Pulmonary Neoplasia (lung cancer) Pathology Flashcards
Lung cancer aetiology
tobacco
asbestos
other occupational exposures (hydrocarbons, nickel)
Air pollution
radiation
pulmonary fibrosis
Pulmonary fibrosis
lung tissue becomes thickened / scarred
Two types of carcinogen in lung (as well as small and non -small)
adenocarcinoma
squamous cell carcinoma
Tumours of bronchial glands are
very very rare
Metastases are
very very common
Carcinoma of the lung - 4 main cell types
Squamous cell
adenocarcinoma
small cell carcinoma
large cell carcinoma
% squamous cell
40%
% adenocarcinoma
41%
% small cell carcinoma
15%
% large cell carcinoma
4%
broncioloalveolar cell carcinoma is another one but is now called
adenocarcinoma in situ
Two histological types of lung carcinoma
small cell carcinoma
non-small cell carcinoma
Small cell carcinomas account ……%
15%
non-small cell carcinomas (NSCLC) account for ……. %
85%
Types of non-small cell carcinoma
adenocarcinoma
squamous cell carcinoma
large cell carcinoma
Primary lung cancer presents ….. in its natural history
late
Local effects of lung cancer (main)
Bronchial obstruction
Direct invasion
Pleural
lymph nodes metastases
Local effects:
Bronchial obstruction
endogenous lipoid pneumonia
infection/abscess
bronchiectasis
Local effects:
Pleural
inflammatory
malignant
Local effects:
direct invasion
chest wall
Local effects:
direct invasion
nerves
mediastinum
Lymph nodes metastases
lymphangitis carcinomatosa
Lung cancer distant metastases locations
liver adrenal glands bone brain skin
other effects of lung cancer (non-metastatic)
clubbing and hypertrophic pulmonary osteoarthropathy
Lung Cancer investigations
CXR
Bronchoscopy (biopsy and brushings/washings)
Trans-thoracic fine needle aspiration
trans-thoracic core biopsy
pleural effusion
other imaginary techniques (CT scanning, MRI, PET scans)
Pleural effusion
build up of excess fluid between pleural membranes
PET scan
positron emission tomography
Non-small cell carcinomas 5 year survival rate
10-25%
Small cell carcinoma 5 year survival rate
4%
biomarker for adenocarcinoma
EGFR
ALK translocations