Respiratory10 Flashcards
Types of lung cancer
Types of lung cancer. (6)
Adenocarcinoma Squamous cell carcinoma Small cell (oat cell) carcinoma Large cell carcinoma Bronchial carcinoid tumor Mesothelioma
Most common lung cancer in nonsmokers and females.
Adenocarcinoma
What mutation is common in adenocarcinoma?
Activating mutation in k-ras
Bronchioloalveolar (subtype of adenocarcinoma)
CXR - hazy infiltrates similar to pneumonia
Excellent prognosis
Grows along alveolar septa –> apparent “thickening” of alveolar walls
What is adenocarcinoma associated with?
Hypertrophic Osteoarthropathy
Which lung cancers are located in the periphery?
Adenocarcinomas
Large cell carcinoma
Which lung cancers are centrally located?
Squamous cell Small cell (oat cell)
Hilar mass arising from bronchus.
Squamous cell carcinoma
Characteristics of Squamous cell carcinoma.
Cavitation
Cigarettes
HyperCalcemia (produces PTHrP)
Histo of Squamous cell carcinoma.
Keratin pearls
Intercellular bridges
Characteristics of Small cell (Oat cell) carcinoma.
Undifferentiated --> AGGRESSIVE
May produce:
- ACTH
- ADH
- Antibodies vs. presynaptic Ca++ channels
(Lambert-Eaton syndrome)
- Amplification of myc oncogenesSmall cell carcinoma is a neoplasm of what cell type?
Neuroendocrine Kulchitsky cells
- small dark Blue cells
How do you treat small cell?
Chemo
*Inoperable
Characteristics of Large cell carcinoma.
Highly Anaplastic Undifferentiated tumor
Poor prognosis
Pleomorphic giant cells
*Less responsive to Chemo –> removed surgically
Characteristics of Bronchial Carcinoid tumor.
Excellent Prognosis; metastasis rare
Symptoms d/t Mass Effect
Occasionally carcinoid syndrome
What is Carcinoid syndrome?
Serotonin secretion –>
- Flushing
- Diarrhea
- Wheezing
Histo of Bronchial Carcinoid tumor.
Nests of neuroendocrine cells
Chromogranin Positive
Characteristics of Mesothelioma.
Malignancy of pleura associated w/ Asbestos
Results in:
- Hemorrhagic pleural effusions
- Pleural thickening
Histo of Mesothelioma.
Psammoma bodies
Histo of Small Cell Carcinoma.
Sheets of tumor cells w/ nuclear molding
High Mitotic Rate
Necrosis
“Salt & Pepper” neuroendocrine-type chromatin
What is a Pancoast tumor?
Carcinoma that occurs in APEX of lung
May affect Cervical Sympathetic Plexus
What may a Pancoast tumor cause?
Horner’s syndrome
Findings in Horner’s syndrome.
Ipisilateral Ptosis
Miosis
Anhidrosis
What is Superior Ven Cava Syndrome?
An obstruction of the SVC that impairs blood drainage from the Head, Neck, and Upper extremities
If severe can raise Intracranial Pressure:
- HA, dizziness, Risk of Aneurysm/Rupture of cranial arteries
*Medical Emergency
Common causes of SVC syndrome.
Malignancy
Thrombosis from indwelling catheters
