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Systems: Respiratory > Pathology of Lung Cancer > Flashcards

Pathology of Lung Cancer Flashcards

1
Q

What is the most common aetiology of lung cancer?

A

TOBACCO (duh)

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2
Q

What is the second most common cause of lung cancer?

A

Asbestos

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3
Q

What is the third most common cause of lung cancer?

A

Environmental radon

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4
Q

What are the two main pathways for carcinogenesis in the lung?

A

In the lung periphery=Adenocarcinoma

In the central lung airways = Squamous cell carcinoma

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5
Q

What type of cell is found in lung periphery?

A

Bronchioloalveolar epithelilal stem cells

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6
Q

What type of cell is found in the central lung airway?

A

Bronchial epithelial stem cells

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7
Q

Describe the evolution of bronchogenic Carcinoma

A
  • Squamous Dysplasia to
  • Carcinoma (In situ) to
  • Invasive bronchogenic carcinoma
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8
Q

Describe the evoltution of Adenocarcinoma

A

Aytpical Adenomatous Hyperplasia (AAH) to

  • Adenocarcinoma in situ to
  • Invasive Adenocarcinoma
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9
Q

Name the key driver mutations of adenocarcinogenesis and the % of cases.

A

-KRAS (35%)-Smoking induced
-EGRF (15%)
-BRAF, HER2 (2%)
ALK rearrangements (2%)

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10
Q

What is a benign mass of cartilage

A

Chondroma

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11
Q

What are the four main types of lung carcinoma?

A

Squamous Cell
Adenocarcinoma
Small cell carcinoma
Large cell carcinoma

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12
Q

What is NSCLC?

A

Non-small cell carcinomas = A GROUP OF LUNG CARCINOMAS

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13
Q

What is a pneumonectomy?

A

Removal of lung

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14
Q

What are the local effects of lung cancer?

A
  • Bronchial Obstruction
  • Pleural
  • Direct invasion
  • Lymph Node Metastases
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15
Q

Describe how the Bronchi/bronchioles can be obstructed?

A
  • Collapse
  • Endogenous Lipoid pneumonia
  • Bronchiectasis
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16
Q

What happens during endogenous lipoid pneumonia?

A

Normal cells cannot be removed to due tumour blocking bronchiole. Muco ciliary elevator blocked. Build up of lung debris mostly made of lipids.

17
Q

What happened to pleura form local effects of cancer?

A
  • Inflammation

- Malignant (worse)

18
Q

What happens if direct invasion happens?

A

-Chest walls
-Nerves
Mediastinum

19
Q

What nerves are often affected by direct invasion and what is the outcome of this?

A
  • Phrenic=diaphragmatic paralysis
  • L Recurrent Laryngeal= Hoarse, Bovine cough
  • Brachial Plexus= pancoast T1 damage
  • Cervical sympathetic- Horners syndrome
20
Q

What causes Horners syndrome?

A

Sympathetic ganglion had been destroyed

21
Q

Symptoms of Horners?

A

Lid lag

Veins will not drain

22
Q

What are the locations of distant metastases?

A
  • Liver
  • Adrenals
  • Bone
  • Brain
  • Skin
23
Q

What are the non- metastatic paraneoplastic effects of Lung cancer?

A 
Skeletal
Endocrine
Neurological
Cutaneous
Haematological
Cardiovascular
Renal
24
Q

Describe the skeletal affects of lung cancer?

A
  • Clubbing

- (Hypertrophic pulmonary osteoarthropathy (HPOA)

25
Q

Describe the Neurological affects of lung cancer?

A
  • Polyneuropathy
  • Encephalopathy
  • Cerebellar degeneration
  • Myasthenia
26
Q

Describe the Cutaneous affects of lung cancer?

A
  • Acanthosis nigricans

- Dermatomyositis

27
Q

Describe the haematologic affects of lung cancer?

A
  • Granulocytosis
  • Eosinophilia
  • DIC
28
Q

Describe the cardiovascular affects of lung cancer?

A

-Thrombophlebitis migrans

29
Q

Describe the renal affects of lung cancer?

A

-Nephrotic syndrome

30
Q

Describe the Endocrine affects of lung cancer?

A
  • ACTH (molecule similar in shape produced can lead to cushings disease)
  • siADH (lead to diabetes)
  • PTH ( hyper calcaemia)
  • Carcinoid syndrome
  • Gynecomastia
31
Q

What are the investigations used to diagnosis lung cancer?

A
  • Chest X-ray
  • Sputum cytology (rarely)
  • Bronchoscopy
  • Trans-thoracic Fine needle aspiration
  • Trans-thoracic Core biopsy
  • Pleural effusion
  • Advanced imaging
32
Q

What types of bronchoscopy are available?

A
  • Bronchial biopsy
  • Bronchial brushings and Washings
  • Endobronchial US-Guided aspiration
33
Q

What are the predictive factors for Adenocarcinoma?

A

EGFR, KRAS,HER2, BRAF

ALK Translocation

34
Q

What are the predictive factors for squamous cells?

A

FGFR1 gene copy number, DDR2 & FGFR2 mutations

35
Q

What immune check point do most drugs act upon in fighting cancer?

A

Drugs prevent PD-L1 reaction taking place.

Systems: Respiratory (19 decks)

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