Lung Tumours

Question 1

What is the most common type of lung tumour?

Answer 1

The most common type of lung tumour are carcinomas (arising from lining epithelium)

Question 2

True or false:

Lung cancer is quite rare…

Answer 2

FALSE:

Lung cancer is very common, it’s the 2nd most common cancer in the uk

Question 3

What are some of the risk factors of getting lung cancer…

Answer 3

• Smoking
• Industrial hazards (asbestos, uranium, radon)
• Family history
• Immunodeficiency

Question 4

What is the percentage of lung cancers that arise from smoking?

Answer 4

87% of lung cancers arise from smoking

Question 5

What presenting complaints (symptoms) would leady you to believe someone may have lung cancer?

Answer 5

-Cough
-Weight loss
-Chest pain
-Dyspnoea (shortness of breath)
Can have more effects if cancer has spread to different areas (eg- hoarsness if spread to larynx)

Question 6

What is Paraneoplastic syndrome?

Answer 6

It’s where the tumour secretes hormones such as:

• ADH
• ACTH
• Parathormone, parathyroidhormone
• Calcitonin
• Gonadrotropins
• Seretonin and bradykinin

It happens in 1-10% of lung cancer patients

Question 7

What are the types of lung carcinoma classifications…

Answer 7

• Small cell carcinoma (20-25%)
• Non-small cell carcinoma (squamous cell carcinoma, adenocarcinoma, large cell carcinoma)
• Combined carcinoma

Question 8

What type of lung carcinoma does this best describe:

‘small, tightly packed, darkly stained ovoid tumour cells that resemble oats. Also termed ‘oat cell carcinoma’.

Answer 8

SMALL CELL CARCINOMA

This occurs in major bronchi and periphery. Early lymphatic and blood spread. (mostly incurable by surgery)

Question 9

How would you describe the histopathology of small cell carcinoma?

Answer 9

They’re small tightly packed darkly stained cells that resemble oats. Also termed out cell carcinoma.

Question 10

How would you describe the histopathology of (non small cell carcinoma) Squamous cell carcinoma?

Answer 10

They are well differentiated cells that resemble stratified squamous epithelium. Characterised by Keratin formation and/or intercellular bridges.

Question 11

What type of lung carcinoma does this best describe:

‘They are well differentiated cells that resemble stratified squamous epithelium. Characterised by Keratin formation and/or intercellular bridges.’

Answer 11

This describes the non-small cell SQUAMOUS cell carcinoma.

They usually arise centrally from bronchi

Question 12

What type of lung carcinoma does this best describe?

‘Well differentiated have obvious gladular elements 80% contain mucin’
This type of lung carcinoma is the most common type in women and non-smokers. (75% still smokers). Tend to be peripherally located and sometimes assiciated with scarring (TB).

Answer 12

This decribes the non-small cell ADENOCARCINOMA

Question 13

How would you describe the non-small cell lung carcinoma of ADENOCARCINOMA?

Answer 13

‘Well differentiated have obvious gladular elements 80% contain mucin’
This type of lung carcinoma is the most common type in women and non-smokers. (75% still smokers). Tend to be peripherally located and sometimes assiciated with scarring (TB).

Question 14

How would you describe a (non- small cell carcinoma) Large cell carcinoma?

Answer 14

They are large anaplastic epithelial cells that grow in islands and sheets.
Undiffrentiated malignant epithelial tumours. Neuroendocrine variant: highly malignant, nests and islands of tumour cells with glandular cytoplasm, central necrosis and peripheral palisading.

Question 15

Which type of lung carcinoma does this best describe:
‘They are large anaplastic epithelial cells that grow in islands and sheets. Undiffrentiated malignant epithelial tumours.’

Answer 15

This describes ‘large cell carcinoma’ of the lung (category of non-small type carcinoma)

Question 16

True or false:

‘The lung is the most common site of metastatic neoplasm’

Answer 16

TRUE

The lung is the most common site of metastatic neoplasm.

Question 17

Where do lung metastases usually come from (the primary tumour)

Answer 17

Common sites of primary lung metastases are:

• Bowel
• Prostate
• Breast
• Kidney

Question 18

How do primary tumours spread to the lung?

Answer 18

Primary tumours can spread to the lung via blood, lymphatics, or directly by continuity

Question 19

What are tumours called when in the lining of the cavity around the lung?

Answer 19

They’re called ‘pleural tumours’ and secondary metastasis (from breast of lung) is more commone that primary pleural tumours (malignant mesothelioma).

Question 20

What’s the name of the primary tumour associated with the pleura of the lung?

Answer 20

Malignant mesothelioma is the name given to primary tumours of the pleura.

Question 21

What is a main risk factor for developing malignant mesothelioma (cancer of the pleura)

Answer 21

Exposure to aspestos is a large risk for developing malignant mesothelioma.

Question 22

Which type of lung cancer does this best describe?

Increased risk in people exposed to asbestos. Plaques result from asbestos exposure can be found on the pleural surface.

Answer 22

Malignant mesothelioma (pleural tumour) of the lung.

Question 23

What lung cancer does these symptoms best describe:

• Chest pain
• Dysonoea (SOB)
• Pleural effusion
• 50% of people die within 12 months of diagnosis

Answer 23

Malignant mesothelioma (cancer of the pleura)