Neoplastic Disorders Flashcards
Rare neuroendocrine (enterochromaffin cell) tumors characterized by slow growth and low METS
Bronchial carcinoid tumors
Serotonin, ACTH, ADH, MSH
Substances secreted by bronchial carcinoid tumors
Bronchial carcinoid tumors are usually ___ ___
Well differentiated
How many patients with a bronchial carcinoid tumor are asymptomatic?
25-39%
What are the two clinical manifestations of bronchial carcinoid tumors?
- asymptomatic
2. Carcinoid syndrome
Diarrhea due to increase in serotonin
Carcinoid syndrome
What levels can be increased in bronchial carcinoid tumors that cause flushing, tachycardia, bronchoconstriction, hemodynamic instability, and acidosis?
Bradykinin and histamine
How do you diagnose bronchial carcinoid tumors?
“Pink to purple well-vascularized central tumor”
How do you manage bronchial carcinoid tumors?
Excision
What is the most common cause of cancer deaths in men and women?
Malignant bronchogenic carcinoma
What is the most common cause of bronchogenic carcinoma?
Cigarette smoking (including 2nd hand)
Bronchogenic carcinoma accounts for ____% of lung cancer seen in smokers
85
Where are METS most likely to spread to with bronchogenic carcinoma?
Brain Bone Liver Lymph nodes Adrenals
What is the first line treatment for non small cell carcinoma?
Surgery
NSCLC is usually ______ spread
Locally
Which Bronchogenic carcinoma accounts for 85% of cases?
NSCLC
What ist he most common type of bronchogenic carcinoma in smokers, non smokers, and women?
Adenocarcinoma
Adenocarcinoma is typically _______ located
Peripheral
Associated with smoking and cavitary lesions, hypercalcemia, and pan coast syndrome
Squamous cell carcinoma
Squamous cell carcinoma is typically _______ located
centrally
Usually peripheral and very aggressive
Large cell (anaplastic) carcinoma
Rare, interstitial lung pattern associated with voluminous sputum; Associated with the best prognosis
Bronchoalveolar NSCLC
Metastasizes early* METs usually found on presentation. Increased association with smoking.
Small cell (oat cell) carcinoma SCLC
Why is Small cell carcinoma usually central and aggressive?
Bc there is mets at presentation
Is surgery usually a treatment of choice for SCLC?
No
Small cell carcinoma is eerily associated with?
Paraneoplastic syndromes
What ist he management for small cell carcinoma?
Chemotherapy with or without radiation
Dilated neck veins, facial plethora, prominent chest veins
SVC syndrome
What is SVC syndrome most commonly associated with?
Small cell carcinoma
what are the clinical manifestations of bronchogenic carcinoma?
Trousseaus syndrome SVC syndrome Hypercalcemia/Hyponatremia Cushing's syndrome Eaton-lambert syndrome Pancoast syndrome
Hypercalcemia is a clinical manifestation most often associated with?
Squamous cell carcinoma
Hypernatremia is a clinical manifestation most often associated with?
Small cell carcinoma
Cushing’s syndrome and eaton-lambert syndrome most often associated with?
Small cell carcinoma
Shoulder pain, horner’s syndrome (mitosis, ptosis, anhydrosis), and atrophy of hand/arm muscles are a triad called?
Pancoast syndrome
Pancoast syndrome is a clinical manifestation most often associated with?
NSCLC esp. squamous cell
Where would you find a pancoast tumor? How does it explain pancoast syndrome?
In the apical region under the clavicle, it presses on cervical CNs
How big does a lesion have to be for it to be considered a mass?
3cm
Pulmonary nodules are also known as __ __
Coin lesions
What are solitary nodules usually a result of?
Old or active TB
Fungal infection
Foreign body reaction
Wegener’s granulomatosis, sarcoidosis, and RA are all pulmonary nodules that result from ___
inflammation
What is the most common anterior mediastinal tumor?
Thymoma
Rounds and smooth (
Benign pulmonary nodule
Irregular, speculated
Rapid (may double in 4 months)
Cavitary with thickened walls
Malignant pulmonary nodule
When are pulmonary nodules usually found?
Unexpectedly at radiography; most are asymptomatic
What will give an accurate assessment of a pulmonary nodule?
CT
How do you definitively diagnose a pulmonary nodule?
Biopsy
What is another name for a solitary pulmonary nodule?
Coin lesion
What surrounds a coin lesion?
Usually normal lung tissue
Granulomas that result from TB, histoplasmosis, and coccidiomycosis are usually what type of pulmonary nodule?
Infectious
A lesion that has not enlarged in ___ years suggests a benign cause
2
Malignant lesions are usually greater than ___cm in diameter
2
Malignant lesions typically have _____ margins
indistinct
Malignant lesions usually ____ progress
rapidly
Malignant lesions are _______ calcified
rarely
How do you manage a pulmonary nodule that has a low probability of malignancy?
They should be watched with CTs every 3 months for a year, then reduced to every 6 months for 2 years
How do you manage a pulmonary nodule that has a high probability of malignancy?
Resect ASAP
How do you manage a pulmonary nodule that has an intermediate probability of malignancy?
Biopsy
What will help delineate the mass and detect adenopathy or the presence of multiple nodules
CT
