Pathology of Lung Cancer Flashcards
What is the major cause of Lung cancer
Smoking - 85%
What is further examples of the aetiology of lung cancer
asbestos exposure (mineral)
Environmental radon (decay of radioactive elements in granite type rocks)
Other occupational exposures such as nickel, hydrocarbons etc.
Air pollution from an urban environment
Other radiation
Pulmonary fibrosis
In what gender is the risks of lung cancer higher and why
Male - higher cigarette consumption
What is another name for Lung cancer
Pulmonary Neoplasia
How is pack years measured
packs per year per day
How do you reduce you risk of lung cancer as a smoker a
abstinence
What does tobacco consumption effect
The epithelium
Multi hit theory of carcinogenesis - activating procarcinogenesis
Is the livers detoxification for tobacco smoke efficient
No
What is the two main pathways of the carcinogenses of the lungs and there tumour names
In the lung periphery - adenocarincoma
In the central lung airways - squamous cell carcinoma
What changes occur in the lung periphery (main lung)
branchioalveolar epithelia stem cell transforms
What changes occur in the central lung airways
Bronchial epithelia stem cells transform
What are the 5 onconogenes in lung cancer
KRAS EGFR BRAF HER2 ALK rearrangements
What onconogenes is smoking induced
KRAS
What is the potentially tumours of the lungs
- Benign causes of mass lesion
- Carcinoid tumour – low grade malignancy.
- Tumours of bronchial glands (very rare)
- Lymphoma
- Sarcoma
- Metastases to lung – very common
What is the detrimental effect of primary lung cancer being a silent disease
symptoms don’t show for a long time, increasing its malignancy - making it less likely to be cured
What do squamous cells lead to in lung cancer
Hypercalcemia - destruction of bones
What is the leading cell type of lung cancer
adenocarinoma (in the periphery of the lungs)
What is the effect of small cell carcinoma on the endocrine
releases hormones
What parts surrounding the respiratory tract can lung cancer locally effect
Bronchial Pleural Lymph node chest wall nerves
What is the effects of bronchial obstruction caused by lung cancer
Collapse of the lungs
infection
abscess
increased mucous -mucous ciliary escalator blocked
Endogenous lipoid pneumonia (cholestrol)
Bronchiectasis - bronchial widening
What causes changes in the pleura
inflammation of the tumour
What can the tumour directly invade
The chest wall (e.g. pericardium, vena cava)
The destruction of the phrenic nerve by metastasis lung cancer results in what
paralysis of the diaphragm
Destruction of the Left recurrent laryngeal causes what?
paralysis of vocal cords
Presents a Bovine cough -cow like sound
Destruction of what nerve would cause neurological syndromes in the arm
Brachial plexus
Lung cancer destroying cervical sympathetic ganglion (nerves on the side of the neck ) results in what syndrome
Horner’s syndrome
a condition marked by a contracted pupil, drooping upper eyelid, and local inability to sweat on one side of the face, c
Where is the distant metastasis of lung cancer
liver, adrenal glands, bone, brain, skin
Where can the Paraneoplastic Effects of Lung cancer affect in the body
skeletal endocrine Neurological cutaneous Haematologic Cardiovascular Renal (check notes for the conditions)
Secondary to local effect of lung cancer are either what
neural or vascular
What are non metastasis effect usual mediated by
auto - immunity
What is examples of non metastasis effects
Finger clubbing
Hypertrophic Pulmonary Osteoarthropathy (combined clubbing and inflammation of small hand joints)
What are the investigations for Lung cancer
Chest x ray (or adv. CT/MRI/PET)
Bronchoscopy
Trans-thoracic fine needle aspiration/biopsy
What does the prognosis for lung cancer depend on
- Stage of disease
- Classification of disease
- Markers/oncogenes/gene expression profiles
What prognosis is worse non small cell carcinoma or small cell carcinoma
small cell carcinoma
What selects patients for therapy
predicative biomarkers
when does endogenous lipoid pneumonia occur
when obstruction occur and lipids from dead alveolar walls enter the bronchial tree
What are the symptoms of Horners syndrome
a condition marked by a contracted pupil, drooping upper eyelid, and local inability to sweat on one side of the face, caused by damage to sympathetic nerves on that side of the neck
