Lung Neoplasms Flashcards
Carcinoid tumor: slow growing neuroendocrine tumor that is bronchocentric; tumor with architecture of nested cells, (like pancreatic islets of langerhans with endocrine cells).
Tumor arises from neuroendocrine cells in the epithelial surfaces of lungs, GI, and pancreas. Pulm carcinoids are borderline tumors–most benign and cured by surgery, but some metastasize.
Carcinoid tumor: neoplastic neuroendocrine cells have abundant cytoplasm and uniform, well differentiated nuclei; few mitoses and almost no necrosis/apoptosis, thus low-grade.
Adenocarcinoma: a non-small cell CA usually seen as peripheral or subpleural tumors that invade/destroy lungs; the most common bronchogenic carcinoma and most common lung CA in non-smokers and in women. In comparison to squamous CC, AdCa has higher risk for metastasis, but usually presents in earlier-stages.
Show infitrative/spiculated growth and glandular, acinar, or solid architecture. Pleomorphic tumor cells: large nuclei, prominent nucleoli and vacuolated cytoplasm.
SCC: arises from larger central airways in smokers (most often males); see infiltrative growth with pink keratin pearl formation, patchy necrosis, and keratinizing cytoplasm. See mitoses and apoptotic bodies as well as stromal desmoplasia (spindly fibroblasts).
SCC producing keratin (arrow); see pink cytoplasm of neoplastic cells, mitotic figures and apoptotic bodies. Also see stromal desmoplasia in between.
See SCC most often in male smokers.
peripheral SCC that has invaded the chest wall to infiltrate the rib and intercostal muscle.
Pancoast tumors are peripheral SCC’s that arise in the apical lung and invade the chest wall of the superior sulcus to involve nearby neural structures.
Small cell carcinoma; very aggressive, high-grade, neuroendocrine bronchogenic tumors with very strong associated with smoking; usually seen as large central subcarinal and hilar masses, often with mets to lymph nodes or CNS.
Cells are primitive, poorly-differentiated, with sparse cytoplasm (hence “small cell”) and high rates of mitoses/apoptosis. Tumors are usually solid growths, no recognizable structures.
Pts almost always present in stage IV with mets, so surgery rarely a tx option; tumor responds well to chemo at first, but usually becomes resistant thereafter, survival less than 1 year.
Pulmonary hamartoma; disorganized, but well circumscribed proliferation of mature tissues (cartilage, fibroblasts, airways, fat, smooth muscle), can occur in almost any organ; common cause of solitary pulmonary nodules, most common benign tumor of lung. Cartilage often ossifies, shows up as “popcorn calcifications” on radiology.
