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Renal/Resp > Tumors of Lung > Flashcards

Tumors of Lung Flashcards

1
Q

How many years after smoking do your cancer risk return to control levels?

A

10 years

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2
Q

What potential carcinogens are in tobacco smoke?

A

initiator (benzopyrene)

promoter (phenol derivatives)

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3
Q

What asbestos + smoking cancer risk?

A

50 to 90 times greater risk than gen. pop.

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4
Q

What indoor air pollution may be responsible for non-smokers lung cancer?

A

radon exposure -ubiquitous radioactive gas

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5
Q

What oncogenes are associated with small cell carcinoma?

A

c-myc

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6
Q

What oncogenes are associated with adenocarcinoma?

A

K-ras
EGFR
EML4-ALK

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7
Q

What does benzopyrene cause DNA damage at what codon?

A

same codons of p53 gene as seen in mutations in clinical lung cancers

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8
Q

What is a pancoast tumor?

A

tumor at extreme apex of lung
SVC syndrome
or honrers

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9
Q

What are the types of non small cell carcinoma

A 
squamous cell carcinoma
adenocarcinoma
-glandular
-papillary
-solid
-bronchioloaveolar
Large cell carcinoma
adenosquamous carcinoma
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10
Q

What is small cell carcinoma vs non small cell carcinoma?

A

treatment decisions
small cell very responsive to chemotherapy but surgery doesnt work

non small cell carcinoma treat with resection and chemo

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11
Q

What is contraindicated in squamous cell carcinoma?

A

bevacuzimab; toxicity can cause hemorrhage

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12
Q

What is the mutations that lead to response to erlotinib and gefitinib?

A

EGFR mutation

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13
Q

What cause resistance to erlotinib and gefitinib?

A

KRAS mutation

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14
Q

What is pemextrexed used to treat?

A

non squamous cell carcinoma

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15
Q

What are the morphology of squamous cell carcinoma?

A

central cavitary necrosis
males common
arise centrall; usually endobronchial, polypoid growth

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16
Q

What is the histology of squamous cell carcinoma?

A

keratin formation, intercellular bridges, atypia and invasion

large groups and nests of round, oval and polyhedral cells; squamous pearls

17
Q

What is adenocarcinoma morphology?

A

most common type in women and non-smokers

peripheral with pleural retratction or puckering associated with scarring

slow growing with metastasize
asymptomatic

18
Q

What is bronchioalveolar carcinoma?

A

subset of adenocarcinoma

single peripheral nodule or multiple nodules or diffuse pneumonia

19
Q

What is the histology of bronchioalveolar carcinoma?

A

lepidic spread-spread along alveolar septa
nonmucinous (clara cells, type II pneumocytes)
mucinous(tal columnar mucinous cells)

20
Q

What are the small cell carcinoma details?

A

predominant in males, smokers,
central location
highly malignant, median survival
submucosal/circumferential infiltration; rare endobronchial polypoid growth

extensive necrosis, secretory granules of neuroendocrine type
paraneoplastic syndrome

21
Q

How does small cell carcinoma appear on histology?

A

lymphocytic appearance

22
Q

What does large cell carcinoma appearance

A

large cells without differentiation

ultrastrucutral evidence of glandular or squamous differntiation

23
Q

What is giant cell carcinoma?

A

highly malignant

mostly peripheral

24
Q

Where do bronchogenic carcinoma metastasize?

A 
hilar lymph nodes
adrenal glands
liver
brain
bone
25
Q

What are the classification of small cell carcinoma

A 
limited disase (hemithorax with/without LN involvement)
Extensive disease (contralateral lung, distant metastasis)
26
Q

What are the staging of non small cell carcinoma?

A

TNM
Tumor size
Node involvmenet
mtastasis

27
Q

What is paraneoplastic syndrome?

A

symptom complexes that occur in pt with cancer that cannot be explained by spread or elaboration of horomones by tumor cell

28
Q

What is the importance of paraneoplastic syndrome

A

earliest manifestation of occult neoplasm
signficant problems
may mimic metastaes and be difficult to treat

29
Q

What are the small cell carcinoma associated paraneoplasms?

A

cushings (ACTH)
hyponatremia (innappropiate ADH secretion)
Carcinoid syndrome (serotonin)
Myasthenic syndrome (eaton-lambert syndrome)

30
Q

What are the paraneoplasms associated with squamous cell carcinoma?

A

hypercalcemia (parathoromone)

31
Q

What is the microscopic appearance of a carcinoid tumor?

A

nests/cords/masses
uniform cells with round nuclei
salt and pepper chromatin
IHC: NSE, chromogranin, synaptophysin +

32
Q

What are the clinical course and prognosis of carcinoid tumors?

A

hemoptysis, cough, obstructive symptoms (intraluminal growth) –infections, bronchiectasis, atelactasis or emphysema

carcinoid syndrome -intermittent diarrhea, flushing nad cyanosis

metastases rare
benign course and amendable to resection

Renal/Resp (22 decks)

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