Pathology of Lung Cancer

Question 1

tumors in lung are usually –

Answer 1

fatal/malignant

Question 2

neoplasm is – of tissue that grows by rapid cell proliferation and continues growth after ceased stimuli

Answer 2

abnormal new growth

Question 3

benign tumor cells

Answer 3

resemble cell of origin (well differentiated)

Question 4

benign tumors grow –

Answer 4

locally

Question 5

can benign tumors spread beyond site of origin?

Answer 5

no

Question 6

tumors that cause fewer or no clinical problems

Answer 6

benign tumors

Question 7

tumors that rarely cause death

Answer 7

benign tumors

Question 8

malignant tumor cells

Answer 8

lose resemblance to cell of origin (poorly differentiated)

Question 9

malignant tumors infiltrate local tissues

Answer 9

invasion

Question 10

malignant tumors spread from site of origin

Answer 10

regional and distant metastases

Question 11

tumor that can damage vital organs

Answer 11

malignant tumors

Question 12

tumors that cause death

Answer 12

malignant tumors

Question 13

– differentiated cells metastasize quickly

Answer 13

poorly

Question 14

lung cancer is most common of –

Answer 14

cancer death

Question 15

T/F: risk of lung cancer remains above normal even in ex-smokers

Answer 15

true

Question 16

T/F: some types of lung cancer only occur in smokers

Answer 16

true

Question 17

tumors arise from –

Answer 17

single cell

Question 18

how do we stage cancers?

Answer 18

size, extent and spread of neoplasm

Question 19

major histologic types of lung cancer

Answer 19

squamous cell carcinoma, adenocarcinoma, neuroendocrine tumors (small cell carcinoma)

Question 20

squamous cell carcinoma is closely linked to –

Answer 20

smoking

Question 21

squamous cell carcinoma is usually located in –

Answer 21

central chest

Question 22

squamous cell carcinoma usually arise from –

Answer 22

dysplastic squamous metaplasia

Question 23

gross presentation of lung of squamous cell carcinoma

Answer 23

chalky, easily crumble (friable)

Question 24

histology of squamous cell carcinoma

Answer 24

sheets of cells with eosinophils (red-orange) cytoplasm and “keratin pearls”

Question 25

tumor that arises out of an injured epithelial cell

Answer 25

carcinoma

Question 26

turmor grows out of bronchial gland cell

Answer 26

carcinoma

Question 27

rarely a tumor will grow out of cartilage (mesoderm)

Answer 27

sarcoma

Question 28

tumors that arise from endothelial cells

Answer 28

angiomas

Question 29

pathologic stage depends on

Answer 29

tumor size, chest wall invasion, lymph node involvement, metastases

Question 30

progression of normal epithelium to invasive carcinoma

Answer 30

``` normal epithelium hyperplasia squamous metaplasia dysplasia carcinoma in situ invasive carcinoma ```

Question 31

main risk factor for adenocarcinoma

Answer 31

smoking

Question 32

well differentiated adenocarcinomas seen in non smokers are associated with --

Answer 32

EGFR mutation

Question 33

histology of adenocarcinoma

Answer 33

hyper plastic cells with atypia

Question 34

types of neuroendocrine carcinomas

Answer 34

carcinoid tumor and small cell carcinoma

Question 35

well differentiated tumor with good prognosis

Answer 35

carcinoid (neuroendocrine carcinoma)

Question 36

can carcinoid metastasize?

Answer 36

yes

Question 37

is carcinoid associated with smoking?

Answer 37

no

Question 38

carcinoid tend to occur in --

Answer 38

younger patients

Question 39

carcinoid histology

Answer 39

organoid pattern resembles glands but very monomorphic appearing cells

Question 40

neuroendocrine carcinoma strongly linked to smoking and usually present in older patients

Answer 40

small cell carcinoma

Question 41

poorly differentiated and poor prognosis neuroendocrine carcinoma

Answer 41

small cell carcinoma

Question 42

histology of small cell carcinoma

Answer 42

very small dark cells with very little cytoplasm, extensive crush artifact, necrosis and many mitoses

Question 43

why is synaptophysin stain weak in small cell carcinoma?

Answer 43

poorly differentiated

Question 44

primary sarcomas and lymphomas are --

Answer 44

rare

Question 45

lungs are the most common destination for --

Answer 45

metazoic tumors

Question 46

--, traveling in veins eventually dump into lungs via pulmonary artery

Answer 46

sarcomas

Question 47

-- traveling in lymphatic veins, dump into thoracic duct which empties into systemic venous system

Answer 47

carcinomas

Question 48

EGFR mutation result in

Answer 48

well-differentiated adenocarcinoma

Question 49

mutation of this signaling molecule that is downstream from EGFR results in an upregulation of signaling pathway beyond EGFR point

Answer 49

K-RAS

Question 50

K-RAS mutation is common in --

Answer 50

smokers

Question 51

K-RAS mutation results in

Answer 51

moderate to poorly differentiated non small cell carcinoma (adenocarcinoma)

Question 52

T/F: K-RAS mutation is twice as common as EGFR

Answer 52

true

Question 53

K-RAS mutation is predictive of poor prognosis in resected disease as well as -- to treatment to EGFR inhibitors

Answer 53

resistance

Question 54

-- used as a prognostic marker or screen for EGFR treatment for non-responders

Answer 54

K-RAS

Question 55

mesothelioma is a rare but highly lethal malignancy from mesothelial cells lining --

Answer 55

pleural surface

Question 56

greatest risk factor for mesothelioma

Answer 56

asbestos exposure