Lung Cancers

Question 1

Small Cell

Answer 1

Center / Smoking

Very aggressive

Histo - neuroendocrine Kulchitsky cells (small, dark blue), chromogranin A + and neuron specific enolase +

Genetics - myc amplification

Paraneoplastic syndromes - ACTH, SIADH, Lambert-Eaton, antibodies against neurons (myelitis, cerebellar degeneration, encephalitis)

Question 2

Adenocarcinoma

Answer 2

Peripheral / most common in non-smokers and overall

Histo - glandular, mucin +

Genetics - KRAS, EGFR, ALK

Associated w/ hypertrophic osteoarthopy (clubbing)

Question 3

Bronchioalveolar Adeno Subtype

Answer 3

Carcinoma in situ

Histo - grows along alveolar septa –> apparent thickening of alveolar wall but will tall columnar cells containing mucin

X-Ray - may look like hazy infilatrate

Better prognosis

Question 4

Squamous Cell Carcinoma

Answer 4

Central / Smoking

Hilar mass arising from bronchus

Cavitations - Cigs - hyperCalcemia

Histo - keratin pearls and intercellular bridges

Question 5

Large Cell Carcinoma

Answer 5

Peripheral

Highly anaplastic and undifferentiated

Poor prognosis and less responsive to chemo

Histo - pleomorphic giant cells

Strong association w/ smoking

Question 6

Bronchial Carcinoid Tumor

Answer 6

Excellent prognosis

Histo - nests of neuroendocrine cells; chromogranin +

Symptoms due to mass effect or carcinoid syndrome (flushing, diarrhea, wheezing)