Neoplasms Of The Lung

Question 1

Common gene mutation found in the adenocarcinoma and squamous cell histologic types

Answer 1

AKT1

Question 2

Px that can tolerate pneumonectomy

Answer 2

FEV1 of greater than 2L or greater than 80% of predicted

Question 3

Px that have an adeqaute reserve for lobectomy

Answer 3

FEV1 greater than 1.5L

Question 4

Major Contraindication to thoracic surgery in NSCLC cases according to ACC AHA

Answer 4

(1) Myocardial infarction within the past 3months
20% will die of reinfarction
(2) uncontrolled arrhythmias
(3) FEV1 less than 1L
(4) CO2 retention (resting pCO2 > 45mmHg)
(5) DLCO

Question 5

Defn of Solitary Pulmonary Nodule

Answer 5

Xray density completely surrounded by normal aerated lung with circumscribed margins, of any shape, usually 1-6cm in greatest diameter

Question 6

When is PET Scan indicated in SPN

Answer 6

Useful if lesion is greater than 7-8mm in diameter

Question 7

According to Mayo investigators, what are the 3 clinical charatceristics and 3 radiologic characteristics that were noted to be independent predictors of malignancy?

Answer 7

Clinical Characteristics:

(1) age
(2) cigarette smoking status
(3) prior cancer diagnosis

Radiologic characteristics

(1) nodule diameter
(2) spiculation
(3) upper lobe location

Question 8

Only 2 radiographic criteria thought to predict the benign nature of SPN

Answer 8

(1) lack of growth of over a period of greater than 2 years
(2) certain characteristic patterns of calcification (dense central nidus, multiple punctuate foci, “bulls eye” (granuloma), “popcorn ball” (hamartoma)

Question 9

Lung lesions that present as “ground glass opacities” GGOs on CT Scan

Answer 9

Atypical Adenomatous Hyperplasia (AAH)
Adenocarcinoma In Situ (AIS)
Minimally Invasive Adenocarcinoma (MIA)