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24 Cards in this Set
- Front
- Back
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The vast majority of cancers in the lung arise from what cell type?
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From epithelial cells (carcinomas)
Sarcomas from mesenchymal cells and primary lymphomas are rare |
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What are some cell types found in the proximal respiratory tree?
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Ciliated cells
Goblet cells Neuroendocrine cells Reserve cells |
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What are some cell types found in the respiratory bronchiole?
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Ciliated cells
Neuroendocrine cells Clara cells (No goblet cells) |
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Epidemiology of lung cancer
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Currently the leading cause of cancer death in both men and women in the US.
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How does the respiratory epithelium respond to chronic damage?
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By undergoing squamous metaplasia (pseudostratified ciliated columnar --> stratified squamous epithelium). This is reversible
Also by undergoing dysplasia. |
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How long does it take for mild dysplasia to progress to a carcinoma?
How long does it take to grow to a size detectable on X-ray? |
About 15-20 years.
About 25- 35 years. |
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What are some early symptoms of lung cancer?
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Fever
Cough Hemoptysis Recurrent pneumonia |
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What is the overall survival rate for lung cancer?
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Only 10-12%
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What are late symptoms of lung cancer?
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Weight loss
Weakness Pericardial and pleural effusions Superior vena cava syndrome Hoarseness Mets to brain (seizures, paralysis) |
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What is the general pattern of spread of carcinoma of the lung?
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Spreads along bronchi
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What is a paraneoplastic syndrome?
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When the tumor secretes a substance on its own.
This is frequently seen with small cell carcinoma. |
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Gross presentation:
Most metastases are _____. And most primary tumors are ______ _______. |
Gross presentation:
Most metastases are MULTIPLE. And most primary tumors are SOLITARY MASSES. |
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What are the six types of lung cancer?
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1. Squamous cell (Epidermoid) carcinoma
2. Adenocarcioma 3. Bronchoalveolar carcinoma 4. Large cell carcinoma 5. Small cell carcinoma 6. Mixed types. |
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c/c small cell carcinoma with non-small cell carcinoma.
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Small cell carcinoma has a much greater metastatic potential, but responds better to chemotherapy.
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Squamous cell carcinoma of the lung: general attributes.
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- Keratin pearls (extracellularly = "pearls", intracellularly in cytoplasm)
- Central tumors that cavitate centrally - Do not metastasize outside of the lung until tumor is large - Highest correlation with smoking among the lung cancers. - Classically preceeded by squamous metaplasia --> dysplasia --> carcinoma in situ) |
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Adenocarcinoma of the lung: general attributes.
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- Formation of glands, papillae, tubules, production of mucin.
- Peripheral tumors without a visible connection to an airway, often in vicinity of peripheral lung scars (scar carcinomas). - Usually metastasize before become large. - Most common type among women - Do not have as strong an association with smoking as squamous cell carcinoma. |
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Bronchioalveolar carcinoma of the lung: general attributes.
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- Growth along alveolar septa
- Lung architecture remains intact - Forms a diffuse infiltrate that looks like pneumonia. - Can be multifocal, leading to respiratory failure. - May appear "deceptively bland" - Appear to arise from Clara or type II alveolar cells |
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Large cell carcinoma of the lung: general attributes.
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- Placed in this category because they are poorly differentiated.
- Behave clinically like adenocarcinomas, but are more aggressive - Also known as non-small cell carcinomas |
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Small cell carcinoma of the lung: general attributes.
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- Malignant tumor characterized by small cells with little to no cytoplasm and dense, dark nuclei.
- Derived from neuroendocrine cells and have neurosecretory granules in their cytoplasm. - Most associated with paraneoplastic syndromes. - Arise centrally - Strong association with smoking - Often have already metastasized by the time of diagnosis - Respond WELL to chemotherapy. |
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Adenoid cystic carcinoma: general attributes
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- Most commonly originate from the salivary glands, but also trachea and bronchi
- Slow growing - Invade adjacent structures - Metastasize late - "Cords and nests of cells in a dense stroma" |
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Carcinoid tumor: general attributes
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- Usually benign neuroendocrine tumors (cells contain neurosecretory granules)
- Often arise centrally as a polypoid growth within the lumen of a bronchus - "Appear like carcinoids from the bowel, having uniform cells arranged in packets and nests." - Rarely malignant |
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Hamartoma: general attributes
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- Benign peripheral cartilaginous masses
- Often detected as coin lesions |
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Thymoma: general attributes
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- Tumors originating from the thymus.
- Well encapsulated with benign behavior. - Do not metastasize. - Composed of a mixture of epithelial and lymphocytic elements. - Myasthenia gravis is associated with thymomas in 30-40% of cases |
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What are the two types of lung cancer that are the most associated with smoking?
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Small cell and squamous cell carcinoma.
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