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26 Cards in this Set

  • Front
  • Back
Hamartoma definition
- Discrete tumor of benign normal tissues in excess/disarray
- is removed for dx, does not need to be treated
Hamartoma clinical
- Adolescence -> adulthood
- None in newborns b/c it is not congenital
– it is important because it mimics a new carcinoma
– they frequently calcify
Hamartoma radiology
- will show Solitary nodule +/- popcorn calcification
– Peripheral > central
Hamartoma path
- 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
what causes cancer in cigarett smoke
anthracenes, pyrenes
prognostics in NSCLC
- Stage, performance status, weight loss
- maybe gender, ploidy, k-ras mutation, p53 protein accumulation
prognostics in SCLC
- Stage, performance status
- maybe gender, age, # of mets sites are probably
Squamous carcinoma clinical
- 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
Squamous carcinoma radiology
- central >> peripheral
- a too-wide mediastinum
Squamous carcinoma path
- 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
Adenocarcinoma clincial
- 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)
Adenocarcinoma radiology
- peripheral > central
– associated blunting of costoprhenal angle due to effusion
Adenocarcinoma path
- +/- glands and +/- mucin
– any gland formation is enough to call it adenocarcinoma
– red staining mucin production is enough to make dx too
Bronchiolo-alveolar carcinoma clinical
- 20-25% of adeno
– there is a rising incidence
– not associated w/ smoking
- Cough and bronchorrhea (frothy sputum production)
Bronchiolo-alveolar carcinoma radiology
- 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!!
Bronchiolo-alveolar carcinoma path
- 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!
Large cell undifferentiated carcinoma
- (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
Small Cell Lung Carcinoma clincal
- 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
Small Cell Lung Carcinoma radiology
- Central in >90%
- there is frequent metastases to LNs and distant sites
Small Cell Lung Carcinoma path
- Malignant cytology, no nuclei, and high mitotic activity and necrosis
– there is viable carcinoma mixed w/ cogitative necrosis
Mesothelioma clinical
- malignant neoplasm of mesothelial cell (pleura)
- Associated with asbestos exposure
Mesothelioma radiology
diffuse pleural involvement and may have associated effusion
Mesothelioma path
- 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
Metastatic carcinomas
- breast adenoCA
- GI adenoCA
- Renal adenoCA
- Head/neck squamous cell CA
metatstatic Sarcomas
- Osteosarcomas
- Soft tissue sarcomas
Metastatic Melanomas
- 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