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Respiratory System > Pathology of Lung Cancer > Flashcards

Pathology of Lung Cancer Flashcards

1
Q

Number of deaths due to lung cancer worldwide

A

Around 1.59 million

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2
Q

By how much is the number of deaths expected to increase over the next 20 years

A

More than 1.8 times over

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3
Q

Lung cancer aetiology

A 
Tobacco
Asbestos
Environmental radon
Occupational exposure
Air pollution and urban environment 
Other radiation
Pulmonary fibrosis
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4
Q

What percentage of smoking attributes to tobacco

A

> 85%

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5
Q

What percentage of smokers get lung cancer

A

10%

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6
Q

Are females or males more susceptible to lung cancer

A

Females

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7
Q

What percentage of non-smoking lung cancers are due to passive smoking

A

25%

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8
Q

Passive smoking increases the risk of lung cancer by what percentage

A

50-100%

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9
Q

Tobacco smoke and lung cancer

A

Epithelial effects
Multi-hit theory of carcinogenesis
Host activation of pro-carcinogens

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10
Q

Multi-hit theory of carcinogenesis

A

Several genetic changes need to to occur in a specific sequence in one cell in order for cancer to occur

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11
Q

Two main pathways of carcinogenesis occur in which areas of the lung

A

In the lung periphery

In the central lung airways

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12
Q

Carcinogenesis in the lung periphery

A

Bronchiolalveolar epithelial stem cells transform - adenocarcinoma

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13
Q

Carcinogenesis in the central lung airways

A

Bronchial epithelial stem cells transform - squamous cell carcinoma

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14
Q

Key mutations in adenocarcinogenesis (biomarkers)

A 
KRAS
EGFR
BRAF
HER2
ALK rearrangements
ROS1 gene rearrangements
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15
Q

Smoking induced key driver mutations in adenocarcinogenesis

A

KRAS

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16
Q

Key mutations in squamous cell carcinoma

A 
FGFR1
DDR2
PIK3CA
MET
BRAF
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17
Q

Tumours of the lung

A 
Benign
Carcinoid tumour
Tumours of bronchial glands
Lymphoma
Sarcoma
Metastases
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18
Q

5 main types of carcinomas of the lungs

A 
Non-small cell:
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Alveolar carcinoma
Small cell:
Small cell carcinoma
19
Q

Small cell carcinomas account for what percentage of carcinomas

A

15%

20
Q

Non-small cell carcinomas account for what percentage of carcinomas

A

85%

21
Q

Primary lung cancers are asymptomatic until

A

Disease is very advanced and metastatic

22
Q

Local effects of lung cancer

A

Bronchial obstruction
Pleural
Direct invasion
Lymph node metastases

23
Q

Bronchial obstruction effects

A

Collapse
Endogenous lipoid pneumonia
Infection/abscess
Bronchiectasis

24
Q

Pleural effects

A

Inflammation

Malignancy

25
Q

Direct invasion into

A

Chest wall
Nerves
Mediastinum

26
Q

Nerves that can be effected by direct invasion

A

Phrenic
L recurrent laryngeal
Brachial plexus
Cervical sympathetic

27
Q

Lymph node metastases effect

A

Mass effect

Lymphangitis carcinomastosa

28
Q

Lung cancer can directly metastasise to

A 
Liver
Adrenals
Bone
Brain
Skin
29
Q

Distant effects

A

Distant metastases
Secondary to local effects
Non-metastatic effects

30
Q

Effects secondary to local effects

A

Neural

Vascular

31
Q

Examples of non-metastatic effects

A

Finger clubbing

HPOA

32
Q

Hormones secreted in excess by small cell carcinoma

A

ACTH

siADH

33
Q

Hormone secreted in excess by squamous carcinoma

A

PTH

34
Q

Excess PTH hormone results in

A

Hypercalcemia

35
Q

Lung cancer investigations

A 
Chest x-ray
Sputum cytology 
Bronchoscopy
Trans-thoracic fine needle aspiration
Trans-thoracic core biopsy
Pleural effusion cytology and biopsy
Advanced imaging techniques
36
Q

Advanced imaging techniques

A

CT, MRI, PET

37
Q

Prognostic factors in lung cancer

A

Stage of disease
Type of disease
Markers/oncogenes/gene expression profiles

38
Q

Percentage of people with lung cancer that get surgical treatment in Scotland

A

10-12%

39
Q

5 year survival rate of non-small cell carcinomas

A

10-25%

40
Q

5 year survival rate of small cell carcinoma

A

4%

41
Q

Immune checkpoints examples (biomarker)

A

PD1/PD-L1

CTLA4

42
Q

Immunotherapy effect

A

Causes immune system to switch back on

43
Q

Immune checkpoint inhibitors

A

Drugs that work against immune checkpoints

44
Q

Immune checkpoints

A

Control immune reactions

Respiratory System (20 decks)

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