Pathology of lung malignancies

Question 1

Oncogenes associated with carcinomas

Answer 1

C-MYC, KRAS, EGFR, C-MET, C-KI

Question 2

Precursor lesions for Lung CA

Answer 2

Squamous dysplasia and carcinoma in situ

Atypical Adenomatous hyperplasia

Diffuse idopathic pulmonary neuroendocrine cell hyperplasia- neuroendocrine tumors

Question 3

Glandular differentiation or mucin production by the tumor cells

Answer 3

Adenocarcinoma

Question 4

Most common type in women and nonsmokers

Answer 4

Adenocarcinoma

-KRAS and EGFR mutations - worse outcome and resistance to EGFR inhibitors

Question 5

Precursor lesion for adenoCA

Answer 5

arise from atypical adenomatous hyperplasia progressing to bronchioalveolar CA which transforms into invasive adenocarcinoma

Question 6

Well demarcated focus of epithelial proliferation of cuboidal to low columnar epithelium; with cytologicatypia

Answer 6

Atypical adenomatous hyperplasia

Question 7

Occurs in pulmonary parenchyma in terminal bronchioalveolar regions

Answer 7

Bronchialveolar Carcinoma

Question 8

Almost always in peripheral lung as a single nodule or more often, as multiple diffuse nodules that sometimes coalesce

Answer 8

Bronchioalveolar carcinoma

Question 9

Histology of bronchioalveolar carcinoma

Answer 9

appears as pure bronchioalveolar growth pattern 9adenocarcinoma in situ) with no evidence of stromal, vascular, or pleural invasion

Question 10

2 types of bronchioalveolar Carcinoma

Answer 10

1. Nonmucinous
   - columnar, peg-shaped or cuboidal cells
2. Mucinous
   - tall, columnar cells with cytoplasmic and intra-alveolar mucin
   - Less likely to amenable to surgery
   - if there are cells containing mucin

Question 11

Squamous pearls

Individual cells with eosinophilic dense cytoplasm

Answer 11

KERATINIZATION

-highest frequency of p53 mutations

Question 12

Benign; coin lesion on chest film, peripheral, solitary less than 3-4 cm well circumscribed

Answer 12

Lung hamartoma