Neoplastic lung diseases Flashcards
Genetic mutations associated with SCC of the lungs
Deletions involving 3p, 9p, and 17p –> tumor suppressors
Genetic mutations associated with small cell carcinomas of the lungs
MYC gene amplification
Inactivation of TP53 and RB
3p deletion
Genetic mutations associated with adenocarcinoma of the lungs
EGFR, ALK, KRAS, ROS, MET, and RET
Microscopic features of atypical adenomatous hyperplasia in the lungs
Dysplastic cuboidal epithelium and mild interstitial fibrosis
Microscopic features of bronchioloalveolar carcinoma
Adenocarcinoma in situ –> dysplastic cells growing along alveolar septae, with or without IC mucin
Prognosis in bronchioloalveolar carcinoma
Excellent
Precursor lesions of lung cancers
Squamous dysplasia and carcinoma in situ
Atypical adenomatous hyperplasia
Adenocarcinoma in situ/bronchioloalveolar carcinoma
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
Peripherally located lung tumor associated with scarring. CXR finding is a pneumonia like consolidation. Microscopy shows lepidic pattern and infiltrating glands with mucin.
Adenocarcinoma
Lung cancer that expresses thyroid transcription factor 1 (TTF-1)
Adenocarcinoma
Central lung tumor, near hilum in large bronchus. Grossly appears as a gray-white, firm to hard, fungating or infiltrating lesions, with areas of hemorrhage and necrosis.
Squamous cell carcinoma
Lung cancer type that can produce PTHrP leading to hypercalcemia
Squamous cell carcinoma
Lung tumor with a hilar or central location. It is derived from neuroendocrine progenitor cells of the lining bronchial epithelium
Small cell carcinoma
Lung tumor positive for neuron specific enolase and neurosecretory granules on electron microscopy. Most commonly associated with ectopic hormone production.
Small cell carcinoma
Microscopy of lung tumor show small, round, oval, or spindle shaped cell with scant cytoplasm and ill-defined borders. It has fine granular chromatin. Immunohistochemistry is positive for chromogranin, synaptophysin, neuron specific enolase, and neural cell adhesion molecule.
Small cell carcinoma
Lung tumor that expresses high levels of anti-apoptotic protein BCL2
Small cell carcinoma
Azzopardi effect of small cell carcinoma
Basophilic staining of vascular walls due to encrustation by DNA from necrotic tumor cells
Lung cancer type that is a diagnosis of exclusion with absent markers for adenocarcinoma and SCC
Large cell carcinoma
Finding in pleural effusion fluid when the effusion is caused by a malignancy
Malignant cells
Symptoms of Cushing syndrome
Weight gain
Hypertension
Hypokalemia
Muscle weakness
Lung cancer(s) associated with Cushing syndrome
Small cell lung cancer
Symptoms of SIADH
Euvolemic hyponatremia and concentrated urine
HA
Weakness
Altered mental status
Seizures
Respiratory depression
Death
Lung cancer(s) associated with SIADH
Small cell lung carcinoma
Lung cancer(s) associated with hypercalcemia
SCC
Lung cancer(s) associated with hypertrophic osteoarthropathy and digital clubbing
Non-small cell lung cancer, particularly adenocarcinoma
Paraneoplastic syndrome characterized by auto-antibodies directed to the neuronal calcium channel causing muscle weakness
Lambert-Eaton myasthenic syndrome
Lung cancer(s) associated with opsoclonus/myoclonus ataxia syndrome
SCC
Lung cancer(s) associated with paraneoplastic encephalomyelitis and paraneoplastic cerebellar degeneration
Small cell carcinoma
Microscopy of lung tumor shows small monomorphic cells with round nuclei and scant cytoplasm arranged in nests separated by a delicate fibrovascular stroma
Carcinoid tumor
Low-grade malignant epithelium neoplasm. Neuroendocrine tumor of the lung. Appears as a spherical mass that projects into the lumen of the bronchus
Carcinoid lesion
Symptoms of carcinoid syndrome
Intermittent diarrhea
Flushing
Cyanosis
Disorderly growth of a tissue indigenous to site. Appear as a rounded radio-opacity in CXR when located in the lungs
Hamaroma
Most common site of metastatic neoplasm
Lungs
Genetic mutation in 80% of mesotheliomas
Homozygous deletion of tumor suppressor gene CDKN2A/INK4
Lung is encased by a thick layer of soft, gelatinous, grayish-pink tumor tissue
Mesothelioma
Microscopy types of mesothelioma
Epithelioid
Sarcomatoid
Biphasic
Positive immunohistochemistry in mesothelioma
Calretinin
Cytokeratin
Wilms tumor 1
Podoplanin
Negative immunohistochemistry in mesothelioma
Claudin 4
Lung tumor cells show numerous long slender microvilli and abundant tonofilaments on electron microscopy
Mesothelioma
Most common cause of death in mesothelioma
Cardiorespiratory failure caused by encasement of the heart and lungs by tumor
