Pathoma - lung cancer Flashcards
What are the 3 key risk factors for the development of lung cancer?
Cigarette smoke (polycyclic aromatic hydrocarbons and arsenic are particularly mutogenic)
Radon (formed by radioactive decay of uranium, which is present in soil - can accumlate in basements)
Asbestos (lung cancer > mesothelioma)
Where does lung cancer fall on cancer incidence and cancer mortality
1 cancer mortality
How will primary lung cancer appear on X-ray
Solitary “coin” lesion
What benign lung lesions also appear as “coin lesions”?
Granuloma (TB, fungus)
Bronchial hamartoma (composed of lung tissue + cartilage)
What is the lung location and population affected by small cell carcinoma?
“S” cancers = central + smokers
Characteristic histology of small cell carcinoma and what cells they arise from
Undifferentiated small cells (poor prognosis)
Arise from neuroendocrine (Kulchitsky) cells
What are possible hormones produced by small cell carcinoma
ADH - SIADH
ACTH - Cushing’s
What is Eaton-Lambert syndrome?
Antibodies against pre-synaptic Ca2+ channels produced by small cell carcinoma
What location and population does Squamous cell carcinoma occur in
“S” = central + smokers
Characteristic histology of squamous cell carcinoma
Keratin pearls or intracellular bridges (desmosomes connecting squamous cells become visible when cells are pulled apart)
What product may be produced by squamous cell carcinoma?
Parathyroid hormone-related peptide (PTHrP) = hypercalcemia
What lung location and population are affected by adenocarcinoma
Peripheral
Most common tumor in non-smokers and female smokers
Characteristic histology of adenocarcinoma on histology
Glands or mucin
What lung location and population are affected by large cell lung carcinoma
Peripheral + smoking
Characteristic histology of large cell lung carcinoma
Poorly differentiated large cells with no keratin pearls, intercellular bridges, glands, or mucin
(process of elimination)
What is the lung location and population affected by brochioloalveolar carcinoma
Peripheal - subtype of adenocarcinoma (adenocarcinomo in situ)
Not related to smoking
Characterstic histology of brochioloalveolar carcinoma
Columnar cells containing mucin that grow along pre-existing bronchioles and alveoli
X-ray presentation of brochioloalveolar carcinoma
Hazy infiltrates similiar to pneumonia
Characteristic histology of carcinoid tumor
Well-differentiated neuroendocrine cells
Chromogranin positive
Most common sources of metastatic lung cancer
Breast and colon
Treatment for small cell carcinoma vs. non-small cell
Small cell: chemo (think: cells so small that surgeon can’t see them)
Non-small cell: surgical resection
Complication of lung cancer
SPHERE:
S - Superior vena cava syndrome
P - Pancost tumor
H - Horner syndrome
E - Endocrine (paraneoplastic)
R - Recurrent laryngel nerve compression (hoarsness)
E - Effusions (pleural or pericardial)
Common locations for lung cancer to mestasize to
Adrenal gland
Brain
Bone
