Lung Malignancy

Question 1

peripheral tumours tissue samples?

Answer 1

Fine needle aspiration, pleural biopsy

Question 2

Non-small cell carcinomas include? better Rx?

Answer 2

squamous cell
adenocarcinoma
adenosquamous
large cell
sarcomatoid

Rx: usually surgery

Question 3

Small cell carcinoma is sensitive to?

Answer 3

chemotherapy

Question 4

squamous cell carcinoma dx needs what 2 things?

Answer 4

intercellular bridges

keratinization

Question 5

Adenocarcinoma where usually? and appearance?

Answer 5

mucin production have mucoid appearance
peripheral, well circumscribed
unrelated to bronchi maybe some pleural involvement

Question 6

Adenocarcinoma in-situ considered if present how?

Answer 6

non-resolving consolidation/pneumonia

for months

Question 7

Small Cell Carcinoma is special why?

Answer 7

can show neuroendocrine differentiation

Question 8

Small Cell Carcinoma associated with smoking?

Answer 8

yes

Question 9

adenocarcinoma associated with smokin?

Answer 9

not necessarily

Question 10

Small Cell Carcinoma grows where usually?

Answer 10

centrally, get obstruction, bronchi, SVC, regional lymph node

Question 11

how to treat Small Cell Carcinoma? why?

Answer 11

usually presents late:

Rx: chemo, usually not surgery

Question 12

Small Cell Carcinoma cells micro look?

Answer 12

nuclear molding
scant cytoplasm
large nucleus

Question 13

Large Cell Carcinoma common?

Answer 13

usually rare

Question 14

Large Cell Carcinoma dx how?

Answer 14

need to look at entire tumour because some areas are undifferentiated
diagnosis of exclusion

Question 15

Large Cell Carcinoma macro look?

Answer 15

lipoid

Question 16

Thyroid transcription factor 1 increases risk of thyroid cancer and?

Answer 16

primary lung carcinoma

Question 17

lung cancer distant metastases?

Answer 17

adrenals 50%
liver 30-50%
brain 20%
bone 20%

other lobes of lungs as well

Question 18

molecular genetics important in which lung cancer?

Which 2 are most important?

Answer 18

adenocarcinoma

EGFR and ALK

Question 19

Who gets EGFR? and ALK?

Answer 19

EGFR: young asian non smoking females
ALK: young men age 40-60

Question 20

which lung cancer has poorer prognosis?

Answer 20

small cell carcinomas

Question 21

Neuroendocrine tumours Carcinoid makes?

Answer 21

ACTH usually

Question 22

Central tumours tissue sampling?

Answer 22

ulcerates maybe sputum or bronchial washings