Neoplasms Flashcards
tumor surpressor genes implicated in bronchogenic carcinoma
p53
Retinobalstoma
genes on short arm of Chromosome 3
non small cell carcinomas
Squamos
Adenocarcinoma
Large Cell carcinoma
Adenosquamous
response to chemotherapy, small cell and non small cell
small cell only responds to chemo
surgical option in non-small cell
most common bronchogenic carcinoma in males
squamous cell
squamous cell pearls due to keratin synthesis found in
squamous cell carcinoma
most common bronchogenic carcinoma of women, non-smokers
also most common ____
adenocarcinoma
most common lung cancer in US
___ causes DNA damage at same condons of p53 gene, as seen in mutations of bronchogenic carcinoma
benzopyrene
horner’s syndrome in pancoast tumor
ipsilateral ptosis
miosis
ipsilateral anhydrosis
microscopic carcinoid
nests/cords/masses
unifrom cells with round nuclei
salt and pepper chromatin
IHC: NSE, chromogranin synaptophysin
prognosis determination bronchogenic carcinoma
TNM (no-small cell)
Small cell -limited disease = confined to single hemithorax with no lymph node involvement
small cell extensive - not confined, lymph involvement
definition paraneoplastic syndrome
symptom complexes that occur in patients with caner that cannot be readily explained by local or distat spread, por by elaboration of hormones by tumor cells
prognosis, bronchogenic carcinoma
highly malignant (4months)
most common visceral malignancy in maless
bronchogenic carcinoma
demographics small cell carcinoma
male smokers, central location
histo small cell carcinoma
associated symptoms
necrosis (crush artifact)
secretory neuroendocrien granules
advanced stage
paraneoplastic syndrome common
routes of metastasis bronchogenic carcinomas
hilar lymph nodes (lymphatic spread)
adrenal glands (hematogenic)
liver (hematogenic)
brain (hematogenic)
bone (hematogenic)
histo sqaumous cell carcinoma
**central cavity necrosis **
central
keratin formation
intercellualr bridges
usually endobronchial
response to chemo small cell carcinoma
excellent response
(but recurs rapidly)
presentation bronchogenic carcinoma
50s
7months of symptoms
Cough
Weight loss
chest pain
dypsnea
inscreased sputum
4 histo presentations, adenocarcinoma
glandular with mucin
papillary
solid
or **Lepidic (Bronchioalveolar) - **single periphereal nodule, or multiple nodules, lepidic spread along alveolar septa
demographic carcinoid tumors
<40 years
m=f
histo large cell carcinoma
large cells without differentiation
highly malignant
mostly peripheral
Bronchogenic carcinoma etiology
Tabocco
industrial hazards
air polution (indoor radon)
genetics (oncogenes)
scarring
pattern Bronchioalveolar subtype of adenocarcinoma
lepidic spread along alvolar septa
nonmucinus type follows clara, type 2 cells, typically nodular
mucinous type (tall, columnar cells) worse prognosis, typical diffuse
clinical course carcinoid tumors
hemoptysis
cough
obstructive symptons (if intraluminal growth)
infections, bronchietasis, atelectasis or emphysema
carcinoid syndrome
metastases rare (typically benign)
epidermal growth factors confiend to adenocarcinoma
EGFR
KRAS
EML4-ALK
(predictive of response and resistance)
presentation and pathogenesis carcinoid syndrome
intermittnent diarrhea
flushing
cyanosis
(neuroendocrine cell 5HT secretion)
growth+metastasis squamous cell vs adenocarcinoma
adenocarcinoma grows more slowly, metatasizes more frequently than squamous cell
paraneoplastic syndromes (5)
(common in small cell
Cushings (ACTH)
Hyonatremia (innaporpriate ADH secretion)
Carcinoid syndrome (5HT)
Hypercalcemia (parahormone) (squamous cell)
myastehnic syndrome (eaton lambert)
presentation andenosquamous carcinoma
squamous+adeno
peripheral
associated with scarring
similar to adenocarcinoma clinically
smokers
drug with toxicity (hemorrhage) in SqCC
Bevacuzimab
5 year survival for SCC, Adeno carcinoma, small cell
10% for SCC and AdenoCa
3% for small cell
