Pathology: Lung Cancer genetic/immunostain Markers Flashcards
targetted therapy for EGFR
erlotinib
targeted therapy for ALK
crizotinib
egfr-dependent pathway is found in
non-smokers
KRAS dependent pathway found in
smokers
name the five types of adenocarcinoma
acinar--> most common papillary micropapillary bad prognisis lepidic (AIS--> good ) solid (bad prognosis)
cancer most likely to cavitate
Squamous cell carcinoma
profile of adeno carcinoma
CK 7+
Napsin A+
TTFi +
profile of squamous cell carcinoma
CD 5/6 +
p40+
p63+
contraindicated in squamous cell carcinoma
bevacizumab
most likely cancer to cause paraneoplastic syndrom
small cell
- cushing’s
- SIADH
- eaton-lambert syndrome
most likley to cause hypercalcemia
squamous cell
PTHRp
syndrome seen with carcinoid tumors
carcinoid syndrome
- flushing
- diarrhea
- cyanosis
pembertons sign seen with
small cell
facial flushingand distended head/nek veins upon raising both arms
cancer most associated with smoking
small cell carcinoma
medastinal lympahdenopathy out of proportion to lung lesion
SMall cell
cavitation more likley to be
squamous cell
non-smoker most likley to be
adenocarcinoma
“lepidic” growth pattern
adenocacinoma in situ
“formerly bronchioloalveolar carcinoma”
–> not invasive and great prognosis
two types of adenocarcinoma in situ of lung
- mucinoud and 2. non mucinous
NON-Mucinous AIS prominent in
smokers
mucinous AIS promenent in
smokers
stage I and 2
small enough to be removed
stage 3
involvement of structure unable to be surgically removed wihtout distant mets
stage 4
structures unable to be surgically removed and with distant mets
non-mucinous more likley to arise from ____ cells
terminal respiratory unit cells CLARA cells and TIIP’s
radiographic sign for non-mucinous
groud glass–> Single Nodule
better prognosis AIS subtype
NON-mucinous–> more often Sxlly resectable
Non-mucinous profile
EGFR +
TTFI+
CK 20-
TTFI -
Mucinous more promient in
non-smokers
radiographic signs of
pneumonia pattern–> multifocal nodules
AIS with worse prognosis
Mucinous sub type–> usually not surgically resctable
mucinous profile
CK 20+
KRAS +
TTFI -
EGFR -
chromogrammin + types
Small cell carcinoma
Carcinoid
centrally located lesaions that cause cough and or hemoptysis
SCLC
Squamous cell
most common to cause hemoptysis
Squamous cell–> because most likely to cavittate
brain mets wiht unidentified source
- Lung– unidentified lesion
2. breast second most common
tx of small cell lung carcinoma
never surgically resectable–> go directly to cytotoxic chemotherapy
markers for primary lung tumor
CK 7+
TTF1 +
CK 20-
cdx2-
Colon primary markers
ck 20+
cdx2+
breast primary markers
ck7+ only
kidneys markers
negative for all four
ck7 cdx2 ttf1, ck20
mesothelioma marker
p67
smoking and asbestos exposure increase risk of ____ x 5 fold
bronchogenic lung cancer only
pt’s with asbestos exposure more likely to get_____
lung cancer over mesothelioma
profile of mesothelioma
WT1
CK 5/6
d2-40
calretin
genetic mishap in mesothelioma
homozygous deltion of CDKn2A/INK4a
