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26 Cards in this Set
- Front
- Back
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Hamartoma definition
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- Discrete tumor of benign normal tissues in excess/disarray
- is removed for dx, does not need to be treated |
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Hamartoma clinical
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- Adolescence -> adulthood
- None in newborns b/c it is not congenital – it is important because it mimics a new carcinoma – they frequently calcify |
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Hamartoma radiology
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- will show Solitary nodule +/- popcorn calcification
– Peripheral > central |
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Hamartoma path
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- gross will show solitary, lobulated, cartilaginous (excess and in dissary)
– micro will show normal tissues in excess or disarray – grow as a popcorn in the periphery of the lung |
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what causes cancer in cigarett smoke
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anthracenes, pyrenes
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prognostics in NSCLC
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- Stage, performance status, weight loss
- maybe gender, ploidy, k-ras mutation, p53 protein accumulation |
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prognostics in SCLC
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- Stage, performance status
- maybe gender, age, # of mets sites are probably |
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Squamous carcinoma clinical
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- 30%
- 98 % are smokers – May secrete PTH-like compound – perineoplastic syndrome - may cause obstruction of the airway with distal atelectasis, post obstructive pneumonia – may cavitate - there is hypercalcemia and clubbing |
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Squamous carcinoma radiology
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- central >> peripheral
- a too-wide mediastinum |
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Squamous carcinoma path
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- Bronchi > Larynx > Trachea
– +/- Desmosomes – +/- Keratin production (keratin pearls) – often bronciogenic (stemming from bronchi) – begins w/ dysplasia, can become invasive – if invasive, afferent lymphatics will have mets in subcapsular sinuses |
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Adenocarcinoma clincial
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- 30%
- Most common carcinoma in non-smokers, but 80% are smokers - likely to spread to LNs and outside chest - HPO or clubbing alone may be present (due to paraneoplastic syndrome) |
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Adenocarcinoma radiology
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- peripheral > central
– associated blunting of costoprhenal angle due to effusion |
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Adenocarcinoma path
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- +/- glands and +/- mucin
– any gland formation is enough to call it adenocarcinoma – red staining mucin production is enough to make dx too |
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Bronchiolo-alveolar carcinoma clinical
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- 20-25% of adeno
– there is a rising incidence – not associated w/ smoking - Cough and bronchorrhea (frothy sputum production) |
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Bronchiolo-alveolar carcinoma radiology
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- peripheral, and can be multifocal and bilateral
– know that multifocal nodules can be this, and not just infection or mets – the only 1o lung cancer that can present this way!! |
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Bronchiolo-alveolar carcinoma path
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- Lepidic (butterfly-like, does not destroy interstitium) growth pattern
- Mucinous or non-mucinous – Unifocal or multifocal – there is distinction of multifocal 1o from mets!! - if type 1 and type 2 epi have been replaced w/ cancer, air cant diffuse! |
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Large cell undifferentiated carcinoma
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- (10%)
- Radiology non specific - H and E undifferentiated – EM ? adenocarcinomas – cDNA microarrays for the distinct disease – just know that it is just non-small cell, otherwise unspecified |
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Small Cell Lung Carcinoma clincal
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- 20%
- definitely smokers – Ectopic ACTH, ADH, Eaton-Lambert, carcinoid – usually high stage at presentation – there is response to chemo/RT, but low 5 yr survival |
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Small Cell Lung Carcinoma radiology
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- Central in >90%
- there is frequent metastases to LNs and distant sites |
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Small Cell Lung Carcinoma path
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- Malignant cytology, no nuclei, and high mitotic activity and necrosis
– there is viable carcinoma mixed w/ cogitative necrosis |
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Mesothelioma clinical
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- malignant neoplasm of mesothelial cell (pleura)
- Associated with asbestos exposure |
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Mesothelioma radiology
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diffuse pleural involvement and may have associated effusion
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Mesothelioma path
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- Malignant w/ deeply invasive growth pattern
– Epithelial, spindle cell, or biphasic – finding asbestos crystal will make Dx easier – Immuno is keratin (+) – EM shows long microvilli |
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Metastatic carcinomas
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- breast adenoCA
- GI adenoCA - Renal adenoCA - Head/neck squamous cell CA |
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metatstatic Sarcomas
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- Osteosarcomas
- Soft tissue sarcomas |
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Metastatic Melanomas
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- Extrapulmonary 1° melanoma much more common than pulmonary 1°
– No known 1° in 5-10% of cases – there is variable architecture & cytology – it may be pigmented – you need to use immunohistochemistry to confirm |
