Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr 2 - Clinical Pathology > Malignant Lung Pathology > Flashcards

Malignant Lung Pathology Flashcards

1
Q

Define a malignant lung tumour

A

Tumours within the lung that possess potentially lethal abnormal characteristic that enables them to invade and metastasise/spread to other tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two types of malignant lung tumours?

A

1ary and 2ary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are 1ary malignant lung tumours?

A

Originate in the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common (>90%) type of 1ary malignant lung tumour?

A

Carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are carcinomas broadly classified?

A

Based on light microscopy (histology);

1) Small cell carcinoma (15-20%)
2) Non-small cell carcinoma (80-85%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Non-small cell carcinomas can be further divided into what?

A

Based on histology;

1) Squamous cell carcinoma (20-30%)
2) Adenocarcinoma (30-40%)
3) Large cell undifferentiated carcinoma (10-15%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 2 features do SCCs show?

A

areas of keratinisation and/or intercellular bridges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 2 features do adenocarcinomas show?

A

Produce mucin and/or show areas of gland formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which tumours show areas of keratinisation?

A

SCCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which tumours show areas of gland formation?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aside from SCCs, adenocarcinomas and large cell undifferentiated carcinomas, what are 3 other 1ary malignant lung tumours (less common)?

A
  1. Carcinoid tumours
  2. Malignant mesenchymal tumours
  3. Primary lung lymphomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Survival of carcinoid tumours?

A

Low grade malignant tumours, better survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who are primary lung lymphomas more commonly seen in?

A

can be seen in HIV/AIDS patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common type of malignant mesenchymal tumour?

A

synovial sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 2ary lung tumours?

A

Tumours that have arisen in other areas of body and metastasised to the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Are 1ary or 2ary lung tumours more common?

A

2ary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do 2ary lung tumours typically present?

A

As multiple discrete nodules, can also be solitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common form tumour that can metastasise to cause a 2ary lung tumour?

A

Most common are carcinomas from various sites eg. Breast, GI tract, Kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What other tumours can metastasise to cause a 2ary lung tumour?

A

Sarcomas
Melanomas
Lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Epidemiology of Lung Cancer

A

Most common cause of cancer death in the UK and worldwide.

In the UK around 45 000 new cases are diagnosed each year and > 30 000 deaths/year.

M > F, only slight

Major public health problem.

Age usually between 40 and 70 yrs, rare in younger individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What has the rise in the incidence of Lung Cancer over the last century closely paralleled?

A

Cigarette smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the 5 year survival rate of lung cancer?

A

5-10%

23
Q

Aetiology of lung cancer?

A
  1. Tobacco smoking
  2. Occupational/Industrial hazards, eg Asbestos, uranium, arsenic, nickel
  3. Radiation – mines in which there is radon

Can ALSO be predisposed by;

  1. Lung fibrosis
  2. Genetic mutations
24
Q

Which genetic mutations can predispose to lung cancer? Who are these seen in?

A

EGFR, KRAS, ALK etc

Usually seen lung cancers in non smokers

25
Q

Mutations in which genes drive lung cancer?

A

Mutations in key genes regulating cell proliferation, DNA repair and apoptosis

26
Q

How can cigarette smoke lead to SCC?

A

Squamous metaplasia –> dysplasia –> carcinoma in-situ –> frank squamous carcinoma

27
Q

What is squamous metaplasia?

A

A pre-neoplastic change of the bronchial epithelium observed in the lungs in response to toxic injury induced by cigarette smoke

28
Q

What does squamous epithelium replace in squamous metaplasia?

A

Columnar epithelium

29
Q

What is dysplasia?

A

A broad term that refers to the abnormal development of cells within tissues or organ

30
Q

What is carcinoma in situ?

A

Carcinoma in situ refers to cancer in which abnormal cells have not spread beyond where they first formed.

31
Q

How many pack years is 40 cigarettes per day for 6 months?

A

1

32
Q

Where do 2/3rd of world smokers reside?

A

China

33
Q

What is the latent period between exposure to asbestos and development of carcinoma?

A

20 years

34
Q

The risk of carcinoma after asbestos exposure increases 20-100 fold if combined with what?

A

Cigarette smoking

35
Q

What other respiratory illnesses is asbestos associated with?

A

lung fibrosis and mesothelioma

36
Q

What is mesothelioma?

A

malignant tumour of the pleura

37
Q

What is a common feature of brain metastases?

A

Epilepsy/seizures

38
Q

How do bone metastases affect calcium levels?

A

Increased calcium levels - bone metastases cause an imbalance between bone formation and bone resorption, resulting in the release of excess calcium into the blood.

39
Q

How do bone metastases affect fragility of bone?

A

Increased risk of pain and fracture

40
Q

Why can lung cancer present with haemoptysis?

A

Central tumours arising in proximal airways can ulcerate and bleed

41
Q

Why can lung cancer present with breathlessness or features of pneumonia?

A

Tumour obstructing airways with distal collapse or consolidation

42
Q

Lung tumours can infiltrate into adjacent structures. What are the features if it infiltrates;

a) pleura
b) chest wall/ribs
c) recurrent laryngeal nerve
d) sympathetic chain
e) oesophagus

A

a) pleural effusion presenting as breathlessness
b) pain
c) hoarseness
d) Horner’s syndrome
e) dysphagia

43
Q

What are common sites of metastases of lung tumours?

A

lymph nodes, pleura liver, bone, adrenal, brain

44
Q

How would metastases to bone present?

A

Fracture

45
Q

How would metastases to lymph nodes present?

A

Lumps in neck

46
Q

Non specific features of lung cancer?

A
  • Usually metabolic effects
  • Weight loss, lethargy
  • Electrolytic disturbances
  • Finger clubbing
47
Q

What electrolyte disturbances are seen in small cell carcinoma?

A

Hyponatraemia or hypokalaemia

48
Q

What electrolyte disturbances are seen in SCC?

A

Hypercalcaemia

49
Q

What is lymphangitis carcinomatosa?

A

Lymphatics within the lung are diffusely involved by tumour.

50
Q

If patients are diagnosed with early stage (disease limited to lung or extension into local nodes), what management can they be offered?

A

Surgery or radical radiotherapy - almost curative

Patients must be fit for surgery

51
Q

What is Personalised/Precision Medicine?

A

Selection of patients for a specific treatment based on the presence of specific biomarkers which indicate sensitivity to corresponding targeted therapies and /or lower toxicity risk, such patients will have the greatest chance of deriving benefit from the treatments.

52
Q

Recent Advances in Treatment of Lung Cancer with advanced disease :

A

Targeted/tailored therapy

Based on tumour genomics, driver mutations eg EGFR mutations, ALK re-arrangements, ROS 1, BRAF etc

Immune checkpoint inhibitors eg PD-L1

53
Q

Which immune checkpoint can be looked for in personalised treatment of lung cancer?

A

PD-L1

Yr 2 - Clinical Pathology (80 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions