Pathology of Pulmonary Neoplasia Flashcards
Give 3 causes of lung cancer
- Tobacco
- asbestos/occupational exposure
- environmental radon/radiation/pollution
- pulmonary fibrosis
What pulmonary epithelium does tobacco smoke affect?
- Central bronchial epithelium
- Peripheral lung epithelium
Inherited polymorphisms predispose what?
- Metabolism of pro-carcinogens
- nicotine addiction
How many main pathways of carcinogenesis are there in the lung?
2
What are the main pathways of carcinogenesis in the lung?
- lung periphery
- central lung airways
What cells are transformed in the carcinogenesis of the lung periphery?
Bronchioloalveolar epithelial stem cells
What cells are transformed in the carcinogenesis of the central lung airways?
Bronchial epithelial stem cells
What are the most common type of lung cancer in non-smokers?
Adenocarcinoma
What type of lung cancer is strongly associated with smoking?
Squamous cell carcinoma
What gene is commonly smoking induced in Adenocarcinogenesis?
KRAS
What 3 genes are mutated in adenocarcinogenesis that are not related to tobacco carcinogenesis?
- BRAF
- HER2
- ALK
Carcinoid tumours are tumours with a low grade
malignancy
Are metastases to the lung common or uncommon?
Common
What four main cell types are mutated in carcinoma of the lung?
- squamous cell
- adenocarcinoma
- small cell carcinoma
- large cell carcinoma
What histological type of lung carcinoma is most common?
Non-small cell carcinoma (NSCLC)
Primary lung cancer presents when in its natural history?
Late
Signs and symptoms of primary lung cancer may not show until the disease is very
advanced
Give an effect that lung cancer might cause
- Bronchial obstruction
- Pleural
- Direct invasion
- Lymph node metastases
Give an example of a bronchial obstruction
- collapse
- endogenous lipoid pneumonia
- infection/abscess
- bronchiectasis
Pleural involvement in lung cancer is more likely to be treated and curable with surgery if it is
Inflammatory
Give a nerve that is likely to be affected by direct invasion of lung cancer
- phrenic
- left recurrent laryngeal
- brachial plexus
- cervical sympathetic
Distant metastases from the lung is most likely to spread where?
- liver
- adrenal glands
- bone
- brain
- skin
Give 3 classes of non-metastatic paraneoplastic effects of lung cancer
- skeletal
- endocrine
- neurological
- cutaneous
- haematologic
- cardiovascular
- renal
Other than imaging techniques, what investigations can be done in suspected lung cancer?
- bronchoscopy
- trans-thoracic fine needle aspiration
- trans-thoracic core biopsy
What are the two main prognostic factors in lung cancer?
Stage and classification of disease
Rather than curing cancer, non-operable treatment
prolongs life
How do tumours avoid destruction by our immune system?
Tumours “switch off” immune system using immune checkpoints
