respiratory neoplasia

Question 1

never smokers getting lung cancer

Answer 1

usually TP53 mutation carriers

Question 2

two types of carcinoma

Answer 2

squamous cell carcinoma and adenocarcinoma

Question 3

pathogenesis

Answer 3

p53 over expression or mutation in most squamous cell carcinoma
CDKN2 mutation or losses in SCC
adenocarcinoma - many mutations in receptor tyrosine kinases

Question 4

pathological findings in lung cancer

Answer 4

mass in the lung
pleural effusion
paraneoplastic syndromes

Question 5

mass in the lung may have

Answer 5

pleural invasion 
bronchial invasion 
lymph node involvement 
chest wall invasion 
nerve involvement

Question 6

site of respiratory neoplasms

Answer 6

lower respiratory tract vs upper respiratory tract

Question 7

classification of lung cancer

Answer 7

epithelial - 99%
mesenchymal
lymphoid
germ cell tumours

Question 8

treatment for small cell carcinoma

Answer 8

chemotherapy not surgery

Question 9

squamous cell carcinoma

Answer 9

tumour differentiates towards squamous cells

Question 10

adenocarcinoma

Answer 10

tumour differentiates towards gland cells

Question 11

neuroendocrine carcinomas

Answer 11

small cell carcinoma
large cell neuroendocrine carcinoma
carcinoid tumours

Question 12

4 types of epithelial carcinomas

Answer 12

squamous cell carcinoma
adenocarcinoma
neuroendocrine
large cell undifferentiated carcinoma

Question 13

adenocarcinoma description

Answer 13

the cancer of non smokers
forms glands
grows more slowly but metastasise widely and early

Question 14

squamous cell carcinoma description

Answer 14

more common in men and smokers
locally aggressive, often. necrotic
enlarged cells, atypical nuclei

Question 15

small cell carcinoma description

Answer 15

always central 
lymphatic spread 
large nuclei but not much cytoplasm 
nuclear moulding 
ectopic hormone production

Question 16

large cell carcinoma description

Answer 16

multinucleatiion, giant cells, frequent mitosis

Question 17

carcinoid

Answer 17

low grade neuroendocrine tumours

slow grwoing, low grade, malignant tumours

Question 18

grading

Answer 18

the extent to which neoplastic parenchymal cells resemble the corresponding normal parenchymal cells, both morphologically and functionally
correlates with outcome

Question 19

staging

Answer 19

how far has the tumour spread

enables comparison of cases for research and risk stratification

Question 20

paraneoplastic syndromes

Answer 20

tumour produces circulating chemical mediators that have endocrine or paracrine effects

Question 21

hormones produced by paraneoplastic syndromes

Answer 21

antidiuretic hormone
adrenocorticotropic hormone
prostaglandin
serotonin and bradykinin

Question 22

pathology testing

Answer 22

• sputum cytology
• pleural fluid cytology
• fine needle aspirate
• bronchoscopy
• biopsies of tumour
• resection

Question 23

prognosis of lung cancer

Answer 23

depends on type and stage

no screening

Question 24

holistic management issues

Answer 24

variability with access to PET scan, thoracic surgery units, CT guided core biopsy, pathology, molecular testing

Question 25

pleural cancer

Answer 25

mesothelioma

- modified epithelium

Question 26

asbestos related pathology

Answer 26

localised pleural plaques 
pleural effusions 
asbestosis 
bronchogenic carcinoma 
mesothelioma 
laryngeal and colonic carcinoma

Question 27

mesothelioma pathology

Answer 27

infiltrative tumour, tracks along pleural surfaces
dense fibrosis
epithelioid, sarcomatoid and biphasic types