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Respiratory System DO > Pathology of Lung Cancers > Flashcards

Pathology of Lung Cancers Flashcards

1
Q

Why is lung cancer one of the most common worldwide cancers

A

Due to the consumption of tobacco

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2
Q

How many people died due to lung cancer in 2012

A

1.59 million

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3
Q

How many new cases of lung cancer were there in 2015 (Scotland)

A

5052

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4
Q

How many deaths from lung cancer were there in 2016 (Scotland)

A

4035

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5
Q

What is the most common and important cause of lung cancer

A

Tobacco smoking

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6
Q

Name 7 causes of lung cancer from most important to least important

A

Tobacco
Asbestos
Environmental radon – from ground (granite rock)
Other occupational exposure (Chromates, Hydrocarbons, Nickel)
Air pollution and Urban environment
Other radiation
Pulmonary fibrosis

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7
Q

How many lung cancers are due to tobacco

A

Over 85%

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8
Q

How many smokers get lung cancers

A

10%

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9
Q

What is the risk of obtaining lung cancer in male and female smokers

A 
Males = 22 times higher
Females = 12 times higher
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10
Q

Are male or female smoker more susceptible to lung cancer

A

Females

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11
Q

What is the risk of obtaining lung cancer linked to

A

Amount of tobacco consumed but there is no safe smoking threshold

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12
Q

What is the risk of a passive smoker obtaining lung cancer

A

50-100% increased risk

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13
Q

How many non-smoking lung cancers is caused by passive smokers

A

25%

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14
Q

How many males and females in the UK smoke

A

1/3

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15
Q

How many men and female smoke worldwide

A

50% men

12% female

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16
Q

In which countries is tobacco consumption soaring

A

China
South and South East Asia
South America

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17
Q

How many chemical compounds are found in tobacco smoke

A

Over 4000

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18
Q

How many recognised carcinogens are there in tobacco smoke

A

60

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19
Q

What type of cancers do the polycyclic aromatic hydrocarbons (PAH) found in cigarette smoke seem to be causing

A

Cancers in the large central bronchial airways

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20
Q

What type of effects can tobacco smoke have

A

Epithelial effects

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21
Q

What type of theory is behind the carcinogenesis of lung cancer

A

Multi-hit theory

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22
Q

What can the genetics of the host activate

A

Pro-carcinogens

23
Q

What can inherited polymorphisms predispose

A

Metabolism of pro-carcinogens

Nicotine addiction

24
Q

Which cells transform in the lung periphery and what type of lung cancer do they cause

A

Bronchioloalveolar epithelial stem cells transform

Adenocarcinoma

25
Q

Which cells transform in the central lung airways and what type of lung cancer do they cause

A

Bronchial epithelial stem cells transform

Squamous cell carcinoma

26
Q

Which type of lung cancer are women more susceptible to

A

Adenocarcinoma

27
Q

Which type of lung caner is increasing and which is decreasing

A

Squamous cell carcinoma = decreasing

Adenocarcinoma = Increasing

28
Q

What is invasive bronchogenic carcinoma associated with

A

Smoking

29
Q

How do peripheral lung adenocarcinomas develop

A

Start with:
Atypical adenomatous hyperplasia (AAH) then develop into
Adenocarcinoma in situ before becoming
Invasive adenocarcinoma

30
Q

Which type of lung cancer is less strongly associated with smoking and seen in non-smokers

A

Peripheral lung adenocarcinomas

31
Q

Name 5 adenocarcinoma oncogenes

A 
KRAS - approx. 35%
EGFR - approx. 15%
BRAF - approx. 2%
HER2 - approx. 2%
ALK rearrangements - approx. 2%
32
Q

What is the process of adenocarinogenesis dependent on and how can this help treatment

A

Oncogene signalling

If signalling is blocked this could terminate the growth of cancer

33
Q

Which of the adenocarcinoma oncogenes are smoking induced

A

KRAS

34
Q

Which oncogene targets have agents approved by the FDA and EMA

A

EGFR
ALK rearrangements
ROS1 rearrangements BRAF mutations

35
Q

Why are metastases common in the lung

A

As it is the only organ in the body to receive the entire blood flow

36
Q

What types of tumours can be found in the lung

A

Benign causes of mass lesions
Bronchial gland tumors (rare)
Lymphomas
Sarcomas

37
Q

What type of bronchial glad tumors are there

A

Adenoid Cystic Carcinoma
Mucopidermoid carcinomas
Benign adenomas

38
Q

Name the 4 main lung cancer cell types

A

Squamous cell
Adenocarcinoma
Small cell carcinoma
Large cell carcinoma

39
Q

What are the two histological types of lung carcinomas

A

Small cell carcinomas (SCLC)

Non-small cell carcinomas (NSCLC)

40
Q

What does Non-small cell carcinomas (NSCLC) consist of

A

Adenocarcinoma
Squamous cell carcinoma
Large cell carcinomas
Others

41
Q

Do primary lung cancers grow with signs and symptoms or clinically silent

A

Clinically silent

42
Q

When do primary lung cancers tend to present

A

Late in its natural history

43
Q

What types of symptoms do primary lung cancers tend to have

A 
Very few (if any) signs or symptoms
Symptoms could be from changes in the character of cough or coughing up blood
44
Q

When do symptoms of primary lung cancer tend to show

A

When the disease has become very advanced

45
Q

When can primary lung cancer be found

A

Incidentally during an investigation for something unreleated

46
Q

What type of obstruction can lung cancer cause

A

Bronchial obstruction

47
Q

What can brocnical obstruction lead to

A

Collapse
Endogenous Lipoid Pneumonia
Infection / Abscess
Bronchiectasis

48
Q

What can lung cancer case

A

Bronchial obstruction
Pleural invasion
Direct Invasion
Lymph Node metastases

49
Q

What can pleural invasion cause

A

Inflammation of pleura

Malignancy of pleura

50
Q

Where can be directly invaded by lung cancer

A

Chest wall

Mediastinum

51
Q

What can be affected in the mediastinum is invaded (be specific)

A 
Nerves: 
Phrenic – diaphragmatic paralysis
Left Recurrent laryngeal – Hoarse, Bovine cough		
Brachial plexus – Pancoast T1 damage			
Cervical Sympathetic - Horner’s syndrome
52
Q

What does Horner’s syndrome cause

A

Pinpoint pupil
Droopy eyelid
Prevents sweating on affected side of the face

53
Q

What can lymph node metastases cause

A

Mass effect

Lymphangitis carcinomatosa

Respiratory System DO (33 decks)

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