Pathology of Lung Cancer Flashcards
What is the number one cause of cancer related deaths?
Lung cancer
bet you’d never have guessed that
What is the biggest cause of lung cancer?
Tobacco
After tobacco, what are the three highest causes of lung cancer?
- Asbestos
- Environmental radon (from natural uranium bearing rocks, like granite)
- Air pollution/ urban environment
What % of lung cancer seen is due to smoking.
85%
Out of ten people how many develop lung cancer?
1 in 10
Even if you don’t smoke, why may you develop smoking related lung cancer?
Prolonged inhalation of smoke fumes
Describe what happens when a person stops smoking.
Risks of lung cancer reduce but gradually and slowly.
There will be persisting genomic damage
Name the two groups of chemicals found in cigarettes
Polycyclic aromatic hydrocarbons
N-nitrosamines
Name the two groups of carcinogenesis in lung cancer.
Adenocarcinoma
Squamous cell carcinoma
How does tobacco smoke effect the epithelium?
It damages airway epithelial cells, causing inflammation and increasing the risk of lung cancer.
Which process can smoking increase?
Carcinogenesis
What can tobacco smoke activate?
Pro-carcinogens
Where do adenocarcinomas form in the lungs?
Around the periphery
Describe the development of an adenocarcinoma in the lungs.
Atypical Adenomatous hyperplasia
(
v
Adenocarcinoma in Situ
(
v
Invasive adenocarcinoma
What type of cell transform in the lungs in the formation of an adenocarcinoma?
Bronchioloalveolar epithelial stem cells
Where can a squamous cell carcinoma form?
Central lung airways
Describe the development of a squamous cell carcinoma in the lungs.
Bronchial basal cell hyperplasia
(
v
Squamous dysplasia and carcinoma in situ
(
v
Invasive squamous cell carcinoma
What type of cell transforms to form a squamous cell carcinoma?
Bronchial epithelial stem cells
List some of the possible tumours in the lungs.
Carcinoid Tumour
Benign causes of mass lesion
Lymphoma
Sarcoma
Tumours of Bronchial Glands
Metastases
Which tumour is very rare in the lungs but can still happen?
Tumours of Bronchial Glands
Define carcinoma
Cancer in the epithelium tissue.
Name the four main subdivions of carcinoma.
Squamous Cell
Adenocarcinoma
Small Cell Carcinoma
Large Cell Carcinoma
Name the two main subdivions of histological types of lung carcinoma
Small cell carcinoma
Non-small cell carcinomas
Name some of the carcinoma’s in the division of NSCLC.
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinomas
Others
Describe symptoms for primary lung cancer
Kind of a trick question
Often ‘silent’ -> no symptoms
Symptoms develop late into the development
If someone shows symptoms of lung cancer, what does this suggest?
That’s it’s potentially fatal
How is lung cancer usually discovered?
Accidently while carrying out other investigations like chest x-rays etc.
Describe what you might see on an x-ray of someone with squamous cell carcinoma?
Lots of holes as tumour usually causes lots of cavities
Name one red-flag symptom which suggest lung cancer.
Haemoptysis
What are some of the local effects of bronchial obstruction?
Bronchial collapse
Endogenous Lipoid Pneumonia
Infection / Abscess
Bronchiectasis
What happens when a tumour involves the pleura?
If a tumour invades the pleura, the pleura can come distorted and the tumour can go through it and into the chest wall
What is the result of lung cancer impacting the phrenic nerve?
Diaphragmatic paralysis
What is the result of lung cancer impacting L Recurrent laryngeal nerve?
Hoarse, bovine* cough
*non- explosive cough of someone unable to close their glotti
What is the result of lung cancer impacting the brachial plexus?
Pancoast T1 damage
What is the result of lung cancer impacting the Cervical Sympathetic nerve?
Horner’s syndrome
What is Lymphangitis carcinomatosa?
Inflammation of the lymph nodes caused by a mallignancy
List some distant places lung cancer can metastasise to.
Liver, Adrenals*, Bone, Brain, Skin
*glands located at the top of the kidneys
List the possible skeletal impacts of lung cancer.
Clubbing
HPOA*
*Hypertrophic pulmonary osteoarthropathy
List the possible endocrine effects of lung cancer.
ACTH, SIADH, PTH
Carcinoid syndrome
Gynecomastia*
*increase in the amount of breast gland tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone
List the possible neurological effects of lung cancer.
Polyneuropathy*
Encephalopathy**
Cerebellar degeneration
Myasthenia (Eaton-Lambert)
malfunction of many nerves around the body
**functioning of brain is affected
**neuromuscular disease
List the possible cutaneous (skin) effects of lung cancer.
Acanthosis nigricans*
Dermatomyositis**
*dry patches of skin usually armpit groin area
**condition which causes muscle weakness and skin rash
List the possible haematologic effects of lung cancer.
Granulocytosis
Eosinophilia
DIC
List the possible cardiovascular effects of lung cancer.
Thrombophlebitis migrans
List the possible renal effects of lung cancer.
Nephrotic syndrome
In terms of endocrine complications due to lung disease, what type of carcinoma causes ACTH and SIADH?
Small cell
In terms of endocrine complications due to lung disease, what type of carcinoma causes PTH?
Squamous
List some investigations used for the diagnosis of lung cancer
Chest X-Ray
Bronchoscopy
Trans-thoracic Fine Needle Aspiration
Trans-thoracic Core Biopsy
Pleural effusion cytology and Biopsy
CT
MRI PET
Name the common way top stage lung cancer.
TMN
Tumour
Node
Metastsis
How do tumours evade immune responses?
They inhibit immune checkpoints
What type of therapeutic treatment is being used more to try and fight lung cancer?
Immune checkpoint inhibitors
