Pulmonary Neoplasia Flashcards
What is a sarcoma?
Malignant tumour of bone
What components of tobacco smoke are carcinogens?
Polycyclic hydrocarbons Aromatic Amines Phenols Nickels Cyanates
What other risk factors are there for lung cancers besides smoking?
Asbestos Nickel Chromatins Radiation Atmospheric pollution (Genetics)
What is the advantage of primary tumours?
Can be removed surgically
What are the local effects of lung cancer?
Obstruction of airways
Invasion of chest wall (present with chest pain)
Ulceration (haemoptysis)
What are the common metastatic sites of lung cancer?
Nodes
Bones
Liver
Brain
Where does metastatic lung cancer usually spread to first?
Mediastinum
What are the systemic effects of lung cancer?
Weight loss
What are the 4 types of smoking-related lung tumours?
Adenocarcinomas
Squamous carcinomas
Small cell carcinoma
Large cell carcinoma
How can a histological diagnosis be made?
Biopsy
What are the main types of lung cancer?
Small cell lung cancer (SCLC)
Non-small-cell lung cancer (NSCLC)
How is small cell treated? And what is the issue?
Chemotherapy
Issue is rapidly increasing resistance
How is NSCLC treated?
Surgery
Chemotherapy
Radiotherapy
How does immunohistochemistry distinguish adenocarcinomas?
Adenocarcinomas express TTF (Thyroid transcription factor)
How does immunohistochemistry help to distinguish SSC?
SSC expresses nuclear antigen p63 and high molecular weight cytokeratins
How can SSC (squamous cell carcinoma) be identified in terms of immunohistochemistry?
Antibodies identify p63 antigen
Which oncogene often has a mutation in SCLC?
Myc
Which tumour suppressor genes commonly have a genetic abnormality in SCLC?
p53
Rb
3p
Which oncogenes commonly have a genetic abnormality in NSCLC?
Mac
K-ras
HER2 (neu)
Which tumour suppressor genes commonly have a genetic abnormality in NSCLC?
p53 1q 3p 9p 11p Rb
Point mutations activate EGFR in absence of EGF - this is seen especially in which type of lung tumour?
Adenocarcinoma
To what kind of drugs to tumours with point mutations that activate EGFR in absence of EGF respond to?
Tyrosine kinase inhibitors (Erlotinib)
Which drug EML4-ALK fusion oncogene?
Crizotinib
Expression of which gene causes inactivation of the cytotoxic immune response by binding to the respective receptor on T lymphocytes?
PD-L1
What are the 4 types of bronchial pulmonary epithelium?
Ciliates
Mucous
Neuroendocrine
Reserve
What are the different pulmonary epithelia in the bronchioles?
Clara aka Club cells
Type I & II alveolar lining cells
How do peripheral adenocarcinomas tend to spread through existing lung structures? (3 steps)
Atypical adenomatous hyperplasia
Spread of neoplastic cells along alveolar walls (bronchioalveolar carcinoma)
True invasive carcinoma
What are the 2 prognostic indicators in lung cancer?
Tumour stage (main) Tumour histological Subtype
What are carcinoid lung neoplasms?
Neuroendocrine neoplasms of lower grade malignancy
Where are bronchial gland tumours often more severe?
Salivary glands
What are the two types of bronchial gland neoplasm?
Adenoid cystic carcinoma
Mucoepidermoid carcinoma
What is a mesothelioma?
Primary malignant neoplasm in the pleura
