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Respiratory > Pahtology of lung cancers > Flashcards

Pahtology of lung cancers Flashcards

1
Q

What are the leading causes of lung cancers in order?

A 
Tobacco
Asbestos
Environmental radon exposure (granite)
Occupational exposures
Air pollution
Pulmonary fibrosis
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2
Q

What quantity of lung cancers are attributable to smoking?

A

> 85%

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3
Q

If a smoker has lung cancer, is smoking always the cause?

A

No

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4
Q

Does risk of lung cancer drop after quitting smoking?

A

Yes, but slowly and takes place over a long period of time. 15 years+ down the line there is still a measurable risk among heavy smokers.

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5
Q

What kind of cancer is caused by N-nitrosamines?

A

Adenocarcinomas

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6
Q

What are the 2 kinds of epithelia in lungs?

A

Epithelium of the bronchi and bronchioles

Epithelium of the periphery

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7
Q

Do more cancers occur in the periphery or the bronchi/bronchioles?

A

Periphery

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8
Q

What kind of lung cancer would a non-smoker would be most likely to develop?

A

Adenocarcinoma

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9
Q

What are the 4 main cell types of lung cancers?

A

Squamous cell
Adenocarcinoma
Small cell carcinoma
Large cell carcinoma

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10
Q

What kind of cancer cell type is usually responsible cavitating cancers?

A

Squamous cell carcinomas

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11
Q

List some local effects of lung cancer.

A 
Bronchial collapse
Endogenous lipoid pneumonia
Infection/abscess
Bronchiectasis
Inflamed pleura
Damage to nerves
Lymphadenopathy
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12
Q

Which nerves are commonly invaded by metastases?

A

Phrenic
Left recurrent laryngeal (weird cough)
Brachial plexus
Cervical sympathetic (Horner’s syndrome)

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13
Q

Give some examples of some non-metastatic effects of lung cancer.

A

Clubbing
Gynecomastia
Nephrotic syndrome

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14
Q

What kind of cancer leads cancer deaths in the UK?

A

Lung

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15
Q

What proportion of cancer deaths in the UK are from lung cancer?

A

22%

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16
Q

List some common symptoms of lung cancer?

A

Cough
SOB
Haemoptysis
Hoarse voice

17
Q

What are the 5 “red flag” symptoms doctors look out for in smokers which result in referral to a specialist/surgery

A 
Any cough of smoker greater than 3 weeks
Haemoptysis
Shoulder pain
Change in voice
Unexplained weight loss
18
Q

What are the most common organs for cancer spread from lungs?

A

Liver and kidneys

19
Q

What does EBUS mean?

A

Endobronchial Ultrasound

20
Q

When would ultrasound be useful in diagnosis?

A

If the tumour is near the chest wall.

21
Q

Describe stage 1 cancers

A

Localised
Can be surgically removed
Can be tracked by CT or PET scans

22
Q

What does it mean if the cancer has metastasised to the liver?

A

Stage 4

23
Q

What is the performance status?

A

ECOG
PS1 is some cancer and some symptoms but doesn’t affect daily routine

PS2 Up and about for more than 50% of the day

PS3 Capable only of limited self care. Confined to bed or chair more than 50% of the day

PS4 Completely disabled. Unable to carry out self care.

24
Q

Important points while breaking bad news

A

Make the diagnosis very clear.

Explain the plan of action.

25
Q

How should mediastinum appear on X-ray?

A

Hilar vascular structures should be crisply defined
Trachea should be central
No widening of the mediastinum

26
Q

What kind of tumour often affects the brachial plexus?

A

Right apex/pancoast tumour

27
Q

What’s the difference between a nodule and a mass

A

Mass is opacity >3cm

Nodule is oapcity <3cm

28
Q

What does TNM staging measure?

A

Size and position of the tumour (T)
Whether tumour cells have spread to lymph nodes (N)
Whether the tumour has metastasised (M)

29
Q

Describe T1 stage tumour.

A

Tumour less than 3 cm

Surrounded by lung or visceral pleura

30
Q

Describe T2 stage tumour.

A

Between 3 and 5 cm
Involves main bronchus, but not carina
Invades visceral pleura

31
Q

Describe T3 stage tumour.

A 
Between 5 and 7 cm
Invades chest wall
Invades phrenic nerve
Invades parietal pericardium
Separate tumour nodules on the same lobe as the primary
32
Q

Describe T4 stage tumour.

A 
Over 7 cm
Invades any of the following:
-Diaphragm 
-Mediastinum
-Heart
-Great vessels
-Trachea
-Recurrent Laryngeal Nerve
-Oesphagus
-Vertebral body
-Carina
33
Q

Describe T4 stage tumour.

A 
Over 7 cm
Invades any of the following:
-Diaphragm 
-Mediastinum
-Heart
-Great vessels
-Trachea
-Recurrent Laryngeal Nerve
-Oesophagus
-Vertebral body
-Carina
34
Q

Describe N0 tumour.

A

No regional lymph node metastases

35
Q

Describe N1 tumour.

A

Ipsilateral peribronchal, hilar or intrapulmonary nodes including by direct extension

36
Q

Describe N2 tumour.

A

Ipsilateral mediastinal , subcarinal

37
Q

Describe N3 tumour.

A

Contralateral mediastinal, contralateral hilar, scalene or supraclavicular

38
Q

What proportion of patients present with metastases?

A

Approximately one third

Respiratory (10 decks)

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