Pathology Of Lung Cancers Flashcards
Aetiology of lung cancer
TOBACCO (more than 85% of cases and 10% of smokers, females may be more susceptible )
asbestos, environmental radon, other occupational exposure, pollution, pulmonary fibrosis
Passive smoking accounts for
Causes at least 25% of the 15% of non-smoking lung cancers
N-nitrosamines
Could cause adenocarcinomas
Polycyclic aromatic hydrocarbons type of cancer caused
Could cause squamous small cell lung cancer
Cigarettes
4000 chemical compounds with 60 carcinogens at least
Multi hit theory of carcinogens
Host activates pro-carcinogens, inherited polymorphisms predispose meaning you have more enzymes that do this
Cancer in lung periphery- what cells are affected and what type of cancer is it
Bronchioalveolar epithelial stem cells transform, adenocarcinoma
Cancer in central lung airways
Bronchial epithelial stem cells transform, squamous cell carcinoma
Oncogene addiction
Some cancers rely on specific mutations to proliferate eg K-ras (smoking induced) and EGFR, BRAF and HER2
Which mutation targets have agents which are approved
EGFR, ALK rearrangement, ROS1 rearrangement, BRAF
Carcinoid tumour
<5% of lung neoplasms, low grade malignancy
Bronchial gland tumours
Very rare
4 main types of lung cancer
Squamous cell, adenocarcinoma (getting more common) small and large cell carcinoma.
Local effects of lung cancer
Bronchi obstruction (collapse, infection/abscess, bronchiectasis, endogenous lipoid pnumonia)
Pleural (inflammatory or malignant)
Direct invasion of chest wall or nerves eg phrenic, left recurrent laryngeal nerve(bovine Cough), brachial plexus, cervical sympathetic. Or of Mediastinum
Lymph node metastasis
Distant effects of lung cancer
Distant metastasis
Neural, vascular
Non metastatic
