Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

S2 Respiratory System > Pathology of Lung Cancer > Flashcards

Pathology of Lung Cancer Flashcards

1
Q

what is the most common cause of death by cancer in Europe?

A

lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what percentage of all deaths in Scotland does lung cancer account for?

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the aetiologies for lung cancer from most important to least?

A

smoking, asbestos, environment radon, chromates + hydrocarbons + nickel, air pollution and urban environment, other radiation, pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what percentage of lung cancer gets attributed to tobacco?

A

> 85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what percentage of smokers get lung cancer?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does smoking increase the chances of lung cancer?

A
  • epithelial effects
  • multi-hit theory of carcinogenesis
  • host activation of pro-carcinogens (inherited polymorphisms predispose; metabolism of pro-carcinogens + nicotine addiction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the two pathways of carcinogenesis in the lung?

A

in the lung periphery and in the central lung airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what transformations occur in the lung periphery?

A

bronchioalveolar epithelial stem cells transform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the outcome of the lung periphery pathway?

A

adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what transformations occur in the central lung airways?

A

bronchial epithelial stem cells transform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the outcome of the central lung airways pathway?

A

squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which of the two pathways is likely to happen in none-smokers as well as smokers?

A

the peripheral lung adenocarcinogenesis is less strongly associated with smoking; it does occur in smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which oncogene mutation is linked to smoking?

A

KRAS (35%?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which oncogenes are not related to tobacco carcinogenesis?

A

EGFR (15%?), BRAF, HER2 (2% each?), ALK rearrangements (2%?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the different tumours which affect the lung?

A
  • lymphoma
  • sarcoma
  • metastases (very common)
  • benign causes of mass lesion
  • carcinoid tumour
  • tumours of bronchial glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are carcinoid tumours?

A
  • <5% of lung neoplasms

- low grade malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are tumours of bronchial glands?

A

either:
- adenoid cystic carcinoma
- mucoepidermoid carcinoma
- benign adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

are tumours of bronchial glands common?

A

NO they are rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what main types of lung carcinomas are there?

A
  • squamous (40%, stable since 197/80s)
  • adenocarcinoma (41%, increase since 197/80s)
  • small cell carcinoma (SCLC) (15%, stable since 197/80s)
  • large cell carcinoma (4%, decrease since 197/80s)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is “adenocarcinoma in situ”?

A

old name given to bronchioloaveolar cell carcinoma, formerly a subtype of adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which are the non-small cell carcinomas (NSCLC)

A

adenocarcinoma, squamous cell carcinoma, large cell carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

is NSCLC a single type of lung carcinoma?

A

NO

23
Q

why is this term even used then?

A

sometimes in diagnosis this term is used because no distinction can be made between particular types of non-small cell carcinoma on small biopsy samples

24
Q

how easily detected is primary lung cancer? why?

A
  • not easily, grow ‘clinically silent” for years
  • presents LATE in its natural history
  • may have few, in any, signs or symptoms until disease is very advanced
  • may be found incidentally, during investigation for something unrelated
  • generally speaking, symptomatic lung cancer is fatal
25
Q

what are the type of local effects of lung cancer?

A

bronchial obstruction, pleural effects, direct invasion, lymph node metastases

26
Q

what are the different effects of bronchial obstruction?

A
  • collapse
  • endogenous lipoid pneumonia
  • infection/ abscess
  • bronchiectasis
27
Q

what are the different pleural effects?

A
  • inflammation

- malignant (tissue destruction?)

28
Q

where can a local direct invasion happen?

A
  • chest wall
  • nerves
  • mediastinum (superior vena cava, pericardium)
29
Q

what happens if the local effect of lung cancer is the direct invasion of nerves?

A
  • if phrenic nerve -> diaphragmatic paralysis
  • if L recurrent laryngeal -> hoarse, bovine cough
  • if brachial plexus -> pancoast T1 damage
  • if cervical sympathetic -> Horner’s syndrome
30
Q

what are the local effects of lymph nodes metastases?

A
  • mass effect

- lymphangitis carcinomatosa

31
Q

what is mass effect?

A

in medicine, a mass effect is the effect of a growing mass that results in secondary pathological effects by pushing on or displacing surrounding tissue

32
Q

where does lung cancer usually metastase to?

A

liver, adrenal, bone, brain, skin

33
Q

what secondary local effects are there?

A

neural, vascular

34
Q

does lung cancer also have some non-metastatic distant effects?

A

yes

35
Q

non-metastatic paraneoplastic effects of lung cancer: what effects on the skeleton?

A
  • clubbing

- HPOA (hypertrophic pulmonary osteoarthropathy)

36
Q

non-metastatic paraneoplastic effects of lung cancer: what effects on the endocrine system?

A
  • ACTH, siADH (small cell), PTH (squamous)
  • carcinoid syndrome
  • gynecomastia
37
Q

non-metastatic paraneoplastic effects of lung cancer: what neurological effects?

A
  • polyneuropathy
  • encephalopathy
  • cerebellar degeneration
  • myasthenia (Eaton-Lambert)
38
Q

non-metastatic paraneoplastic effects of lung cancer: what effects on the cutaneous system?

A
  • acanthosis nigricans

- dermatomyositis

39
Q

non-metastatic paraneoplastic effects of lung cancer: what haematologic effects?

A
  • granulocytosis
  • eosinophilia
  • DIC
40
Q

non-metastatic paraneoplastic effects of lung cancer: what effects on the cardiovascular system?

A
  • thrombophlebitis migrans
41
Q

non-metastatic paraneoplastic effects of lung cancer: what effects on the renal system?

A
  • nephrotic syndrome
42
Q

how do you investigate lung cancer?

A
  • chest Xray
  • bronchoscopy
  • trans-thoracic fine needle aspiration
  • trans-thoracic core biopsy
  • pleural effusion
  • advanced imaging techniques
43
Q

how often is sputum cytology used?

A

rarely

44
Q

what are the different types of bronchoscopy?

A
  • bronchial biopsy
  • bronchial brushings and washings
  • endobronchial US-guided aspiration (EBUS)
45
Q

what are the different types of imaging techniques used for the investigation of lung cancer?

A

CT scanning, MRI, PET, other imaging

46
Q

what factors affect the prognostic of lung cancer?

A
  • stage of disease
  • classification (type of disease, according to markers, oncogenes, gene expression profiles, growth rate, cell proliferation, DNA aneuploidy, immune cell infiltration)
47
Q

why else might prognostic markers be used?

A

to select patients for adjuvant therapy

48
Q

how good is the prognosis in lung cancer?

A

generally dreadful

49
Q

what are the chances of surviving 5 years in Scotland? the US?

A

<7% in Scotland, 15% in the US

50
Q

what if the cancer is operable? is there a correlation with stage?

A

stage 1 > 60% 5YS
stage 2 35% 5YS
YES

51
Q

what percentage of lung cancer patients get surgical treatment in Scotland?

A

around 10%

52
Q

what is the 5YS % for non-small cell carcinomas?

A

10-25%

53
Q

what is the 5YS % for small cell carcinomas?

A

4%, the median survival is 9 months

54
Q

which are the predictive markers used to select patients for therapy?

A
  • adenocarcinoma: EGRF, KRAS, HER2, BRAF mutations, ALK translocations etc etc
  • squamous cell: FGFR1 gene copy number, DDR2 & FGFR2 mutations etc

S2 Respiratory System (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions