Pathology Ch. 15: Lung Carcinoma

Front 1

Grow as finger-like or spherical polypoid masses that commonly project into the lumen of the bronchus and are usually covered by intact mucosa.

Back 1

Central carcinoids:
Confined to the main stem bronchi

Front 2

Small, inconsequential, hyperplastic nests of neuroendocrine cells seen in areas of scarring or chronic inflammations

Back 2

benign tumorlets

Front 3

Do atypical or typical carcinoids spread to the lymph nodes. What other characteristics separate these?

Back 3

atypical
Atypical lesions undergo necrosis and many mitoses. They also have increased pleomorphism, prominent nucleoli, and grow in a disorganized fashion.

Front 4

Tumor is composed of organoid, trabecular, palisading, ribbon, or rosette-like arrangements of cells separated by a delicate fibrovascular stroma. The individual cells are regular, with uniformly round nuclei, and moderate amount of eosinophilic cytoplasm.

Back 4

carcinoid tumor

Front 5

Produce little intraluminal mass, but instead penetrate the bronchial wall to fan out in the peribronchial tissue, producing a "collar-button lesion"

Back 5

Carcinoid tumor

Front 6

Most common site of metastatic neoplasms. Growth of contiguous tumors usually from?

Back 6

lung
Espohageal carcinoma and mediastinal lymphomas

Front 7

Multiple discrete nodules, termed cannonball lesions, that are spread throughout all lobes, more so at the periphery.

Back 7

metastatic lung CA

Front 8

Currently the most common cause of cancer worldwide, and the most common cause of cancer mortality

Back 8

Lung carcinoma

Front 9

Linear progression of squamous cell carcinoma in tobacco smokers

Back 9

Squamous metaplasia...squamous dysplasia...carcinoma in situ...invasive carcinoma

Front 10

mutations of p53 are associated with what carcinogen?

Back 10

G:C mutations of p53, due to benzo(a)pyrene

Front 11

Industrial hazards that cause lung cancer

Back 11

radiation
uranium exposure
asbestos
radon

Front 12

Most common form of lung cancer

Back 12

adenocarcinoma

Front 13

Lung tumors that produce ACTH and ADH are predominantly/

Back 13

small cell carcinomas

Front 14

Lung cancers that produce hypercalcemia

Back 14

squamous cell tumors

Front 15

Muscle wkns caused by auto-antibodies directed to the neuronal calcium channel. associated with what cancer?

Back 15

Lambert-Eaton Myasthenic syndrome:
Small cell carcinoma

Front 16

Produce severe pain of the ulnar nerve, and Horner's syndrome of (enopthalmos, ptosis, miosis, and anhidrosis) on the same side as the lesion. Where are these lesions located?

Back 16

Pancoast tumors:
Apical lung cancers in the superior pulmonary sulcus that tend to invade the neural structures around the trachea.

Front 17

Clinical Features due to Cancer:
Pneumonia, abscess, and lobar collapse
Lipoid pneumonia
Pleural effusion
Hoarseness
Dysphagia
Diaphragm paralysis
Rib destruction
SVC syndrome
Horner syndrome
Pericarditis, tamponade
Pathologic Basis???

Back 17

Tumor obstruction
Tumor obstruction w/ accumulation of lipid in foamy macrophages
Tumor spread into pleura
Recurrent laryngeal invasion
Esophageal invasion
Invasion of phrenic nerve
chest wall invasion
SVC compression
sympathetic ganglia invasion
pericardial invlovement

Front 18

Major presenting symptoms of lung cancer

Back 18

Cough is number one, then weight loss, chest pn, and dyspnea

Front 19

Brocnhioalveolar tumors by definition are? How do they kill/

Back 19

Non-invasive tumors that do not metastisize.
Suffocation

Front 20

Which lung cancers remained localized for slightly longer, and thus have a slightly better prognosis?

Back 20

adenocarcinoma and squamous cell

Front 21

Lung cancers most often arise where?

Back 21

Around the hilus of the lung from the larger bronchi.

Front 22

Primary carcinomas that arise from the periphery of the lung from the alveolar septal cells or terminal bronchioles.

Back 22

adenocarcinomas including the bronchioalveolar type.

Front 23

Most common organs of primary lung metastases

Back 23

Adrenals- 50%
liver-30-50%
brain and bone-20%

Front 24

Preceded for years by squamous metaplasia or dysplasia in the bronchial epithelium, which then transforms into carcinoma in situ

Back 24

squamous cell carcinoma

Front 25

Often grows until the tumor begins to obstruct the lumen of a major bronchus, often producing distal atelectasis and infection

Back 25

squamous cell carcinoma

Front 26

A red or yellow-white mottling in tumors is suggestive of?

Back 26

hemhorrage and necrosis

Front 27

Earliest changes in smoking damaged respiratory epithelium

Back 27

goblet cell hyperplasia, basal cell hyperplasia, and squamous cell metaplasia....which leads to dysplasia

Front 28

Loss of nuclear polarity, nuclear hyperchromasia, pleomorphism, and mitotic figures are characteristic of what?

Back 28

dysplasia

Front 29

May be the first manifestation of an underlying occult pulmonary lesion

Back 29

Metastases

Front 30

Primary lung cancer metastasizes via?

Back 30

lymph and hematogenous pathways.

Front 31

Symptomatic stage of squamous cell carcinoma

Back 31

Tumer obstructs the lumen of a major bronchus, producing atelectasis and infection.

Front 32

Malignant epithelial tumor with glandular differentiation or mucin pruduction

Back 32

adenocarcinoma

Front 33

Most common type of lung cancer in women and non-smokers

Back 33

adenocarcinoma

Front 34

Location and size of lesions of adenocarcinoma. The majority are positive for? produce?

Back 34

more peripheral and smaller
Thyroid transcription factor-1
mucin

Front 35

KRAS mutations occur primarily in? Outcome? What gene mutation may have a better outcome?

Back 35

Adenocarcinoma
worse outcome with KRAS
EGFR

Front 36

Grow more slowly than squamous cell, but metastasis spreads widely and early

Back 36

adenocarcinoma

Front 37

Occurs in the pulmonary parenchyma in the terminal bronchioloalveolar regions. Most often Location? Resembles?

Back 37

Bronchioalveolar carcinoma
Occurs peripherally
Most often presents as multiple, diffuse nodules that sometimes coalesce to produce a pneumonia-like consolidation...resembles pneumonia w/ grey-white consolidation.

Front 38

Characterized histologically by no invasion of stromal, vascular, or pleural invasion, w/ lepidic growth along preexisting structures without destruction of alveolar architecture.

Back 38

bronchioloalveolar carcinoma:
Mucinous-
Spread aerogenously, with multiple satellite tumors
Non-mucinous-
Peripheral lung nodule, usually without spread.

Front 39

Types of bronchioloalveolar carcinoma:

Back 39

Mucinous:
Spreads aerogenously, forming satellite tumors. These present as multiple nodules with possible consolidation of the lung, resembling lobar pneumonia. Contains Tall, columnar cells, w/ cytoplasmic and intra-alveolar mucin.
Non-mucinous:
Single nodular tumor. Columnar, peg-shaped or cuboidal cells.

Front 40

Arises from atypical adenomatous hyperplasia

Back 40

Adenocarcinoma of the lung...progresses to bronchiolaveolar carcinoma...then invasive adenocarcinoma.

Front 41

Recognized as well-demarcated focus of epithelial proliferation composed of cuboidal to low columnar epithelium.

Back 41

Atypical andenomatous hyperplasia...precursor for adenocarcinomas

Front 42

Histologically characterized by the presence of keratinization and/or intracellular bridges, with prominent hyperchromatic nucleus

Back 42

Squamous cell carcinoma:
Cytoplasm is markedly eosinophilic.

Front 43

p53 overexpression is seen with what lung tumor?

Back 43

squamous cell

Front 44

Location of most squamous cell tumors?

Back 44

Arise centrally from the segmental or subsegmental bronchi.

Front 45

Contains small epithelial cells, with scant cytoplasm, ill-defined cell borders, granular nuclear chromatin, and absent or inconspicuous nucleoli. Is necrosis common?

Back 45

Small cell:
Necrosis is extensive, Basophilic staining of vascular walls due to encrustation of DNA from necrotic tumor cells.

Front 46

Basophilic staining of vascular walls due to encrustation of DNA from necrotic tumor cells.

Back 46

Azzopardi effect...small cell carcinoma

Front 47

Cell growth and size of small cell carcinoma?

Back 47

Growth occurs in clusters, with small round cells smaller than 3 resting lymphocytes.

Front 48

Derivation of small cell carcinoma. Often secrete?

Back 48

Neuroendocrine progenitor cells of the lining of the bronchial epithelium.
Contain neurosecretory granules, and often secrete hormones.

Front 49

Most aggresive of lung tumors, metastisize widely, and are virtually incurable by surgical resection.

Back 49

small cell

Front 50

Undifferentiated malignant epithelial tumor that has large nuclei, prominent nucleoli, and moderate amounts of cytoplasm

Back 50

large cell

Front 51

Basophilic staining of vascular walls due to encrustation of DNA from necrotic tumor cells., with large nuclei and prominent cytoplasm within cells.

Back 51

Neuroendocrine large cell carcinoma

Front 52

Basophilic staining of vascular walls due to encrustation of DNA from necrotic tumor cells.

Back 52

neuroendocrine differentiation

Front 53

Partial obstruction via tumor may cause? Total obstruction?

Back 53

Emphysema
atelectasis

Front 54

Common cause of severe suppurative or ulcerative bronchitis or bronchiectasis

Back 54

impaired drainage of airways

Front 55

May represent squamous cell and adenocarcinoma that is completely undifferentiated

Back 55

large cell

Front 56

May cause venous congestion and edema of the head and arm, and, ultimately, circulatory compromise

Back 56

SVC syndrome:
Compression or invasion of the SVC.

Front 57

The presence of chromogranin, synaptophysin, and CD57 suggests?

Back 57

neuroendocrine