Lung Neoplasms Flashcards
True or False: lung cancer is the most common cause of cancer mortality worldwide.
True
What is the most common cause of lung cancer?
Smoking
What % of lung carcinomas occur in active smokers or those who’ve stopped recently?
87%
Benzo[a]pyrene is a carcinogen that can cause a mutation in which protein, leading to lung cancer?
P53
Uranium miners have a ___x risk of cancer if theyre non-smokers and __x risk if they are smokers.
4x
10x
This is the chemical that can cause lung cancer in closed spaces and is inhaled when attached to environmental aerosols.
Radon
What can inhaled carcinogens do to oncogenes and tumor supressors to cause lung CA?
Activate oncogenes
Inhibit tumor supressors
What are the 3 precursor lesions that have a very good chance to progress to cancer?
Squamous dysplasia and carcinoma in situ
Atypical adenomatous hyperplasia
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.
What pt population is at risk for small cell carcinoma?
male smokers
(cancers starting with “S” are associated with “S”mokers, they’re “c”entral, and they are assocaited with paraneoplastic “S”yndromes)
Are small cell carcinomas benign or malignant?
Highly malignant
What are the histological features of small cell carcinoma?
Poorly differentiated cells, most show neurosecretory granules
Where in the lung are small cell carcinomas?
Central
What are the paraneoplastic syndromes assoacited with small cell carcinoma?
ADH
ACTH
Eaton-Lambert syndrome
What is the Tx for small cell carcinoma: Chemo, surgery, or both?
ONLY chemo
What is the most common tumor for male smokers?
Squamous cell carcinoma
What is happening during the years of asymptomatic Squamous cell carcinoma?
Squamous metaplasia
When do Sx start in Squamous cell carcinoma?
When the tumor obstructs, destroys, or grows within the tissue
What is the most common mutation for Squamous cell carcinoma?
p53 mutations
What are the 2 u see on histology for Squamous cell carcinoma?
ketatin pearls or intercellular bridges
Where in the lung are Squamous cell carcinoma?
Central
What is the 1 paraneoplastic syndrome associated with Squamous cell carcinoma?
Hypercalcemia from fromduction of PTHrP
What is the most common tumor in non-smokers and FEMALE smokers?
Adenocarcinoma
The majority of Adenocarcinoma tumors are + for which serum protein?
Thyroid transcription factor-1
What is the most common mutation to cause Adenocarcinoma?
KRAS mutations
What are the 2 thing seen in histology for Adenocarcinoma?
Glands or Mucin
Where in the lung are Adenocarcinomas?
Peripheral
How do u get large cell carcinomas?
Smoking
What shows up on histology for large cell carcinomas?
Poorly differentiated large cells
What DOES NOT show up on histology for large cell carcinomas?
anything from prev cancers- keratin pearls, interceullar bridges, glands, or mucus
Where are large cell carcinomas located?
Central or Peripheral
Do large cell carcinomas have a good or bad prognosis?
Poor prognosis
Is bronchioloalveolar carcinoma related to smoking?
No
How does bronchioloalveolar carcinomas grow in the lung?
Grow along pre-existing bronchioles and alveoli
Which cells give rise to bronchioloalveolar carcinomas?
Clara cells
Where in the lung is bronchioloalveolar carcinoma?
peripheral
Bronchioloalveolar carcinomas present with PNA-like consolidation and have a poor or excellent prognosis?
Excellent prognosis
True or False: Carcinoid tumors are not related to smoking.
True
What shows up on histological exams for Carcinoid tumors?
Well differentiated neyroendocrine cells
Carcinoid tumors are + for which marker?
Chromogranin +
Carcinoid tumors can be central or peripheral and can form what in the bronchus?
Polyp-like mass
True or Fase: Carcinoid tumors often cause carcinoid syndrome.
False. They rarely do.
What is the most common location for metastasis to the lung?
Breast or colon
What is seen on imaging for metastasis lesions in the lung?
“cannon-ball” nodules
Are metastasis in the lung more or less common and primary tumors of the lung?
More common
What are the major Sx to lung carcinoma?
Cough, weight loss, chest pain, and dyspnea
….not very specific here….
If the tumor causes a pleural effusion, where is the tumor located?
Tumor spread into the pleura
If the tumor causes hoarseness, where is the tumor pressing?
Recurrent laryngeal nerve
If the tumor causes diaphragm paralysis, where is the tumor pressing?
Phrenic nerve
If the tumor causes SVC syndrome, where is the tumor pressing?
SVC
If the tumor causes Horner syndrome, where is the tumor pressing?
Sympathetic ganglia
Which 2 cancers tend to remain localized longer and have a slightly better prognosis than do the undifferentiated cancers?
Adenocarcinoma and Squamous cell
Hyponatremia, Cushing syndrome, and Eaton-Lambert are paraneoplastic syndromes from which type of tumor?
Small cell carcinomas
Hypercalcemia is a paraneoplastic syndrome from which type of tumor?
Squamous cell tumors
These are benign neuroendocrine neoplasms and often seen in areas of scarring or chronic inflammation.
Tumorlets
What mutation distinguises typical and atypical carcinoid tumors?
p53 mutations (atypical have them)
This is the name of the lesion from a carcinoid tumor where it has penetrated the bronchial wall.
Collar-button lesion
Are carcinoid tumors well- or poorly-differentiated?
Well-differentiated
What are the classic Sx to carcinoid tumors?
persistent cough, hemoptysis, 2o infections… blahblahblahbjsghsjgnsgmpksg
This is a relatively common lesion that is usually discovered incidentally, and shows a coin lesion on CXR.
Harmatoma
What are the harmatoma nodules made of?
connective tissue (usually cartilage) intersected by epithelial clefts and lined by ciliated columnar epithelium
These are rare tumors in kids that present with a fever, cough, chest pain, and hemoptysis. They’re from proliferation of spindle-shaped fibroblasts and myofibroblasts.
Inflammatory Myofibroblastic tumor
True or False: the lung is the most common site for metastatic neoplasms.
True!
These are soft-tissue tumors in the pleura, often attached by a pedicle, and are rarely malignant.
Solitary fibrous tumor
Solitary fibrous tumors have dense fibrous tissue with occasional cysts, and have spirals of what substance within them?
Collagen
What are the 2 most common Sx of primary lung cancer?
Cough and Hemoptysis
