Respiratory pathology Flashcards
- What are common symptoms of lung cancer?
Heamotopsys-coughing blood, chough, chest/shoulder pain, dysnpnae, hoarnsess and finger clubber
- How can samples be acquired for cytological analysis?
PET scans can see the tumors after being given radioactive glucose
Fine needle aspiration
Brochial brushing, lavage and pleural fluid
- What are some features of benign tumours?
Tumour is very metabolically active therefore takes radioactive glucose for pet scan fast
Grow slower, no metastase, no invasion
- What are the three types of non-small cell carcinoma? What percentage of lung cancers are non-small cell?
Small cell lung cancer
Non-small cell lung caner-about 80%
Adenocarcinoma
Large cell carcinoma
- How are the incidences of squamous cell carcinoma and adenocarcinoma changing?
Squamous cell carcinoma is decreasing, adenocarnioma is increasing
- Where do squamous cell carcinomas and adenocarcinomas tend to arise?
Squamous near mediastinum-shallow, adenocarcinoma near periphery
- State three major risk factors for lung cancer.
Smoking, radiation, asbestos
- What are the four stages in the pathway to carcinoma?
Metaplasia, dysplasia, carcinoma in situ, invasive carcinoma
- Why has a precursor lesion for small cell lung carcinoma not been found?
Because small cell cancer goes too quicly and metabolises early
- How do the cells lining the airways change in squamous cell carcinoma?
Ciliated cell undergo metaplasia due to chronic stimulation by cigarette smoke-become squamous
- Which type of lung cancer is common in non-smokers?
adenocarcinoma
- Which types of lung caner are strongly associated with smoking?
Small cell carcinoma and squamous cell carcinoma
- Describe the cytological features of squamous cell carcinoma.
Large nuclei and keratin in cytoplasm
- What is the precursor lesion for adenocarcinoma?
Atypical adenomatous hyperplasia
- At what point does adenocarcinoma in situ become invasive adenocarcinoma?
When the cells aquire a mutation allowing to break stomae and invade. Tjis causes inflammation and leads to fibrious tissue
- Describe the cytological features of adenocarcinoma.
Differentiate to glandular-big atypical nuclei with mucin globules
- Where does adenocarcinoma usually develop and are they usually multi-focal?
They develop near the periphery and are usually multifocal
- What are the two molecular pathways for adenocarcinoma and which one is associated with smoking?
K-ras pathways-smoking
EFGR-responder/resistance mutation
- Why is it important to differentiate between the different pathways? (kras and EGFR-lung cancer)
React very differently to drugs and targeted therapies-kras responds much worse, while EGFR can regress completely
- What is large cell carcinoma?
Poorly differentiated-poor prognosis. Electron microscopy suggests evidence of ssquamous/neuroendocrine
- What are the cytological features of small cell carcinoma?
Look like lymphocytes-large nucleus and little cytoplasm
- Where does small cell carcinoma tend to arise?
Centrally, near the bronchi
- What does the ERCC1 marker determine?
If there marker is there, means advances non-small cell cancer UNLIKELY to respond to cisplatin
- What type of receptor is EGFR and what is used to block this receptor?
Tyrosine kinase like-can use TKL inhbitors
- What are paraneoplastic syndromes?
Systemic effect of tumour due to abnormal expression of factors (eg hormones) not normally in tissue
- State some endocrine paraneoplastic syndromes.
SIADH (make ADH) Cushing syndrome (make ACTH
- What is strongly associated with mesothelioma?
asbestos
