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Path > Pulmonary Malignancies > Flashcards

Pulmonary Malignancies Flashcards

1
Q

RF for pulmonary malignancies

A

smoking/ second hand smoke- synergistic with all other RFs
radon, radiation
asbestos- more bronchogenic cancers than mesothelioma

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2
Q

Presentation of pulmonary malignancy

A 
There are no early symptoms
Common- cough, hemoptysis, weight loss (cacexhia), chest pain, metastasis
SVC syndrome
Pancoast tumor
paraneaplastic syndrome
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3
Q

SVC- syndrome

A

tumor blocks SVC drainage from head –> facial redness and swelling, HA, cyanosis, dilation of veins

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4
Q

Pancoast tumors

A

tumors in lung apices- affects nerves
brachial plexus- pain in arm or shoulder
recurrent laryngeal nerve- hoarseness of voice or vocal paralysis
sympathetic ganglia- Horners syndrome (Ptosis, Miosis, and Anhydrosis)

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5
Q

Paraneaplastic syndromes

A

SCLC- cushing syndrome (ACTH), SIADH
SqCC- hyperparathyroidism (hyperCa and Fractures)
Carcinoid- serotonin syndrome

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6
Q

Pulmonary Malignancy- Dx

A

CXR- coin lesions and compare to old CXR
CT scan- get a better look, nodal mets
Sputum cytology- look for malignant cells in sputum
Biopsy-
-bronchoscope for central tumors
- mediastinoscope for metastases to nodes
- percutaneous CT guided for peripheral tumors
Thoracotomy or wedge resection for non diagnostic biopsy

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7
Q

How are bronchogenic carcinomas divided

A

small cell vs non small cell

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8
Q

What is the key difference between SCLC and NSCLC

A

Treatment modality
SCLC will mets more quickly so is not amenable to Surgery or radiation, so tx with chemo
NSCLC- tx with surgery or radiation

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9
Q

Squamous cells carcinoma (SqCC)- location and size

A

Central and large

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10
Q

SqCC- RF

A

99% smoking related

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11
Q

SqCC- paraneoplastic syndrome

A

hyperparathyroidism

inc PTrH, hyperCa, and fractures

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12
Q

SqCC- microscopy

A

Normal microscopy for SqCC= Squamous cells, keratin pearls, intracellular bridges

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13
Q

SqCC- Tx

A

surgery or radiation

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14
Q

Adenocarcinoma- location, size

A

peripheral, small coin lesion

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15
Q

Adenocarcinoma- RF

A

Most common LC or non smokers

75% smoking associated

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16
Q

Adenocarcinoma- tx

A

surgical resection or radiation

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17
Q

Adenocarcinoma- bronchioalveolar subtype

A

spreads along the alveoli using the BM as scaffolding so its not a solid mass but rather looks like diffuse pneumonia on CXR

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18
Q

Large cell carcinoma (LCC)- location, size

A

central or peripheral
large
this is a wastebasket categories for other tumors

19
Q

LCC- RF

A

99% smoking related

20
Q

LCC- Tx

A

surgery or rads

21
Q

Small cell carcinoma (SCLC = small cell lung cancer) = oat cell carcinoma- location

A

central

22
Q

SCLC- mets

A

metastasizes early normally via hematogenous route

brain is common place it goes- not from TA notes

23
Q

SCLC- RF

A

99% smoking related

24
Q

SCLC- paraneoplastic syndromes

A 
Cushing syndrome (ACTH)
SIADH
25
Q

SCLC- microscopy

A

small dark cells with little cytoplasm

sheet like growth

26
Q

SCLC- tx

A

chemo

27
Q

Brochogenic carcinomas

A

SqCC
Adenocarcinoma
LCC
SCLC

28
Q

Bronchial carcinoid tumor- what is this

A

low grade tumor of neuroendocrine origin

29
Q

Bronchial carcinoid tumor- where does it originate

A

Originates in the bronchi where neurosecratory cells are found
This may lead to obstruction

30
Q

Bronchial carcinoid tumors- paraneaplastic syndrome

A

Serotonin syndrome= flushing, hyperthermia, diaphoresis, tachypnea, dilated pupils, seizure, myoclonus)

31
Q

Seratnonin syndrome and seratonin metabolism

A

Seratonin is metabolized in the liver
carcinoid tumors of the colon (which may produce seratonin) will not cause seratonin syndrome- b/c of first pass metabolism

32
Q

Bronchial carcinoid tumor- microscopy

A

uniform cells

neurosecratory granules on EM

33
Q

Pulmonary hamartoma- what is this

A

slow growing, benign growth of cartilage

remove to differentiate it from cancers

34
Q

Bronchial carcinoid tumor- prognosis

A

very good (not on TA notes)

35
Q

bronchial carcinoid tumor CXR

A

calcified region= granuloma (not on TA notes)

36
Q

Mets to lungs- MC, lesions

A

Breast is MC tumor to mets to lungs

multiple lesions

37
Q

Lymphangytic carcinoma

A

types of metastasis only seen by microscopy not on X ray

little plugs of tumor in lymphatics

38
Q

Malignant mesothelioma- what is this

A

cancer of the pleura

39
Q

Malignant mesothelioma- prognosis

A

always fatal due to SOB and tamponade

40
Q

Malignant mesothelioma- RF

A

almost always assoc with asbestos

41
Q

Malignant Mesothelioma- gross appearance

A

rind like substance around organs

1st lung –> heart/ mediastinum

42
Q

Malignant mesothelioma- microscopy

A

psommoma bodies

43
Q

Seratonin Syndrome- classic triad (from up to date)

A

mental status changes,
autonomic hyperactivity,
neuromuscular abnormalities

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