Pulmonary Neoplasia

Question 1

What is a sarcoma?

Answer 1

Malignant tumour of bone

Question 2

What components of tobacco smoke are carcinogens?

Answer 2

Polycyclic hydrocarbons
Aromatic Amines 
Phenols 
Nickels 
Cyanates

Question 3

What other risk factors are there for lung cancers besides smoking?

Answer 3

Asbestos
Nickel 
Chromatins 
Radiation
Atmospheric pollution
(Genetics)

Question 4

What is the advantage of primary tumours?

Answer 4

Can be removed surgically

Question 5

What are the local effects of lung cancer?

Answer 5

Obstruction of airways
Invasion of chest wall (present with chest pain)
Ulceration (haemoptysis)

Question 6

What are the common metastatic sites of lung cancer?

Answer 6

Nodes
Bones
Liver
Brain

Question 7

Where does metastatic lung cancer usually spread to first?

Answer 7

Mediastinum

Question 8

What are the systemic effects of lung cancer?

Answer 8

Weight loss

Question 9

What are the 4 types of smoking-related lung tumours?

Answer 9

Adenocarcinomas
Squamous carcinomas
Small cell carcinoma
Large cell carcinoma

Question 10

How can a histological diagnosis be made?

Answer 10

Biopsy

Question 11

What are the main types of lung cancer?

Answer 11

Small cell lung cancer (SCLC)

Non-small-cell lung cancer (NSCLC)

Question 12

How is small cell treated? And what is the issue?

Answer 12

Chemotherapy

Issue is rapidly increasing resistance

Question 13

How is NSCLC treated?

Answer 13

Surgery
Chemotherapy
Radiotherapy

Question 14

How does immunohistochemistry distinguish adenocarcinomas?

Answer 14

Adenocarcinomas express TTF (Thyroid transcription factor)

Question 15

How does immunohistochemistry help to distinguish SSC?

Answer 15

SSC expresses nuclear antigen p63 and high molecular weight cytokeratins

Question 16

How can SSC (squamous cell carcinoma) be identified in terms of immunohistochemistry?

Answer 16

Antibodies identify p63 antigen

Question 17

Which oncogene often has a mutation in SCLC?

Answer 17

Myc

Question 18

Which tumour suppressor genes commonly have a genetic abnormality in SCLC?

Answer 18

p53
Rb
3p

Question 19

Which oncogenes commonly have a genetic abnormality in NSCLC?

Answer 19

Mac
K-ras
HER2 (neu)

Question 20

Which tumour suppressor genes commonly have a genetic abnormality in NSCLC?

Answer 20

p53
1q
3p
9p
11p
Rb

Question 21

Point mutations activate EGFR in absence of EGF - this is seen especially in which type of lung tumour?

Answer 21

Adenocarcinoma

Question 22

To what kind of drugs to tumours with point mutations that activate EGFR in absence of EGF respond to?

Answer 22

Tyrosine kinase inhibitors (Erlotinib)

Question 23

Which drug EML4-ALK fusion oncogene?

Answer 23

Crizotinib

Question 24

Expression of which gene causes inactivation of the cytotoxic immune response by binding to the respective receptor on T lymphocytes?

Answer 24

PD-L1

Question 25

What are the 4 types of bronchial pulmonary epithelium?

Answer 25

Ciliates Mucous Neuroendocrine Reserve

Question 26

What are the different pulmonary epithelia in the bronchioles?

Answer 26

Clara aka Club cells | Type I & II alveolar lining cells

Question 27

How do peripheral adenocarcinomas tend to spread through existing lung structures? (3 steps)

Answer 27

Atypical adenomatous hyperplasia Spread of neoplastic cells along alveolar walls (bronchioalveolar carcinoma) True invasive carcinoma

Question 28

What are the 2 prognostic indicators in lung cancer?

Answer 28

``` Tumour stage (main) Tumour histological Subtype ```

Question 29

What are carcinoid lung neoplasms?

Answer 29

Neuroendocrine neoplasms of lower grade malignancy

Question 30

Where are bronchial gland tumours often more severe?

Answer 30

Salivary glands

Question 31

What are the two types of bronchial gland neoplasm?

Answer 31

Adenoid cystic carcinoma | Mucoepidermoid carcinoma

Question 32

What is a mesothelioma?

Answer 32

Primary malignant neoplasm in the pleura