REVIEW 4 (Pulm)

Question 1

Deletions in the _________ of Chromosome _______ are frequently found in all types of lung cancers

Answer 1

Deletions in the short arm of chromosome 3 (3p)

Question 2

Which oncogenes are associated with lung cancer?

Answer 2

K-ras oncogenes

Myc oncogene

Question 3

What 2 tumor suppressor genes are associated with lung cancer

Answer 3

1. Mutations in the p53 gene (50% of Small cell carcinomas and 50% of Non-small cell carcinomas)
2. Retinoblastoma gene (Rb) mutations (>80% of small cell carcinomas, 25% Non-small cell Carcinomas)

Question 4

Which lung carcinoma is a distinctive subtype of adenocarcinoma that grows along preexisting alveolar walls?

Answer 4

Bronchioloalveolar Carcinoma

Question 5

Which lung carcinoma accounts for 1-5 % of all invasive lung tumors?

Answer 5

Bronchioloalveolar carcinoma (BAC)

Question 6

Which Lung carcinoma?

Copious mucin in the sputum is a distinctive sign

Answer 6

Bronchioloalveolar carcinoma (BAC)

Question 7

Which lung cancer?

Grossly:

• may appear as a single peripheral nodule or coin lesion (50%)
• multiple nodules or a diffuse infiltrate indisting-uishible from a lobar pneumonia.

Answer 7

Bronchioloalveolar carcinoma (BAC)

Question 8

Which lung cancer?

2 major histologic patterns:

• 2/3 are nonmucinous
• 1/3 are mucinous tumors featuring increased amounts of goblet cells.

Answer 8

Bronchioloalveolar carcinoma (BAC)

Question 9

Prognosis of which lung cancer?

• tumor limited to the lung (Stage I), detected as a solitary coin lesion= GOOD prognosis
• those w/ multiple nodules or diffuse lung involvement= POORER outcome

Answer 9

Bronchioloalveolar carcinoma (BAC)

Question 10

Which lung carcinomas have the strongest association with cigarette smoking?

Answer 10

Squamous cell and small cell carcinomas

Question 11

Which lung carcinoma accounts for 30% of all invasive lung cancers in the U.S. (about equal to adenocarcinomas) and is always associated with cigarette smoking.

Answer 11

Squamous cell carcinoma

Question 12

Which lung carcinoma?

Most arise in the central portion of the lung, although 10% can arise from the periphery.

Answer 12

Squamous cell carcinoma

Question 13

Which lung carcinoma?

Grossly: firm, gray-white ulcerative masses which extend through the bronchial wall into the adjacent parenchyma.

Answer 13

Squamous cell carcinomas

Question 14

Which lung carcinoma?

diagnosis may be made by cytology from bronchial washings or bronchial brushings during bronchoscopy. (central location

Answer 14

Squamous cell carcinoma

Question 15

Are most Squamous cell carcinoma lung cancers invasive at diagnosis?

–>Resection specimens of these tumors reveal carcinoma in-situ in only one-third of cases, whereas the rest reveal varying degrees of invasion.

Answer 15

Squamous cell carcinoma

Question 16

Which lung carcinoma has the following clinical presentation?

1. cough
2. dyspnea
3. hemoptysis
4. chest pain
5. +/-pneumonia with pleural effusions

Answer 16

Squamous cell carcinoma

Question 17

Which lung carcinoma?

Most centrally located tumors may produce bronchial obstruction with pneumonia, persistent cough and hemoptysis if eroded into a vessel.

Answer 17

Squamous cell carcinoma

Question 18

Why do squamous cell carcinoma lung tumors have a better prognosis?

Answer 18

They tend to metastasize to local lymph nodes (hilar) and somewhat later

Question 19

Which lung carcinoma?

1. Accounts for about 30% of primary lung cancers
2. tends to arise in the periphery of the lungs
3. often associated with scars which can result in puckering of the pleural.
4. Slight association with smoking.

Answer 19

Adenocarcinoma of the lung

Question 20

The following describes the gross appearance of which lung cancer?

• Appear as irregular masses
• on cut section: appear gray-white in color, soft and glistening, depending on the amount of mucus

Answer 20

Adenocarcinoma of the lung

Question 21

10-15% of patients with ________ have no obvious sxs and the tumor is discovered incidentally during routine CXR

Answer 21

Lung cancer

Question 22

The following are some general clinical features of what?

• Coughing/wheezing/dyspnea
• Hemoptysis
• weight loss
• cachexia
• Extension into pleural surface= effusion and progressive dyspnea secondary to compression

Answer 22

Lung cancer

Question 23

The following are clinical features of lung cancer if there is ______ at the time of dx:

• hepatomegaly
• neurologic sxs (seizures)
• Fractures
• Destruction of the adrenal gland- Addison’s disease

Answer 23

Distant metastasis

Question 24

What does the following describe?

• The (pulmonary) lesion remains localized and heal with calcification that can be seen on CXR
• Single nodule

Answer 24

Coin lesion

Question 25

What is the old term for mesothelioma (a carcinoma of the lung)?

Answer 25

Rind Tumor