Question | Answer |
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 |