Tumors Flashcards
1
Q
What are all forms of primary neoplasms of the lung in the pediatric population categorized as?
A
Rare
2
Q
How much more likely are lung masses to be benign compared to malignant?
A
10 times more likely
3
Q
What percentage of all pediatric solid tumors do chest wall tumors represent?
A
1.8%
4
Q
What is the most common location of chest tumors?
A
Mediastinum
5
Q
What are the three compartments of mediastinal masses?
A
- Anterior
- Middle
- Posterior
6
Q
What percentage of mediastinal masses occur before the age of 2?
A
40%
7
Q
What is the etiology of primary pulmonary lesions?
A
Tracheobronchial tree or pulmonary parenchyma
8
Q
Name two subtypes of benign primary pulmonary lesions.
A
- Plasma cell granuloma
- Hamartomas
9
Q
Name three subtypes of malignant primary pulmonary lesions.
A
- Bronchial adenoma
- Bronchogenic carcinoma
- Pleuropulmonary blastoma
10
Q
What is another name for plasma cell granuloma?
A
Inflammatory pseudotumor
11
Q
At what age range is plasma cell granuloma typically seen in the pediatric population?
A
8 - 12 years old
12
Q
What percentage of benign lesions do plasma cell granulomas account for?
A
> 50%
13
Q
What is a characteristic imaging feature of hamartomas?
A
Popcorn-like calcifications
14
Q
What type of tumors are bronchial adenomas considered?
A
Usually benign but can be malignant
15
Q
What are the three histologic types of bronchial adenomas?
A
- Carcinoid
- Cylindroma
- Mucoepidermoid
16
Q
What type of bronchial adenoma accounts for 80-85% of cases?
A
Carcinoid
17
Q
How rare is bronchogenic carcinoma in the pediatric population?
A
Only 60 reported cases
18
Q
What is the mortality rate for bronchogenic carcinoma in children?
A
> 90%
19
Q
What is pleuropulmonary blastoma classified as?
A
Rare malignant tumors
20
Q
What age group is primarily affected by pleuropulmonary blastoma?
A
< 6 years old
21
Q
What are the three pathologic types of pleuropulmonary blastoma?
A
- Type I – purely cystic
- Type II – combination of cystic and solid
- Type III – purely solid
22
Q
What is the most common soft tissue benign lesion of the chest wall?
A
Lipomas
23
Q
What is the most common benign skeletal neoplasm?
A
Osteochondromas
24
Q
What is the treatment for mesenchymal hamartomas?
A
Resection
25
What is the most common malignant chest wall tumor?
Chondrosarcoma
26
What is the typical presentation of primitive neuroectodermal tumors (PNET)?
Development of a painful mass
27
What is the most common mediastinal mass in children?
Lymphomas
28
What is the peak incidence age range for lymphomas?
8 - 14 years old
29
What percentage of lymphomas are Hodgkin lymphoma in children?
1/3
30
What is the most frequent thymic lesion?
Hyperplasia of the thymus
31
What is the treatment for an enlarged thymus causing respiratory obstruction?
Corticosteroids
32
What are thymomas classified as?
Invasive or noninvasive
33
What is a characteristic imaging feature of osteochondromas?
Cartilage cap
34
What is the treatment for malignant chest wall tumors?
Wide resection
35
What is the prevalence of benign thymoma among mediastinal masses?
1%–2% of mediastinal masses
## Footnote
Roughly 1/3 of patients with thymomas will have symptoms of local invasion.
36
How are thymomas classified?
Classified as invasive or noninvasive
## Footnote
Depending on whether they extend past their fibrous capsule.
37
What are thymic cysts?
Cystic remnants of the thymopharyngeal duct
## Footnote
Typically asymptomatic and manifests after 2 y/o.
38
What is the treatment for thymic cysts?
Resection
39
What type of tumor is a teratoma of the thymus?
A type of teratoid mediastinal tumor
## Footnote
Treatment involves resection.
40
What are the classifications of teratoid mediastinal tumors?
1. Benign cystic teratomas
2. Benign teratoids (solid)
3. Teratoids (carcinoma)
41
What elements do benign cystic teratomas contain?
Elements of ectodermal tissue
## Footnote
Such as hair, sweat glands, sebaceous cysts, and teeth.
42
What symptoms can be caused by benign solid teratoid tumors?
Vague chest discomfort, cough, dyspnea, and pneumonitis
## Footnote
Infection may cause a sudden exacerbation of symptoms.
43
What is the incidence of malignancy in solid teratoid tumors?
10%–25%
44
What is the standard workup for nonseminomatous germ cell tumors?
Cross-sectional imaging and preoperative serum studies
## Footnote
Including serum α-fetoprotein, carcinoembryonic antigen, and β-human chorionic gonadotropin.
45
What are the types of vascular-lymphatic abnormalities of the mediastinum?
1. Cavernous hemangioma
2. Hemangiopericytoma
3. Angiosarcoma
4. Lymphangioma (cystic hygroma)
46
What is the treatment for symptomatic mediastinal lymphangiomas?
Surgical excision
## Footnote
Incomplete resection ensures almost certain recurrence.
47
What are the three groups of intrathoracic lipomas?
1. Tumors confined within the thoracic cage
2. Intrathoracic lipomas that extend upward into the neck
3. Intrathoracic lipomas with extrathoracic extension forming a dumbbell configuration.
48
What is a lipoblastoma?
A rare benign tumor arising from fetal embryonal fat
## Footnote
Only 35 cases have been reported, with one in the mediastinum.
49
What are the common neurogenic mediastinal tumors?
1. Neurofibroma
2. Neurilemoma
3. Neuroblastoma
4. Ganglioneuroma
5. Ganglioneuroblastoma
6. Pheochromocytoma
50
What is the typical site of neuroblastoma?
Adrenal medulla
## Footnote
It may occur anywhere along the ganglia of the sympathetic chain.
51
What are the symptoms of neuroblastoma?
Horner’s syndrome, respiratory distress, and metastases in bone, skin, or lymph nodes
## Footnote
May also include miosis, ptosis, and anhidrosis.
52
What is the prognosis for infants under 1 year with neuroblastoma?
Better prognosis and respond better to chemotherapy.
53
What are bronchogenic cysts?
Cystic lesions usually benign, located in the middle mediastinum
## Footnote
May contain tissues normally present in the trachea and bronchi.
54
What is the treatment for esophageal duplication cysts?
Early resection
## Footnote
Between the ages of 6 and 12 months leads to better conservation of normal pulmonary parenchyma.
55
What type of epithelium is characterized by a well-defined muscularis mucosae and striated muscle in its wall?
Modified stratified squamous epithelium
## Footnote
This epithelium type is notably found in certain anatomical structures.
56
What does a Barium esophagram show in cases of esophageal issues?
Smooth indentation of the esophagus
## Footnote
This imaging technique helps visualize structural abnormalities in the esophagus.
57
What is the recommended treatment for esophageal issues diagnosed early in children?
Early resection between the ages of 6 and 12 months
## Footnote
This approach helps conserve normal pulmonary parenchyma and reduces complications.
58
Where do gastroenteric cysts typically lie?
In the posterior mediastinum against the vertebrae
## Footnote
Their positioning is crucial for diagnosis and treatment planning.
59
What are the two types of gastroenteric cysts based on functional activity?
* Acid-secreting cyst – functionally active
* Cysts with no functional activity
## Footnote
The classification affects the management and potential symptoms.
60
What are common associated anomalies with gastroenteric cysts?
* Mesenteric abnormalities
* Vertebral abnormalities (e.g., hemivertebrae, spina bifida, infantile scoliosis)
## Footnote
These anomalies can complicate the clinical picture.
61
What typically characterizes pericardial coelomic cysts?
Mesothelial cysts that are usually asymptomatic and discovered on chest radiography
## Footnote
They are often located anteriorly in the cardiophrenic angles.
62
What is the primary component of intrathoracic meningoceles?
Diverticuli of the spinal meninges
## Footnote
They protrude through the neuroforamen and contain CSF.
63
What is the most common primary tumor of the heart?
Myxoma
## Footnote
This tumor can lead to cardiac failure and is most often found in the atria.
64
What distinguishes primary sarcomas from other cardiac tumors?
They infiltrate the wall of the myocardium and extend into the pericardial cavity
## Footnote
This invasive behavior necessitates an aggressive surgical approach.
65
What are the predominant tumors found in primary neoplasms of the pericardium?
* Mesotheliomas
* Sarcomas
## Footnote
Other types such as leiomyomas and lipomas may occasionally occur.
66
What symptoms should raise suspicion for space-occupying lesions in children?
* Shortness of breath
* Wheezing
* Repeated infections not amenable to usual treatment
* Fevers
* Cough
* Hemoptysis
## Footnote
These symptoms may indicate underlying tumors or other significant pathologies.
67
What is the role of prenatal ultrasound in diagnosing chest lesions?
It has led to a greater understanding of the natural history of lesions presenting in the fetus
## Footnote
Prenatal assessment can aid in monitoring and planning postnatal management.
68
What imaging techniques are useful for diagnosing chest masses?
* Chest radiography
* CT scan
* MRI
* Ultrasonography
## Footnote
Each modality provides different insights into the characteristics of the lesions.
69
What is the significance of a multidisciplinary approach in managing chest tumors in children?
It helps ascertain the correct diagnosis and leads to an effective treatment approach
## Footnote
Collaboration among various specialties is crucial due to the complexity of pediatric tumors.
70
What should be considered when evaluating whether a lesion is benign or malignant?
The potential morbidity and mortality of surgical resection
## Footnote
This evaluation informs treatment decisions and management strategies.
71
What is the common outcome for asymptomatic benign lesions in children?
Watchful waiting without aggressive therapy may be beneficial
## Footnote
This approach minimizes unnecessary interventions while monitoring the lesion.
72
What is the primary mode of treatment for procedures like lobectomy and thymectomy?
Thoracoscopy
## Footnote
Technological advancements have improved the safety and efficacy of this approach.
