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T2 - Phase 2 - Systems Modules (II) > Pulm - Mediastinal & Pleural Disease; Lung Tumors > Flashcards

Pulm - Mediastinal & Pleural Disease; Lung Tumors Flashcards

1
Q

Spontaneous pneumothorax is due to rupture of what?

A

An emphysematous bleb

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2
Q

Does a spontaneous pneumothorax result in collapse of a portion of the lung?

A

Yes.

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3
Q

Does a spontaneous pneumothorax result in any tracheal deviation?

If so, which way?

A

Yes, towards the collapsed lung portion.

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4
Q

Does a tension pneumothorax result in any tracheal deviation?

If so, which way?

A

Yes, away from the pneumothorax.

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5
Q

How do mesotheliomas typically present in a clinical setting?

A

Recurrent pleural effusions;

dyspnea;

chest pain

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6
Q

Mesotheliomas often encase what organ?

A

The lung

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7
Q

How do mesotheliomal cells appear under microscopy and staining?

A

Calretinin-positive polygonal cells with numerous long surface microvilli

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8
Q

Name a few diseases associated with thymic hyperplasia.

A

Myasthenia gravis, Graves, SLE, RA

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9
Q

Thymomas are __________ (benign/malignant) tumors of __________ cells.

A

Thymomas are benign tumors of epithelial cells.

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10
Q

Are thymomas invasive or non-invasive?

A

Can be either

(can only be differentiated via extensive examination)

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11
Q

Thymomas are associated with what autoimmune reactions?

A

Lambert-Eaton syndrome,

pure red cell aplasia,

Grave’s disease,

Cushing’s disease

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12
Q

Are thymic carcinomas characterized by exceptionally small or exceptionally large cells?

A

Exceptionally large

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13
Q

What is the most common germ cell tumor?

A

Mature teratomas

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14
Q

Mature teratomas are _________ (benign/malignant).

Immature teratomas are _________ (benign/malignant).

A

Mature teratomas are benign.

Immature teratomas are malignant.

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15
Q

Immature teratomas are malignancies characterized by what histology (specific to the immaturity)?

A

Immature neuroepithelial tubules

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16
Q

How are seminomal cells shaped?

A

Round, polygonal cells

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17
Q

Parathyroid adenomas are associated with what paraneoplastic syndrome?

A

Hypercalcemia

(due to elevated PTH)

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18
Q

Mid-mediastinal masses are often cystic and arising from what two organs?

A

Bronchial cysts;

pericardial cysts

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19
Q

Are nodular goiters characterized by large or small tubules with colloid?

A

A mix of both large and small tubules with colloid

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20
Q

What form and subtype of lymphoma is common in the anterior mediastinum?

A

Nodular sclerosing Hodgkin’s lymphoma

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21
Q

Which lymphoma can be found in the anterior mediastinum, is more common in males, and often presents with respiratory compromise and CNS involvement?

A

Lymphoblastic lymphoma

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22
Q

Which lymphoma can be found in the anterior mediastinum, is more common in young adult females, and presents with large, atypical cells growing in fibrotic sheets?

A

Diffuse large B-cell lymphoma

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23
Q

Name three neurogenic tumors of the posterior mediastinum that are associated with the peripheral nervous sytem.

SNM

A

Schwannomas;

neurofibromas;

malignant peripheral nerve sheath tumor (MPNST)

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24
Q

Name four neurogenic tumors of the posterior mediastinum that are associated specifically with the sympathetic nervous sytem.

NGGP

A

Neuroblastomas;

ganglioneuroblastomas;

ganglioneuromas;

paragangliomas

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25
Q

What are the three aspects of Carney’s triad?

A

Extraadrenal paraganglioma

+

Malignant GI stromal tumor

+

Pulmonary chondroma

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26
Q

A patient presents with a neurogenic paraganglioma of the posterior mediastinum, a malignant GI stromal tumor, and a pulmonary chondroma. This triad is most common in what demographic?

A

Young women

(Carney’s triad)

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27
Q

Nasopharyngeal carcinomas are strongly associated with what substance to which pathologists are strongly exposed?

A

Formaldehyde

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28
Q

The most common pleural tumors are of what origin?

A

Metastatic

29
Q

Does smoking increase the risk of mesotheliomas?

A

No

30
Q

Mesotheliomas arise after what latency period?

A

25 - 45 years

31
Q

Mesotheliomas are associated with what immunohistochemistry?

A

CKs,

WT-1,

calretinin

32
Q

Solitary fibrous tumors of the pleura ______ (are/are not) associated with asbestos and are CD____+.

A

Solitary fibrous tumors of the pleura are not associated with asbestos and are CD34+.

33
Q

What pleural tumor is CD34+ and associated with STAT6 and NAB2 mutations?

A

Solitary fibrous tumors

34
Q

SVC syndrome is typically indicative of what?

A

A malignancy

35
Q

Pericardial cysts are usually located at the ______________ radiographically (lined by mesothelium).

A

Pericardial cysts are usually located at the right cardiophrenic angle radiographically (lined by mesothelium).

36
Q

Bronchogenic cysts are most common in what location?

A

Posterior to the carina

37
Q

Esophageal cysts are most common in what location?

A

The wall of the lower esophagus

38
Q

Which cysts are associated with the posterior mediastinum?

A

Gastric/enteric cysts

39
Q

Carcinoid tumors of the thymus are associated with ____% of cases of paraneoplastic Cushing’s syndrome.

A

Carcinoid tumors of the thymus are associated with 33% of cases of paraneoplastic Cushing’s syndrome.

40
Q

Adenocarcinomas are responsible for ____% of primary lung malignancies (with ____% being invasive and ____% being in-situ).

A

Adenocarcinomas are responsible for 50% of primary lung malignancies (with 30% being invasive and 20% being in-situ).

41
Q

____________ are responsible for 50% of lung cancer.

____________ are responsible for 20% of lung cancer.

____________ are responsible for 15% of lung cancer.

A

Adenocarcinomas are responsible for 50% of lung cancer.

Squamous cell carcinomas are responsible for 20% of lung cancer.

Small cell carcinomas are responsible for 15% of lung cancer.

42
Q

What is the most common origin of lung tumors?

A

Metastatic

43
Q

Identify if each of the following lung tumors is typically central or peripheral:

Adenocarcinomas

Squamous cell carcinomas

Small cell carcinomas

A

Peripheral

Central

Central

44
Q

What percentage of patients with small cell lung cancer have a history of smoking?

A

99%

45
Q

How is the prognosis associated with small cell carcinoma?

A

Dismal

(regardless of stage)

46
Q

What is the most common type of lung cancer seen in non-smokers and women?

A

Adenocarcinomas

47
Q

How are large cell carcinomas diagnosed?

A

Via exclusion

48
Q

Lung adenocarcinomas are associated with what genetics?

A

KRAS,

EGFR,

ALK

49
Q

Lung small cell carcinomas are associated with what genetics?

A

TP53,

PB,

Myc

50
Q

Low-grade lung malignancies of neuroendocrine glands are known as __________ tumors and are often made of small hyperplastic nests called __________.

A

Low-grade lung malignancies of neuroendocrine glands are known as carcinoid tumors and are often made of small hyperplastic nests called tumorlets.

51
Q

What is the most common benign mesenchymal tumor found in the lungs?

A

A hamartoma

52
Q

Metastatic tumors in the lungs often cause ‘_________’ lesions.

A

Metastatic tumors in the lungs often cause ‘cannonball’ lesions.

53
Q

Non- small cell lung cancers are typically treated with ___________.

Small cell lung cancers are typically treated with ___________.

A

Non- small cell lung cancers are typically treated with resection.

Small cell lung cancers are typically treated with chemotherapy.

54
Q

What is the most common general cause of pleural effusions?

A

Impaired drainage

55
Q

Does the visceral and/or parietal layer of pleura produce pleural fluid?

A

Both

56
Q

Does the visceral and/or parietal layer of pleura have stomata to resorb pleural fluid?

A

Parietal only

57
Q

What is an empyema?

A

A fluid/pus-filled sac between the visceral/parietal pleura

58
Q

How do CXRs of pleural effusions appear?

A

Haziness of lung fields

+

blunting of costophrenic angle

+

“Missing” Diaphragm

59
Q

How are pleural effusions treated?

A

Thoracentesis

+

Diuretics

+

Antibiotics (if septic)

60
Q

________ pleural effusions will shift with gravity while ________ pleural effusions will stay in the same spot.

A

Layering pleural effusions will shift with gravity while loculated pleural effusions will stay in the same spot.

61
Q

Identify whether each of the following is individually associated with transudative or exudative pleural effusions:

CHF

Cirrhosis

Malignancies

A

Transudative

Transudative

Exudative

62
Q

Identify whether each of the following is individually associated with transudative or exudative pleural effusions:

Pneumonia

Hypoalbuminemia

Pulmonary emboli

Nephrotic syndrome

A

Exudative

Transudative

Exudative

Transudative

63
Q

What is the Lights criteria for defining exudative effusions?

Pleural protein : serum protein =

Pleural protein : serum LDH =

A

What is the Lights criteria for defining exudative effusions?

Pleural protein : serum protein = > 0.5

Pleural protein : serum LDH = > 0.6

(or pleural LDH > 2/3 of upper limit of serum LDH)

64
Q

A patient has a pleural effusion with an acidic pH and elevated salivary amylase. What is the diagnosis?

A

Esophageal rupture

65
Q

A patient has a pleural effusion with an high triglycerides and high chylomicrons. What is the diagnosis?

A

Chylothorax

66
Q

A patient has a pleural effusion containing lupus cells.

What is the diagnosis?

A

Lupus pleuritis

67
Q

A patient has a pleural effusion with a high hematocrit within the effusion. What is the diagnosis?

A

Hemothorax

68
Q

A patient has a pleural effusion and an elevated serum amylase.

What is the diagnosis?

A

Acute pancreatitis

69
Q

What is the most useful tool for assessing pleural effusion?

A

Diagnostic thoracentesis

T2 - Phase 2 - Systems Modules (II) (22 decks)

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