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Lung Tumors

Tumors of Lung and Pleura

Top 3 malignant lung neoplasms ? * Adenocarcinomas, SCC, Small Cell Carcinoma
Adenocarcinoma characteristics ? *glandular differentiation or mucin production by tumor cells ..... *grow slowly, but spread quickly..... ***positive for thyroid transcription factor-1 (TTF-1) ***
Molecular Aberrations in Lung Adenocarcinoma and their Clinical significance ? * EGFR - in women/non-smokers, and have good outcome........ *KRAS - in smokers and worse outcome
Preneoplastic lesion that may transform to invasive adenocarcinoma? * Atypical Adenomatous Hyperplasia
Bronchioloalveolar Carcinoma (BAC) ? * has the morpho of an adenocarcinoma .... * have a lepidic pattern
Two subtypes of BAC ? * BAC, non mucinous - cuboidal cells and don't spread..... * BAC, Mucinous - columnar epi and spread easily
BAC < 3 cm ? * now called adenocarcinoma in situ
If invasion is < 5mm ? * minimally invasive adenocarcinoma (100% survival if removed)
Squamous Cell Carcinoma (SCC) basics ? * Most commonly found in men and is closely related with a smoking history and arise centrally.... *
SCC genetics ? * highest in p53 mutations
SCC metaplasic development ? * Goblet cell hyperplasia ---Basal cell or reserve cell hyperplasia ---- Squamous metaplasia
histo of SCC ? * Intercellular bridges, Keratin pearls, Keratinization
Immunophenotype of Squamous cell carcinoma ? * is P63 + and TTF-1 -..... complete opposite of adenocarcinoma
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
Neuroendocrine Proliferations create what tumors ? * Carcinoid Tumors, Small ang Lg Cell Carcinoma
Clinical Features of Carcinoid syndrome in the Lungs ? * intermittent attacks of diarrhea, flushing and cyanosis
Small Cell Carcinoma basics ? * highly malignant - FASTEST growing and strongly associated with cigarette smoking
Molecular Pathology of Small Cell Carc ? * P53 and RB1 mutations
Small Cell Carcinoma histo? * lots of packed basophilic cells
Big difference between lg and small cell carcinoma ? * lg cell has a survival of 5 - 10 yrs.... Small cell is much lower
Some Systemic Manifestations of Lung CA ? *Lambert-Eaton Myasthenic syndrome -----Horner syndrome in Pancoast tumors -----Dermatologic abnormalities- acanthosis nigricans
Lambert-Eaton Myasthenic Syndrome ? usually in small cell carcinomas....*Auto-immune disease that attacks neuromuscular junction.... *weakness temporarily improves after exertion
Pancoast tumor ? * Apex lung tumor that can cause Horners Syn
Acanthosis Nigricans ? * brown plaques that if sudden onset could be due to cancer
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”
Pulmonary hamartoma basics ? * Rounded opacity (coin lesion), well circumscribed
Pleural Tumors : Solitary Fibrous Tumor ? *Consists of dense fibrous tissue with occasional cysts filled with viscid fluid
Pleural Tumors : Malignant Mesothelioma ? *Increased incidence (7-10% lifetime risk) among people with heavy exposure to asbestos
Asbestos bodies ? * Marker of asbestos exposure ...... *Found in increased numbers in the lungs of patients with mesothelioma---Dumbbell Shape
OPP to not do on someone w/ lung cancers ? * Lymphatic pumps and effleurage
Created by: thamrick800