Tumors of Lung and Pleura
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| Top 3 malignant lung neoplasms ? | * Adenocarcinomas, SCC, Small Cell Carcinoma
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| Adenocarcinoma characteristics ? | *glandular differentiation or mucin production by tumor cells ..... *grow slowly, but spread quickly..... ***positive for thyroid transcription factor-1 (TTF-1) ***
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| Molecular Aberrations in Lung Adenocarcinoma and their Clinical significance ? | * EGFR - in women/non-smokers, and have good outcome........ *KRAS - in smokers and worse outcome
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| Preneoplastic lesion that may transform to invasive adenocarcinoma? | * Atypical Adenomatous Hyperplasia
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| Bronchioloalveolar Carcinoma (BAC) ? | * has the morpho of an adenocarcinoma .... * have a lepidic pattern
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| Two subtypes of BAC ? | * BAC, non mucinous - cuboidal cells and don't spread..... * BAC, Mucinous - columnar epi and spread easily
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| BAC < 3 cm ? | * now called adenocarcinoma in situ
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| If invasion is < 5mm ? | * minimally invasive adenocarcinoma (100% survival if removed)
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| Squamous Cell Carcinoma (SCC) basics ? | * Most commonly found in men and is closely related with a smoking history and arise centrally.... *
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| SCC genetics ? | * highest in p53 mutations
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| SCC metaplasic development ? | * Goblet cell hyperplasia ---Basal cell or reserve cell hyperplasia ---- Squamous metaplasia
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| histo of SCC ? | * Intercellular bridges, Keratin pearls, Keratinization
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| Immunophenotype of Squamous cell carcinoma ? | * is P63 + and TTF-1 -..... complete opposite of adenocarcinoma
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| Reasons to distinguish Adenocarcinoma from SCC ? | * EGFR mutations have different responses to different drugs..... *Specific therapies are driven by histologic subtyping .... *Treatment with bevacizumab, (VEGF inhibitor) has been reported to precipitate pulmonary hemorrhage in patients with SCC
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| Neuroendocrine Proliferations create what tumors ? | * Carcinoid Tumors, Small ang Lg Cell Carcinoma
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| Clinical Features of Carcinoid syndrome in the Lungs ? | * intermittent attacks of diarrhea, flushing and cyanosis
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| Small Cell Carcinoma basics ? | * highly malignant - FASTEST growing
and strongly associated with cigarette smoking
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| Molecular Pathology of Small Cell Carc ? | * P53 and RB1 mutations
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| Small Cell Carcinoma histo? | * lots of packed basophilic cells
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| Big difference between lg and small cell carcinoma ? | * lg cell has a survival of 5 - 10 yrs.... Small cell is much lower
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| Some Systemic Manifestations of Lung CA ? | *Lambert-Eaton Myasthenic syndrome
-----Horner syndrome in Pancoast tumors
-----Dermatologic abnormalities- acanthosis nigricans
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| Lambert-Eaton Myasthenic Syndrome ? | usually in small cell carcinomas....*Auto-immune disease that attacks neuromuscular junction.... *weakness temporarily improves after exertion
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| Pancoast tumor ? | * Apex lung tumor that can cause Horners Syn
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| Acanthosis Nigricans ? | * brown plaques that if sudden onset could be due to cancer
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| Pulmonary Langerhans cell histiocytosis basics ? | * Most often seen in adult smokers, may regress spontaneously upon smoking cessation
...... * see Birbeck granules with characteristic periodicity and dilated terminal end “tennis racket configuration”
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| Pulmonary hamartoma basics ? | * Rounded opacity (coin lesion), well circumscribed
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| Pleural Tumors : Solitary Fibrous Tumor ? | *Consists of dense fibrous tissue with
occasional cysts filled with viscid fluid
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| Pleural Tumors : Malignant Mesothelioma ? | *Increased incidence (7-10% lifetime risk) among people with heavy exposure to asbestos
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| Asbestos bodies ? | * Marker of asbestos exposure
...... *Found in increased numbers in the lungs of patients with mesothelioma---Dumbbell Shape
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| OPP to not do on someone w/ lung cancers ? | * Lymphatic pumps and effleurage
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