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Respiratory - Week 3 > Respiratory: - Lecture 2. Pulmonary Neoplasia > Flashcards

Respiratory: - Lecture 2. Pulmonary Neoplasia Flashcards

1
Q

What are the types of Primary Lung Neoplasms ?

A

Benign

Malignant

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2
Q

What types of lung neoplasm are there?

A

Primary Neoplasms - the site at which they originated from

Metastic Neoplasma - Metastasis are secondaries of the primary tumour

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3
Q

What is a Neoplasm?

A

An Abnormal cell growth

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4
Q

What is contained in Tobacco smoke?

A 
Polycyclic hydrocarbons
Aromatic amines
Phenols
Nickel
Cyanates
  • All of these are carcinogens.
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5
Q

What percentage of smokes will die of lung cancer?

A

20%

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6
Q

Generally, what types of cancer is caused by tobacco smoke?

A 
suffer laryngeal
cervical, bladder
mouth
oesophageal
colon cancer

-respiratory cancer

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7
Q

What are the other risk factors that can cause lung cancer?

A 
Asbestos
Nickel
Chromates
Radiation 
Atmospheric pollution
(Genetics)
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8
Q

How can a tumour present ?

A

Local Effects

Systemic effects

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9
Q

What are the Local effects of a tumour?

A

Obstruction of the airway - Causes Pneumonia
Invasion of Chest wall - causes Pain
Ulceration - Haemoptyosis

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10
Q

What is Pneumonia?

A

Pneumonia is an inflammatory condition of the lung affecting primarily in the alveoli

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11
Q

What are secondary sites of cancer called?

A

Metastases

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12
Q

What are the common sites of metastases?

A

Nodes
Bones
Liver
Brain

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13
Q

What is the commonest brain cancer a metastases from?

A

Lung Cancer

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14
Q

What are the Systemic effects of a tumour

A

Weight Loss

Ectopic (abnormal) hormone production

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15
Q

What can hypercalcaemia be a systemic effect of?

A

Squamous cell cancers

-parathyroid hormone

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16
Q

What hormone is produced in excess to cause hypercalcaemia?

A

Parathyroid hormone

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17
Q

What hormone stimulates the cortex of the adrenal gland to produce steroids?

A

Adrenocorticotropic hormone

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18
Q

In squamous cancers what hormone can be produced in excess?

A

Parathyroid hormone

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19
Q

In what cancer can there be an increase in Adrenocorticotropic hormone?

A

Small cell cancers

small cell lung cancer

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20
Q

What are the common types of smoking-associated types of cancer?

A

Adenocarcinoma
Squamous Carcinoma
Small cell Carcinoma
Large Cell Carcinoma

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21
Q

What endocrine related cancers can form in the lung?

A

Neuroendocrine tumours

Bronchial gland tumours

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22
Q

What characterises Squamous Cell carcinoma?

A

Keratinising/production of keratin from the cells

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23
Q

What characterises Adenocarcinoma?

A

Presents in glandular epithelium and spread along pre-existing structures of the lung or gland-like structure.

Occasionally produces mucin which is see in the epithelium (STAINS BLUE)

24
Q

What characterises Small cell carcinoma?

A

Darkly staining tumours
Very little cytoplasm
No attempt at glandular formation
Formed by small nuclei with homogeneous dark nuclei

25
Q

What characterises Large cell carcinoma?

A

Defined by large cells with absence of squamous differentiation or glandular differentiation

26
Q

How are lung cancers subtyped?

A

Standard histological staining
Protein expression within them.

Sometime: Analysis of the sputum. e.g. haemoptysis

27
Q

What antigen is expressed in a squamous cell carcinoma?

A

P63 protein

28
Q

What antigen is expressed in small cell carcinoma and adenocarcinoma?

A

TTF - 1 (Thyroid transcription factor)

29
Q

Why are cancers subtyped?

A

Difference in Treatment.
Difference in Prognosis
Difference in Epidemiology
Difference in Pathogenesis

30
Q

What cancers have the worst prognosis? (from worst to best)

A

Small cell
Large Cell
Squamous cell
Adenocarincoma

31
Q

How are patients treated for small cell carcinoma?

A

Treated by chemotherapy

  • Small cell carcinoma is chemosensitive, however grows back afterwards.
  • Should still be given even in palliative situations
32
Q

What are the Non-small cell carcinomas?

A

Adenocarcinoma
Squamous cell Carcinoma
Large Cell carcnoma

33
Q

What Oncogenes are mutated in Small Cell Lung Cancer?

A

MYC gene

34
Q

Where is the MYC oncogene located?

A

Chromosome 8

35
Q

What Oncogenes are mutated in Non-small cell lung cancer?

A

K-Ras
EGFR
myc

36
Q

What tumour supressor genes are switched off in SCLC?

A

p53
Rb
3p

37
Q

What tumour suppressor genes are switched off in NSCLC?

A 
p53
1q
3p
9p
11p 
Rb
38
Q

What are most adneocarcinoma related to?

A

K Ras mutation

Wild-type EGFR gene

39
Q

What tyrosine kinase inhibitor can be used for some NSCLC?

A

Gefitinib

40
Q

How does Gefitinib work?

A

Tyrosine Kinase Inhibator

- interrupts signalling through the epidermal growth factor receptor (EGFR - oncogene) in target cells.

41
Q

What is the pulmonary epithelium divided into?

A

Bronchial epithelium

Bronchioles/alveoli epithelium

42
Q

What cells are in the Bronchial epithelium?

A

ciliated
mucous
neuroendocrine
reserve

43
Q

What cells are in the Bronchiales and alveoli epithelium?

A

Clara cells

types 1 and 2 alveolar lining cells

44
Q

Describe the process of a tumour formation in the large airways, or for bronchial tumours?

A

Squamous metaplasia

Dysplasia

Carcinoma in situ

Invasive malignancy

45
Q

What tumours generally are large airway tumours/bronchial tumours?

A

Squamous cell

Small cell

46
Q

Describe the pathogensis of basal cell hyperplasia and how it changes to a squamous metaplasia?

A

Cells begin to proliferate from the base due to tobacco smoking - hyerplasia.
Eventually works it way to the epithelium. It changes the epithelium cells to more skin-like epithelium - This is Squamous metaplasia

47
Q

What is the definition of metaplasia?

A

Reversible replacement of one differentiated cell type with another mature differentiated cell type.

48
Q

What is Dysplasia?

A

change in cell or tissue phenotype

49
Q

Describe how a periperal adenocarcinomas forms?

A

Atypical adenomatous hyperplasia

  • tumour spread along the alveolar walls. (Bronchioalveolar carcinoma)
50
Q

What could a differential diagnosis of a Bronchioalveolar carcinoma be?

A

Pneumonia

51
Q

What does the prognosis of the lung cancer depend on?

A

Tumour stage

Histological subtype

52
Q

What staging is used for lung cancer?

A

TNM staging

53
Q

What is a Carcinoid tumour?

A

Neuroendocrine neoplasma of low grade malignancy

Occurs in young people

54
Q

What is a Bronchial gland neoplasm?

A

Tumours seen in salivary glands

55
Q

What is a primary pleural neoplasia called?

A

Mesothelioma

They are generally maligant

Respiratory - Week 3 (10 decks)

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