Pulm Path 4

Front 1

Back 1

Small Cell Carcinoma

Hint 1

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 2

Lung Cancer

Back 2

#1 cause of cancer death in US
presentation - asymptomatic, cough, hemoptysis, obstruction, wheezes
mediastinal spread --> hoarseness, SVC syndrome, diaphragm paralyze
smoking - # of cigs, years smoked, depth of inhalation, age of initiation
asbestos - synergism w/ smoking (boards love synergism)
Chloromethyl ether, radiation, nickel, arsenic, aromatic hydrocarbons

Front 3

Back 3

Small Cell Carcinoma

Hint 3

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 4

Back 4

Small Cell Carcinoma

Hint 4

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 5

Back 5

Small Cell Carcinoma
Chromogranine (neuroendocrine)

Hint 5

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 6

Back 6

Small Cell Carcinoma

Hint 6

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 7

Back 7

Squamous Cell Carcinoma

Hint 7

central, late mets (54%), smoking, male predisposition
arises from proximal bronchi epithelium
keratin pearls
paraneoplastic - HYPERCALCEMIA from PTH like peptides

Front 8

Back 8

Squamous Cell Carcinoma

Hint 8

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 9

Back 9

Squamous Metaplasia

Front 10

Back 10

Squamous Dysplasia

Front 11

Back 11

Squamous Cell Carcinoma

Hint 11

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 12

Back 12

Adenocarcinoma

Hint 12

peripheral, early mets (82%), smoking
Atypical Adenomatous Hyperplasia precursor lesion
slow primary growth but lots of mets (liver, adrenal, bone, brain)
mucin secreting
paraneoplastic: hematologic, GH, corticotropin, calcitonin, FSH

Front 13

Back 13

Adenocarcinoma

Hint 13

peripheral, early mets (82%), smoking
Atypical Adenomatous Hyperplasia precursor lesion
slow primary growth but lots of mets (liver, adrenal, bone, brain)
mucin secreting
paraneoplastic: hematologic, GH, corticotropin, calcitonin, FSH

Front 14

Back 14

Bronchoalveolar Adenocarcinoma

Hint 14

peripheral, late mets, smoking
respects alveolar architecture, often bilateral
CXR - pneumonia that won't go away
good prognosis

Front 15

Back 15

Bronchoalveolar Adenocarcinoma

Hint 15

peripheral, late mets, smoking
respects alveolar architecture, often bilateral
CXR - pneumonia that won't go away
good prognosis

Front 16

Back 16

Large Cell Carcinoma

Hint 16

peripheral, early mets (86%)(50% CNS), smoking, male predominance
rapid growth, poorly differentiated
giant cell and clear cell subtypes

Front 17

Back 17

Large Cell Carcinoma

Hint 17

peripheral, early mets (86%)(50% CNS), smoking, male predominance
rapid growth, poorly differentiated
giant cell and clear cell subtypes

Front 18

Back 18

endobronchial lesion

Front 19

Back 19

Small Cell Carcinoma

Hint 19

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 20

Back 20

Small Cell Carcinoma

Hint 20

central, early bone/brain mets, smoking, male predominance
histo: small cells w/ very little cytoplasm, salt and pepper, no architecture, mush together
Paraneoplastic Syndromes: Cushing, SIADH, Neuromuscular, Carcinoid (serotonin)
Typically not resectable, bad prognosis

Front 21

Back 21

Non Small Cell Carcinoma

Front 22

Back 22

Non Small Cell Carcinoma

Front 23

Back 23

Horner's Syndrome

Hint 23

cervical chain involvement causes
-ptosis
-miosis
-anhidrosis

Front 24

Back 24

Carcinoid

Hint 24

"we biopsied the tumor and it began to bleed like stink"
low grade malignant tumors, neurosecretory derivation, no smoking link, cured by resection

Front 25

Back 25

Carcinoid

Hint 25

"we biopsied the tumor and it began to bleed like stink"
low grade malignant tumors, neurosecretory derivation, no smoking link, cured by resection

Front 26

Back 26

Metastatic Adenocarcinoma

Front 27

Back 27

Metastatic Adenocarcinoma

Front 28

Back 28

Lymphoma

Front 29

Back 29

Lymphoma

Front 30

Back 30

Hamartoma
(well organized tissue in the wrong place)

Front 31

Back 31

Hamartoma
(well organized tissue in the wrong place)

Front 32

Back 32

Metastatic Tumor

Front 33

Back 33

Mesothelioma

Front 34

Back 34

Mesothelioma

Front 35

Pancoast's Tumor

Back 35

superior sulcus tumor, 2-5% of pts w/ bronchogenic cancer, usually squamous cell
may invade brachial plexus

Front 36

SVC syndrome

Back 36

SVC obstruction by bronchogenic carcinoma
symptoms - facial fullness, face/arm edema, dilated collaterals, JVD, responds well to radiation tx

Front 37

Eaton-Lambert Syndrome

Back 37

neuromuscular paraneoplastic syndrome of small cell carcinoma
similar to MG, symptoms more prominent in lower ext
responds to tx of tumor

Front 38

Hypertrophic Osteoarthopathy

Back 38

new bone formation outside the diaphysis of long bones
cured by removal of lung mass of cutting vagus (not advised i would imagine)

Front 39

TX

Back 39

SCLC - chemo, rad, surg?
NSCLC - surg, rad, chemo