question 3

What can excess ADH cause to happen in your body?

Answer 3

Oliguria, water retention, hyponatremia and cerebral edema

Mental status changes due to cerebral edema

Question 4

What laboratory findings would lead you to suspect that someone has SIADH?

Answer 4

hyponatremia

Question 5

Describe characteristics of Lambert Eaton syndrome.

Answer 5

characterized by muscle weakness (difficulty swallowing, ptosis) due to autoantibodies directed against neuronal calcium channels.
Hypercoagulability Syn

Question 6

What test would you do to decipher if a person has Lambert Eaton myasthenia syndrome?

Answer 6

Tension test.

Question 7

What does a negative tensilon test mean?

Answer 7

muscle weakness does not improve with edrophonium/tensilon injections.

Question 8

Another name for migratory thrombophlebitis.

Answer 8

Trousseau syndrome

Question 9

Describe the hypercoagulability syndromes that can be caused by paraneoplastic syndromes.

Answer 9

Due to mucus production by adeno Ca

Migratory thrombophlebitis (Trousseau syndrome)

Non-bacterial endocarditis (systemic infarct)

Disseminated intravascular coagulation

Question 10

What type of lung cancer can cause hypertrophic pulmonary osteoarthropathy?

Answer 10

small cell Ca

Question 11

What are the characteristics of hypertrophic pulmonary osteoarthropathy?

Answer 11

• Periosteal new bone formation
• Finger clubbing
• Arthritis

Question 12

Characteristics of acanthosis nigricans.

Answer 12

Characterized by:

Dark papillomatous plaques on the skin
Axilla

Question 13

What are some investigations to check if someone has lung cancer?

Answer 13

Sputum cytology

Chest X-ray

Chest CT/MRI

Bronchoscopy

Bronchoscopic brush cytology & Biopsy

Cytology of the pleural fliud

Fluroscopic guided Transthoracic lung biopsy

Question 14

Are squamous cell carcinomas strongly related to smoking?

Answer 14

yes

Question 15

Be able to explain the sequence of events from smoking that can cause sq. cell carcinomas?

Answer 15

Smoking > squamous metaplasia > dysplasia > carcinoma in situ > invasive cancer.

Question 16

Where in the lungs are squamous cells typically located?

Answer 16

Centrally located:
Arise in the larger bronchi

Question 17

When a squamous cell carcinoma produces obstruction, what can this lead to?

Answer 17

bronchiectasis

Question 18

Be able to draw out and explain diagram on how PTHrp can affect the body.

Answer 18

Question 19

What are some key features of squamous cell carcinomas that can be witnessed under microscopy?

Answer 19

(keratin –pearls) or intercellular bridges (desmosomes)

Question 20

How does squamous cell carcinomas look under sputum cytology?

Answer 20

Bright red malignant squamous cells and
Keratin pearls

Question 21

Which is most heavily linked to smoking? Adenocarcionmas or sq cell carcionomas?

Answer 21

squamous cell carcionms

Question 22

What is the MC overall primary lung cancer?

Answer 22

adenocarcioma

Question 23

What may adenocariconomas arise from?

Answer 23

scar tissue in the lungs (scar carcinoma)

Question 24

Where are adenocarcinomas located?

Answer 24

peripherally

Question 25

Describe sputum cytology for adenocarcinoma?

Answer 25

may be negative

Question 26

What are the different types of adenocariconomas?

Answer 26

Bronchial

Bronchioloalveolar carcinoma

Scar carcinoma (from scar tissue)

Question 27

Describe how adenocarcinoma looks under microscopy.

Answer 27

tumor composed of glands that secrete mucin

Question 28

Describe the spread of bronchiole-alveolar carcinomas.

Answer 28

along the wall of terminal and respiratory bronchiole, alveolar ducts and alveoli in a hobnail (picket fence) pattern.

Question 29

What may bronchi-alveolar carcinomas present as on X ray?

Answer 29

Grossly and on X ray may present as consolidation similar to pneumonia.

Question 30

What are small cell carcinomas also known as?

Answer 30

oat cell caricinomas

Question 31

What type of cells are small cell carcinomas derived from?

Answer 31

Kulchitsky’s cell (neuroendocrine cells).

Question 32

Do small cell carcinomas have a strong link to smoking?

Answer 32

yes

Question 33

Are small cell carcinomas highly malignant?

Answer 33

yes

Question 34

Where are small cell carcinomas typically located in the lungs?

Answer 34

centrally like squamous cell carcinomas (SCC)

Question 35

Be able to draw out flow diagram on the types of neuroendocrine tumors.

Answer 35

Question 36

Under the microscope how may small cell carcinomas appear?

Answer 36

1. small round cells
2. Cells have scant amount of cytoplasm
3. Nuclear molding is a characteristic feature (better seen in cytology specimens).

Question 37

How may a neuroendocrine tumor found in the lungs appear under EM?

Answer 37

could see Cytoplasmic neurosecretory granules

Question 38

What are tumors cells that are neuroendocrine tumors positive for?

Answer 38

S100

Neuron specific enolase

Chromogranin, synaptophysin, Leu 7

Question 39

What is being seen in this image?

Answer 39

dense core granules characteristic of a neuroendocrine tumor

Question 40

Best treatment for non small cell lung cancer?

Answer 40

surgery

Question 41

Best treatment for small cell lung cancer?

Answer 41

chemotherapy and radiation