Lung Tumours Flashcards
What % of lung tumours are squamous cell carcinomas?
30-50%
State the genetic mutations commonly found in lung squamous cell carcinomas
p53/c-myc
Where are lung squamous cell carcinomas usually found?
Proximal bronchi
Describe the appearance of lung squamous cell carcinoma on histology
Keratinisation, intercellular prickles (desmosomes)
Name at least two subtypes of lung squamous cell carcinoma
Papillary, basaloid
Which biochemical abnormality is associated with lung squamous cell carcinoma?
Hypercalcaemia
Describe the progression to squamous cell carcinoma
Normal epithelium -> hyperplasia -> squamous metaplasia -> angiosquamous dysplasia -> carcinoma in sity -> invasive carcinoma -> local spread -> late metastases
Which group is lung adenocarcinoma most common in?
Female non-smokers
What is lung adenocarcinoma?
Malignant epithelial tumour with glandular differentiation or mucin production
Describe the histology of lung adenocarcinoma
Glandular differentiation with cells containing mucin vacuoles
Which mutation is typically found in lung adenocarcinoma?
EGFR mutation
Describe the progression to adenocarcinoma
Normal epithelium -> atypical adenomatous hyperplasia -> non-mucinous BAC -> mixed pattern adenocarcinoma -> early metastases
What % of lung tumours are adenocarcinomas?
20-30%
What % of lung tumours are small cell carcinomas?
20-25%
What % of lung tumours are large cell carcinomas?
10-15%
Which cells do small cell lung carcinomas arise from?
Neuroendocrine cells
Where do small cell lung carcinomas commonly metastasise to?
Bone, adrenals, liver, brain
Which mutations are commonly found in small cell lung carcinomas?
p53, RB1
What is the prognosis of small cell carcinoma and why?
Poor due to rapid metastases, despite being very chemosensitive
Describe the histological appearance of large cell lung carcinoma
Large cells with large nuclei and prominent nucleoli, no evidence of glandular or squamous differentiation
Which paraneoplastic syndrome is produced by tumour cells secreting ADH?
Syndrome of inappropriate ADH (SIADH)
Which paraneoplastic syndrome is produced by tumour cells secreting ACTH?
Cushing’s syndrome
Which paraneoplastic syndrome is produced by tumour cells secreting PTH or PTH related peptide?
Primary hyperparathyroidism
Which paraneoplastic syndrome is produced by tumour cells secreting calcitonin?
Hypercalcaemia
Which paraneoplastic syndrome is produced by tumour cells secreting serotonin?
Carcinoid syndrome
Which paraneoplastic syndrome is produced by tumour cells secreting bradykinin?
Cough
What are the features of carcinoid syndrome?
Flushing, diarrhoea, bronchoconstriction
Name two mutations found in adenocarcinomas associated with no response to tyrosine kinase inhibitors
K-ras mutation, EML4-ALK mutation
Name a mutation found in non-small cell lung cancer associated with a poorer response to cisplatin
ERCC1
Where do mesotheliomas arise?
Parietal or visceral pleura
What are the symptoms of mesothelioma?
Pleural effusion, chest pain, dyspnoea
