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2 - CPR (pulmonary) > Respiratory Pathology - 5 (neoplasms/PE) > Flashcards

Respiratory Pathology - 5 (neoplasms/PE) Flashcards

1
Q

What does a metastatic malignancy in the lungs look like if it is from testicular cancer?

A

Cannonball mets on CXR

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2
Q

What are 3 Miscellaneous Pulmonary Neoplasms?

A
  • Hamartoma
  • LAM
  • Inflammatory Myofibroblastic tumor
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3
Q

With a Hamartoma in the lungs, what does a CT scan show?

A

Coin lesion

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4
Q

With a Hamartoma, what does low power histology show?

A

Firm marble with smooth edges

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5
Q

Firm marble with smooth edges

A

Low power histology of a Hamartoma in the lungs

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6
Q

With a Hamartoma, what does high power histology show?

A

Fibrous tissue + benign glandular epithelium + hyaline cartilage

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7
Q

Fibrous tissue + benign glandular epithelium + hyaline cartilage in the lungs

A

Hamartoma with high power histology

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8
Q

LAM stands for?

A

Lymphangioleiomyomatosis

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9
Q

In what patients do LAMS usually occur?

A

Young women

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10
Q

What loss of function mutation is present with LAMs?

A

Loss of function of tumor suppressor gene, TSC2

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11
Q

What is a LAM?

A

Proliferation of cells that creates cystic spaces

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12
Q

With LAMs, how do they usually present and why?

A

Pneumothorax!

- Proliferation of cells creates cystic spaces

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13
Q

With LAMs, what cells usually proliferate?

A

Perivascular epithelioid cells that are modified smooth muscle cells

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14
Q

Perivascular epithelioid cells that are (+) HMB-45

A

LAM

- Lymphangioleiomyomatosis

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15
Q

What marker can be (+) for LAM that is usually seen with ____?

A

(+) HMB - 45

– usually seen with Melanoma

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16
Q

In what patient population are Inflammatory Myofibroblastic tumors usually found?

A

Children

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17
Q

What rearrangements occur in Inflammatory Myofibroblastic Tumors?

A

Rearrangements of ALK receptor tyrosine kinase gene

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18
Q

What does an Inflammatory Myofibroblastic Tumor look like and what shape are the cells?

A

Grayish round mass

- Spindle shaped cells

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19
Q

Describe the normal set up of the pleura on the lung

A
  • Lung
  • Visceral pleura
  • Pleural space
  • Parietal pleura
20
Q

What is pleural effusion?

A

Fluid in the pleural space between the visceral and parietal pleura of the lung

21
Q

Transudate fluid

A

LOW protein and low cells

22
Q

How will transudate fluid look?

A

Serous

23
Q

What is a cause of a transudate pleural effusion and its mechanism?

A

Heart failure - increased hydrostatic pressure

24
Q

Heart failure pleural effusion type?

A

Transudative - serous fluid

25
Q

Exudative fluid

A

HIGH protein and some cells

26
Q

What are 2 inflammatory causes of a pleural effusion and the resulting fluid type?

A
  • Infection
  • Malignancy
    = Exudative fluid
27
Q

Inflammatory pleural effusions will NOT be serous fluid. What will they likely look like?

A

Milky or bloody

28
Q

Empyema

A

Bacterial infection that causes an inflammatory exudate with accumulation of pus in the pleural space

29
Q

What is characteristic of Empysemas?

A

Loculations = web like traps for fluid

30
Q

Inflammatory exudate with accumulation of pus in pleural space with loculations

A

Empyema

31
Q

How does the fluid look and what cells are present with Empyemas?

A

Thick and yellow fluid

- Neutrophils and bacteria present

32
Q

What is a Pneumothorax?

A

Air in the pleural space

33
Q

Spontaneous Idiopathic pneumothorax

A

Rupture of subpleural blebs in children

34
Q

What are some possible secondary causes for a pneumothorax?

A

Cystic infections/tumors

Trauma, positive pressure ventilation

35
Q

Describe the pleural cavity pressure to atmospheric pressure relationship with a primary pneumothorax?

A

Atmospheric pressure&raquo_space; Pleural cavity pressure

36
Q

What is a tension pneumothorax?

A

1 way valve allowing air IN but not out!!

37
Q

With a tension pneumothorax, air is pulled in from wherever it is easiest – usually injury site. What happens to the organs?

A

Pushed to opposite side

38
Q

Describe the pleural cavity pressure to the atmospheric pressure with a tension pneumothorax

A

Pleural cavity pressure&raquo_space; atmospheric pressure

39
Q

1 way valve allowing air in but not out of the pleural cavity

A

Tension Pneumothorax

40
Q

What is a common benign pleural tumor?

A

Solitary Fibrous Tumor

41
Q

With a benign Solitary Fibrous Tumor, describe how it looks and what marker is (+)

A

(+) CD34

= well circumscribed, pedunculated mass that is attached to lung by a stalk

42
Q

What is a common malignant pleural tumor?

A

Mesothelioma

43
Q

What is Mesothelioma associated with and what are its 3 variants?

A

Associated with Asbestos exposure and can occur even decades after exposure

  • Epithelioid
  • Sarcomatoid
  • Mixed
44
Q

What marker is (+) and what will be seen on histology with a malignant pleural tumor (mesothelioma)?

A

(+) calretinin

- Ferruginous bodies

45
Q

Outlook for Mesothelioma?

A

Difficult to treat

– survival less than 2 years

2 - CPR (pulmonary) (26 decks)

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