Lung Tumors Flashcards
80% of lung cancers occur in who, and what are the most common types?
- active smokers
- small cell & squamous
What are the 3 genes associated with lung cancer?
- activation of KRAS
- inactivation of p53 & Rb
broncho-alveolar carcinoma is the precursor for which type of carcinoma?
Adenocarcinoma
neuroendocrine cell hyperplasia is the precursor for what type of carcinoma?
small cell carcinoma
A patient presents with a hilar, friable spherical mass that is occluding the lumen of the main bronchus. On cut section it is yellowish-white and has foci of necrosis and hemorrhage producing cavities. What could be your diagnosis?
- small cell carcinoma
- squamous cell carcinoma
a patient presents with a grayish mucoid mass in a peripheral bronchiole. What could be your diagnosis?
adenocarcinoma
A patient with a history of smoking tobacco presents with a mass occluding a large bronchus. On microscopic examination, keratin pearls were seen. On staining, CK5/6 was positive. What is your diagnosis?
Squamous cell carcinoma
Keratinization and glandular appearance in characteristic to what type of carcinoma?
adenosquamous carcinoma
a patient with a positive TTF-1 stain may have what type of carcinoma?
adenocarcinoma
If a patient has an undifferentiated tumor that lacks cytologic features from all other types of carcinomas, what could u diagnose it as?
large cell carcinoma
A patient with paraneoplastic syndrome (ectopic hormone production) and positive chromogranin, NSE, and synaptophysin may have what type of carcinoma?
small cell carcinoma
What are the first lymph nodes that are gonna get affected?
Hilar lymph nodes the mediastinal then cervical then supraclavicular and lastly para-aortic
what are other sites the may get affected?
liver
adrenals
bones
brain
What are the most common local symptoms?
cough
chest pain
dyspnea
haemoptysis
What diseases occur with ectopic hormone production in paraneoplastic syndrome?
- ACTH: Cushing’s
- ADH: Hyponatremia
- Parathormone: Hypercalcemia
- Calcitonin: Hypocalcemia
- Gonadotropins: Gynecomastia
- Serotonin: Carcinoid syndrome
What other types of paraneoplastic syndromes are there?
- neuromuscular: polymyositis, myopathy and peripheral neuropathy
- skeletal: clubbing
- cutaneous: acanthuses nigricans
- cardiovascular: Trousseau’s syndrome
- haematologic: abnormal coagulation
What are the 2 neuroendocrine tumors?
small cell & carcinoid tumor
a 32 year old patient presented with a collar-button like mass at the major bronchus, on cut section is was yellow tan in color. What is your diagnosis and what microscopic features could be found?
- Carcinoid tumor
- Micro: cuboidal cells forming ribbons separated by fibrous septa
finely granular cytoplasm
salt & pepper chromatin
Secondary tumors that look like canon-balls at the periphery of the lung may be caused by what?
Metastatic tumors
Asbestos bodies are found in which tumor, what does this tumor look like grossly?
- malignant mesothelioma (primary pleural tumor)
- thick layer of soft gelatinous greyish pink tumor tissue
where do secondary epithelial tumors metastasize to?
- via lymohatics: breast & lung
- haematogenously: ovaries
