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Block 4 > SFP: Lung Cancers > Flashcards

SFP: Lung Cancers Flashcards

1
Q

What percentage of lung tumors are carcinomas?

A

95%

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2
Q

Where do lung cancers fall on the ranking of cancer-related deaths?

A

1

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3
Q

What percentage of people with lung cancers are active or former smokers?

A

90%

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4
Q

Does secondhand smoke put you at risk for lung cancer?

A

Yes, by about 2-fold

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5
Q

What gene involvement is an early event with most lung cancers?

A

3p tumor suppressor gene deletion

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6
Q

What genes are involved in many non-small cell lung cancers aka adenocarcinoma?

A

KRAS and EGFR

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7
Q

What is the significance of P450 in lung cancers?

A

It activates some carcinogens

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8
Q

What tumors are associated with smoking?

A

Small cell and squamous cell

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9
Q

Describe the origin of carcinoid tumors.

A

They are not caused by smoking and are neuroendocrine tumors

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10
Q

Describe a typical carcinoid tumor.

A

There are few mitoses and no necrosis; very rarely metastasizes

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11
Q

Describe atypical carcinoid tumors.

A

More mitoses and some necrosis; not as malignant as carcinomas but around half metastasize

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12
Q

Where do we tend to see carcinoids in the lung?

A

In or around the bronchi

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13
Q

What stains can be used to identify carcinoid tumors?

A

Synaptophysin and chromogranin

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14
Q

Briefly describe origins of small cell carcinoma.

A

They have a strong relationship to smoking and are neuroendocrine tumors

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15
Q

Where do we normally see small cell carcinoma in the lung?

A

The hilar region

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16
Q

Describe the gross and microscopic morphology of small cell carcinoma.

A

They’re big, fast-growing tumors that involve lymph nodes. They have many mitoses, sparse cytoplasm

17
Q

With which tumors are paraneoplastic syndromes common?

A

Small cell

18
Q

What are paraneoplastic syndromes?

A

Syndromes a patient can exhibit resulting from hormone production by a tumor

19
Q

What hormones from small cell carcinoma are often involved in paraneoplastic syndromes? What develops from them?

A
  1. ACTH: manifestation of Cushing’s disease
  2. ADH: SIDAH
20
Q

What hormone is produced by squamous cell carcinomas? What develops as a result?

A

Parathyroid hormone protein resulting in hypercalcemia

21
Q

When do we call something non-small cell carcinoma?

A

When we cannot fully tell the histologic type but know it is not small cell

22
Q

What is the 5-year survival like in NSCLC?

A

If it is small and confined, it is about 50%. If it is big or has spread or nodes, it is around 30%

23
Q

Where do we find squamous cell carcinoma in the lung?

A

Hilar region

24
Q

Describe gross morphology of squamous cell carcinoma.

A

Big tumor with necrosis

25
Q

Describe histology of squamous cell carcinoma.

A

Big cells with a lot of cytoplasm with squamous features such as keratin pearls and intercellular bridges

26
Q

What is squamous cell carcinoma in-situ?

A

It is limited to the epithelial lining of the lung and does not pass the basement membrane

27
Q

Where in the lung do we usually see adenocarcinoma?

A

Peripherally

28
Q

What is the most common lung cancer in non-smokers and women?

A

Adenocarcinoma

29
Q

What gene mutation occurs in about 1/5th of adenocarcinomas?

A

EGFR

30
Q

What is the origin of adenocarcinoma?

A

Epithelial cells

31
Q

Describe the histology of adenocarcinoma.

A

Abundant cytoplasm, Nuclei with big nucleoli, malignant gland formation

32
Q

What is characteristic about adenocarcinoma?

A

They produce mucin

33
Q

Describe adenocarcinoma in situ.

A

They use the alveolar walls as scaffolding to grow on; it does not invade the basement membrane and uses alveolar capillaries for blood supply

34
Q

Briefly describe large cell carcinoma.

A

They’re undifferentiated and don’t have features that clearly tell us what the tumor is, and they may have giant cells. They usually metastasize.

35
Q

What do mitotic figures look like in large cell carcinoma?

A

Usually very abnormal; the nuclei look different as well

Block 4 (28 decks)

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