Respiratory Pathology - neoplastic disease

Question 1

What age and gender are more likely to have a lung carcinoma?

Answer 1

40-70 years. More common in females.

Question 2

What are the risk factors for lung carcinomas?

Answer 2

Smoking, industrial hazards: radiation, uranium, asbestos, radon. Family history, immunodeficency.

Question 3

What is lung cancer heavily associated with?

Answer 3

87% linked to smoking. Linear correlation between exposure to cigarette smoke and epithelial changes.

Question 4

What are the symptoms of lung carcinoma?

Answer 4

Cough, weight loss, chest pain, dyspnoea. May present with symptoms of metastases.

Question 5

What are para-neoplastic syndromes?

Answer 5

Ectopic hormone secretion by tumour. Occurs in 1-10% of lung cancer patients. Hormones include ADH, ACTH, Calcitonin etc.

Question 6

How do you stage a lung carcinoma?

Answer 6

Using TNM - primary tumour size, lymph nodes, distant mets.

Question 7

What are the different types of lung carcinoma?

Answer 7

Small cell carcinoma.
Non-small cell carcinoma: squamous cell carcinoma, adenocarcinoma, large cell carcinoma.
Combined Carcinoma.

Question 8

What is small cell carcinoma?

Answer 8

Strong relationship to smoking. Occurs in major bronchi and at periphery. Rapidly invades bronchial wall - early lymph and blood-borne spread.

Question 9

What is squamous cell carcinoma?

Answer 9

Most commonly affects men. Closely related to smoking. Arises close to hilum, usually in areas of squamous metaplasia.

Question 10

What is adenocarcinoma?

Answer 10

Most common type in women and non-smokers. Peripherally located. Grows slower than SCC but metastasise early and widely. Sometimes associated with scarring e.g TB

Question 11

What is large cell carcinoma?

Answer 11

Undifferentiated malignant epithelial tumour. Undifferentiated SCC and adenocarcinoma. Nests and islands of tumour cells.

Question 12

What are the common sites of metastases for lung cancer?

Answer 12

Bowel, prostate, breast, kidney.

Question 13

What are pleural tumours?

Answer 13

Secondary mets involvement more common than primary tumour (malignant mesothelioma). Lung or breast.

Question 14

What is malignant mesothelioma?

Answer 14

Primary tumour - increased risk in people with exposure to asbestos. Latent period of 25-45 years. Diffuse lesion that spreads widely in the pleural space.

Question 15

What are the symptoms of malignant mesothelioma?

Answer 15

Chest pain, dyspnoea, pleural effusions.