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66 Cards in this Set
- Front
- Back
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What is this disease?
Morphology - destructive hyaline fibrous lesion with scattered irregular and dilated vessels. - related to testosterone surges |
nasopharyngeal angiofibroma
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What is this disease?
- finger-like growth on nasal septum - "tree like" morphology microscopically - associated with HPV6, 11 |
exophytic papilloma
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What is this disease?
- finger-like growth on lateral nasal cavity - associated with HPV6, 11 |
inverted papilloma
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What is the prognosis of nasopharyngeal angiofibroma?
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3% mortality
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What is the prognosis of nasal papillomas?
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good prognosis
3% develop carcinoma |
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What is this disease?
- often presents as posterior cervical lymph node metastasis - associated EBV DNA, HLA-A2, HLA-BW46 - frequent in southern Chinese |
nasopharyngeal carcinoma
- large undifferentiated carcinoma often associated with non-neoplastic lymphocytes infiltrate |
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What is this disease?
Morphology - large undifferentiated carcinoma often associated with non-neoplastic lymphocytes infiltrate |
nasopharyngeal carcinoma
- often presents as posterior cervical lymph node metastasis - associated EBV DNA, HLA-A2, HLA-BW46 - frequent in southern Chinese, bimodal age distribution (15-25, 60-69) |
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What is the prognosis of nasopharyngeal carcinoma?
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- metastasize to posterior cervical lymph node then to distant sites
- stage I has 85% 5yr survival - younger do better |
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What is this disease?
- growth on vocal cord - thin epithelium(benign squamous mucosa), edemous stroma |
vocal cord nodules
- voice misuse |
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What is this disease?
Morphology - benign squamous hyperplasia with thin fibrous cores Presentation - hemoptysis - hoarseness - dyspnea |
laryngeal papilloma
- HPV6,11 |
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What is this disease?
Morphology(gross) - popcorn like mass in bronchus |
papillomatosis
- often in children (abuse) - HPV6,11 |
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What is the prognosis of papilloma in larynx?
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recurrent, hard to eradicate
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Grossly, what are some DDX for squamous carcinoma in situ?
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- leukoplakia
- hyperkeratosis |
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What are some predisposing factors of squamous cell carcinoma?
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- smoking
- alcohol - asbestos - HPV16,18 |
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Where do you most frequently see squamous cell carcinoma in respiratory tract?
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glottic
- hoarseness - 93% 5yr suvival without metastasis |
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What is the survival rate for supraglottic squamous cell carcinoma?
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- 80%
- 60% metastases |
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What is the survival rate for subglottic squamous cell carcinoma?
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- 40%
- 20% lymph node metastases |
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What is this disease?
Morphology - keritin pearls - abnormal epithelial cell invading basal membrane |
squamous cell carcinoma
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How to determine the grade of a tumor?
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grade is determined by its most undifferentiated area.
- so small cell carcinoma does not have grade since it is differentiated. |
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What is the survival rate squamous cell carcinoma of the lungs?
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15%
- metastasize to regional lymph node then to the liver |
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What is this disease?
Morphology - glandular epithelial elements - destructive fibrosis - see spindle cells |
adenocarcinoma
- more prominent in women and non-smokers - 80% contain mucin |
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What is the precursor lesion for adenocarcinoma?
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- atypical adenomatous hyperplasia
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What is the outcome for adenocarcinoma?
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- 20% 5yr suvival
- metastasize early and more distant |
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What is this disease?
Morphology - growth along alveolar septa without glandular elements - no destructive fibrosis |
bronchioloalveolar carcinoma
- Xray: resemble unresolved pneumonia |
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What is the outcome for bronchioloalveolar carcinoma?
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- 50-75% 5yr survival
- can be cured by surgery - spreads in lung and metastasize late |
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What is this disease?
Morphology - undifferentiated large neoplastic cells, ugly looking - no structure |
large cell carcinoma
- metastasize early and to unsual places |
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What is the outcome for large cell carcinoma?
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10% 5 yr survival
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What is this disease?
Morphology - organoid pattern of delicate fibrovascular stroma - monotonous cells |
carcinoid tumor
- no association with smoking |
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What is this disease?
Morphology - monotonous cells - mitotic figures - necrosis |
atypical carcinoid tumor
- intermediate prognosis |
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What is this disease?
Morphology - large undifferenitated neoplastic cells - peripheral palisading layer |
large cell neuroendocrine carcinoma
- poor prognosis |
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What is this disease?
Morphology - cells about 2-3x lymphocytes - scant cytoplasm - necrosis - mitoses |
small cell carcinoma
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What is the outcome of small cell carcinoma?
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poor
- not a surgical - 5% long term survival |
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What neuroendocrine markers are present in small cell carcinoma?
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- TTF-1
- NCAM (CD56) - synaptophysin |
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What kinds of cancers can metastasize to the lung?
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all except skin and CNS cancers
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Lymphatic vs hematogenous spread of metastatic tumors.
- interstitial pneumonitis pattern - multiple lesions on the periphery - unexplained pulmonary edema or pleural effusion |
lymphatic
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Lymphatic vs hematogenous spread of metastatic tumors.
- scatterd in parencyma |
hematogenous
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What disease is this?
- coin like lesion on CXR - connective tissue on periphery, most often see cartilage |
hamartoma
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What is this disease?
- solitary glandular epithelial nodule that does not grow |
adenoma
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What is this disease?
Morphology - scattered bland fibroblasts in hyalin fibrous stroma - CD34+ - pedicle attached to pleura |
benign mesothelioma
- no relationship to asbestos exposure |
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What is this disease?
Morphology - biphasic (epithelial cells and spindles cells) - claretinin + - WT-1 + |
malignant mesothelioma
- no relaitonship to smoking - heavily exposure to asbestos |
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What is the outcome for malignant mesothelioma?
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50% one yr survival
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Which cancer? parencymal involvement
- peripheral |
- adenocarcinoma
- large cell carcinoma |
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Which cancer? parencymal involvement
- central |
squamous cell carcinoma
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Which cancer? parencymal involvement
- hylar |
small cell carcinoma
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Which cancer? parencymal involvement
- multicentric |
bronchioloalvelar
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What is the most common peripheral primary lung cancer?
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adenocarcinoma
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Which form of bronchoalveolar cancer confers good prognosis, which is not?
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- diffuse form: poor prognosis
- solitary form: good prognosis |
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Clubbing is more common in which cancer, adenocarcinoma or squamous cell carcinoma?
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adenocarcinoma
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Small cell carcinoma is often associated with which paraneoplastic syndrome?
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- ATCH production
- Lambert-Eaton (myasthenic) syndrome |
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What is this disease?
- shoulder pain - pain with ulnar distribution |
Pancost tumor: superior sulcus
- 35% cure with surgery and radiation |
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What is this disease?
- ptosis - myosis - anhydrosis: loss of sweating |
horner's syndrome
- associated with pancoast tumor |
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Etiology of superior vena cava syndrome.
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Cancer
- lung - lymphoma |
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What is this disease?
- facial edema - plethora - distended veins in neck and chest - right central chest mass by xray |
superior vena cava syndrome
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What is this disease?
- small cell carcinoma - hyponatremia |
SIADH (paraneoplastic syndrome)
- ADH excess -> water retention -> hyponatremia |
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What is this disease?
- small cell carcinoma - hypokalemia - muscle weakness |
increased ACTH (paraneoplastic syndrome)
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What is this disease?
- squamous cell carcinoma or carcinoid - hypercalcemia |
paraneoplastic syndrome
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What is this disease?
- small cell carcinoma, adenocarcinoma - hypocalcemia |
- calcitonin (paraneoplastic syndrome)
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What is this disease?
- large cell carcinoma, adenocarcinoma - increased FSH |
- gynecomastia (paraneoplastic syndrome)
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What is this disease?
- small cell carcinoma - proximal muscle weakness - decreased deep tendon reflex - anti-Ca2+ channel antibody found in serum |
Lamber Eaton syndrome (paraneoplastic syndrome)
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What is this disease?
- squamous cell carcinoma - cerebellar ataxia |
paraneoplastic syndrome
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Name some paraneoplastic syndrome assoicated with small cell carcinoma.
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- SIADH
- increased ACTH - calcitonin - lamert eaton |
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Name some paraneoplastic syndrome associated with squamous cell carcinoma.
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- hypercalcemia
- cerebellar ataxia (similar to alcohol) |
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Name some paraneoplastic syndrome associated with carcinoid syndrome.
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- hypercalcemia
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Name some paraneoplastic syndrome associated with adenocarcinoma.
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- calcitonin (hypocalcemia)
- Gynecomastia (increased FSH) - hypertrophic pulm osteoarthropathy |
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Name some paraneoplastic syndrome associated with large cell carcinoma.
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- gynecomastia (increased FSH)
- hypertrophic pulm osteoarthropathy - SVC syndrome |
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Risk factors for head and neck cancer.
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- smoke
- alcohol: squamous cell carcinoma - viral infection |
