Pathoma cancers of lungs table + TNM 12/07 Flashcards

1
Q

Small cell lung carcinoma. oncogene?

A

L-MYC - nuclear regulator; transcription factor; amplification

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2
Q

L-MYC - nuclear regulator; transcription factor; amplification
What tumor?

A

small cell lung carcinoma

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3
Q

Small cell lung carcinoma. Immunohistology marker?

A

chromogranin and synaptophysin - neuroendocrine cell marker

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4
Q

Small cell lung carcinoma. pathohistology?

A

Poorly differented small cells with neuroendocrine differentiation (from Kulchitsky cells)

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5
Q

Small cell lung carcinoma. who is affected?

A

smoking males

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6
Q

Small cell lung carcinoma. location?

A

central

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7
Q

Small cell lung carcinoma. What are important characteristics?

A

Rapidly growth and early metastasize.

Produce endocrine or nervous system paraneoplastics syndromes.
- incr. ACTH -> cushing syndrome
- Incr ADH -> SIADH
- Lambert Eaton myasthenic syndrome

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8
Q

WHAT TUMOR?
Rapidly growth and early metastasize.

Produce endocrine or nervous system paraneoplastics syndromes.
- incr. ACTH -> cushing syndrome
- Incr ADH -> SIADH
- Lambert Eaton myasthenic syndrome

A

Small cell lung carcinoma

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9
Q

Smoking males, what tumors?

A

Small cell lung carcinoma;Squamous cell carcinoma (most common)

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10
Q

Lung adenocarcinoma. What oncogene?

A

ALK - tyrosine kinase
EFGR1 - tyrosine kinase

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11
Q

ALK - tyrosine kinase
EGFR1 - tyrosine kinase
What tumor?

A

Lung adenocarcinoma

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12
Q

Lung adenocarcinoma. In what people?

A
  • Nonsmokers
  • smokers female
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13
Q

Lung adenocarcinoma. What pathohistology?

A

Glands, mucin and TTF-1 expression

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14
Q

Glands, mucin and TTF-1(thyroid transcription factor) expression.
What tumor?

A

Lung adenocarcinoma

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15
Q

Lung adenocarcinoma. Location?

A

Periphery

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16
Q

Lung adenocarcinoma. Important features?

A

Collumnar cells that growth along preexisting bronchioles and alveoles (in-situ)

On immaging - pneumonia-like consolidation

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17
Q

WHAT TUMOR?
Collumnar cells that growth along preexisting bronchioles and alveoles. (in-situ)

On immaging - pneumonia-like consolidation

A

Lung adenocarcinoma

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18
Q

UW. Clubbing and hyperthrophic osteoarthropathy. Tumor?

A

Lung adenocarcinoma

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19
Q

Squamous cell carcinoma. pathohistology?

A

Keratin perls;
intercellular bridges;
p40 expression

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20
Q

Keratin perls;
intercellular bridges;
p40 expression

WHAT TUMOR?

A

squamous cell carcinoma.

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21
Q

Squamous cell carcinoma. What people?

A

MALE SMOKERS (MOST COMMON TUMOR IN THIS POPULATION)

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22
Q

MALE SMOKERS (MOST COMMON TUMOR IN THIS POPULATION)

A

Squamous cell carcinoma.

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23
Q

Squamous cell carcinoma. Location?

A

Central

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24
Q

Squamous cell carcinoma. Important feature?

A

May produce PTHrP -> hypercalcemia

25
Q

Large cell neuroendocrine tumor. pathohistology?

A

Poorly differented large cells (NO glands, mucin, TTF-1, keratin pearls, intercellular bridges, p40).

26
Q

Poorly differented large cells (NO glands, mucin, TTF-1, keratin pearls, intercellular bridges, p40).
WHAT TUMOR?

A

Large cell neuroendocrine tumor.

27
Q

Large cell neuroendocrine tumor. In what patients?

A

smokers (not speficied whether male or female)

28
Q

Large cell neuroendocrine tumor. location?

A

central or peripheral

29
Q

Large cell neuroendocrine tumor. Important feature?

A

Diagnosis of exclusion. According to UW - mayproduce hGC – > gynecomastia, galactorea

30
Q

Carcinoid tumor. Pathohistology?

A

Well differentiated neuroendocrine cells (nests);
Chromogranin positive

31
Q

Well differentiated neuroendocrine cells (nests);
Chromogranin positive

TUMOR?

A

carcinoid tumor

32
Q

Carcinoid tumor relation to smoking?

A

not significantly related to smoking

33
Q

Carcinoid tumor. Location?

A

central or peripheral.

34
Q

Carcinoid tumor. if grows central, what feature?

A

forms a polyp-like mass in the bronchus.

35
Q

forms a polyp-like mass in the bronchus.
What tumor and what location?

A

carcinoid turmor, central growth

36
Q

Carcinoid tumor. important feature?

A

Low grade malignancy.
Can cause carcinoid syndrome

37
Q

Low grade malignancy.
Can cause carcinoid syndrome

A

Carcinoid tumor.

38
Q

Metastasis to lung. What are the most common sources?

A

breast and colon carcinomas

39
Q

Metastasis to lung. Location?

A

multiple ,,cannon ball” nodules on imaging

40
Q

What is more common - primary tumors or metastasis?

A

metastasis

41
Q

EGFR1 mutation is common in what people?

A

asian females nonsmokers

42
Q

What testing guides immunotherapy in advanced disease?

A

PD-L1 expression (pembrolizumabas)

43
Q

PD-L1 expression in what tummors may be present?

A

in non-small cell carcinoma.

44
Q

T - what 3 involvements?

A
  1. Obstruction of SVC -> SVC syndrome
  2. a. Involvement of reccurent laryngeal nerve -> hoarseness
    b. Involvement of phrenic nerve -> diaphragmatic paralysis
  3. a. Involvement of sympathetic chain -> horners syndrome.
    b. Involvement of brachial plexus -> shoulder pain and hand weakness
45
Q

T. Obstruction of SVC ->

A

leads to SVC syndrome (distended head and neck veins with edema and blue discolouration of arms and face
BILATERAL (kai buna obstructed brachiocephalic - tai unilateral)

46
Q

T. Involvement of reccurent laryngeal nerve ->

A

Hoarseness

47
Q

T. Involvement of phrenic nerve ->

A

diaphragmatic paralysis

48
Q

T. Involvement of sympathetic chain ->

A

Horner syndrome - ptosis, myiosis and anhidrosis

49
Q

T. Involvement of brachial plexus ->

A

shoulder pain and hand weakness

50
Q

What is tumor location if involvement of sympathetic chain and brachial plexus is seen?

A

APICAL TUMORS INVOLVING SUPERIOR SULCUS (PANCOAST TUMOR)

51
Q

APICAL TUMORS INVOLVING SUPERIOR SULCUS (PANCOAST TUMOR)?

A

involvement of sympathetic chain and brachial plexus is seen

52
Q

N. Spreads to what lymph nodes?

A

hillar and mediastinal

53
Q

M. Unique site to metastasis?

A

adrenal glands

54
Q

EGFR mutations - treamtent?

A

Erlotinibas

55
Q

ALK translocation - treament?

A

Crizotinibas

56
Q

ALK and EGFR what cancer?

A

Adenocarcinoma

57
Q

PD-L1 - carcinoma?

A

non-small cell

58
Q

PD-L1 treatment?

A

pembrolizumabas