thoracic cancers Flashcards
3 types of non small cell lung cancer
1) adenocarcinoma
2) squamous cell carcinoma
3) large cell carcinoma
three types of adenocarcinoma
1) preinvasive
2) minimally invasive
3) invasive
what is the most frequent type of non small cell lung cancer
adenocarcinoma
what is the most common patient in adenocarcinoma
women and non-smokers
what is preinvasive adenocarcinoma called
adenocarcinoma in situ
what are the two types of adenocarcinoma in situ
nonmucinous and mucinous and then mixed
what is the most common type of AIS
nonmucinous
how invasive is minimally invasive adenocarcinoma
invasion into the stroma is less than 0.5 cm; no invasion into lymphovascular or pleural structures
how invasive is invasive adenocarcinoma
greater than 0.5 cm
what is the location of invasive adenocarcinoma
peripheral
what are the gross features of invasive adenocarcinoma
gray-white, firm, lobulated with scarring with pleural puckering
what are the three histologic patterns seen in invasive adenocarcinoma
1) acinar
2) papillary
3) solid (sheets of tumor cells with intracytoplasmic mucin)
what is the most common histology of lung cancer globally
squamous cell carcinoma
where is squamous cell carcinoma located
centrally
what two cancers have a strong association with smoking
squamous cell carcinoma and small cell carcinoma
histology of squamous cell carcinoma
1) keratinization
2) intracellular bridges (desmosomal attachments between cells)
3) cleared chromatin and prominent nucleoli
location of large cell carcinoma
peripheral
histology of large cell carcinoma
no glandular or squamous differentiation; sheets of cells
large cells with eosinophilic cytoplasm
prominent nucleoli and vesicular nuclear chromatin
small cell carcinoma is _____ of lung tumors
15-20%
location of small cell carcinoma
central mass with extensive hilar/mediastinal lymphadenopathy
pathology of small cell carcinoma
high n/c ratio, nuclei with stippled (salt and pepper) chromatin, very mitotically active, “crush” artifacts (nuclear crowding)
high grade NE tumor
low grade form of small cell carcinoma
carcinoid tumors
location of carcinoid tumors
central (often causing obstructive sx)
what do carcinoid tumors look like?
well-circumscribed, yellow or cherry red, fleshy, smooth surface
histology of carcinoid tumors
can grow in multiple patterns, inc. nests, cords, and ribbons
round/ovoid/spindle shaped cells with uniform cell size
what is the most common lung neoplasm?
metastasis to the lung
when do we see pulmonary hamartoma
6-7th decade
location of pulmonary hamartoma
peripheral and often asymptomatic
popcorn calcification
gross description of pulmonary hamartoma
is the pulmonary hamartoma benign or malignant
benign!
mesenchymal tumor in the pleura
solitary fibrous tumor
where do solitary fibrous tumors arise
most in the visceral pleura, but can arise in the lung
gross pathology of solitary fibrous tumors
solitary, well-circumscribed, slow-growing, firm, whitish, whorled appearance
histology of solitary fibrous tumors
patternless, has a mix of hypo cellular (less pink) and hyper cellular (more pink) areas
two histologic types of malignant mesothelioma
epithelioid and sarcomatoid
most common sign of mets to the pleura
pleural effusion
most common anterior mediastinal lesion
thymoma
most common middle mediastinal lesion
bronchogenic cyst
most common posterior mediastinal lesion
nerve sheath tumor
