Respiratory Tl 2 Cancer Markus

Front 1

Is there a link between mesothelioma and asbestos? Smoking?

Back 1

They are independent of each other ie asbestos exposure and smoking does not increase risk of mesothelioma, and smoking alone, has no increased risk of mesothelioma.

Front 2

What is the frequency of lung cancer subtypes?
NSCC
SCC
Other (5-12%)

Back 2

NSCC 70%
adeno (30%)
sq cell (25%)
Large cell (15%)
SCC 25%

Front 3

This type of lung cancer occurs in smokers and non smokers and 75% of it occurs on the periphery of the lung.

Back 3

Adenocarcinoma

Front 4

How does most adenocarcinoma present? Location? Gender? What is it often mistaken for?

Back 4

As a solitary pulmonary nodule, it is the most common peripheral primary lung cancer. Women. Unresolving pneumonia.

Front 5

T or F
Aggressive mets of adenocarcinomas are well differentiated.
Symptomatic early on?
Good chemo and radiation therapy response.

Back 5

True
False, symptoms=advanced stage
False, chemo and radiation therapy response is poor.

Front 6

What is bronchoalveolar carcinoma a subset of?

Back 6

Adenocarcinoma

Front 7

Solitary nodule, but with a great pronosis is ______________ carcinoma. What is the 1 year survival rate after resection?

Back 7

bronchoalveolar

>80% after resection

Front 8

Diffuse form of bronchoalveolar carcinoma, mimicking pneumonia, has a median survival rate of ________

Back 8

<6 months

Front 9

What is the most likely kind of carcinoma to find in a non smoker?

Back 9

bronchoalveolar

A poor responder to chemo or radiation.

Front 10

Squamous cell carcinoma is most commonly found in (men or women) with a history of smoking.

Back 10

men

Front 11

Name that carcinoma!
Characterized by the presence of keratinization and/or intercellular bridges. Keratinization may take the form of squamous pearls or individual cells with markedly eosinophillic dense cytoplasm.

Back 11

Squamous cell carcinoma

Front 12

Second most common type of lung cancer is

Back 12

Squamous cell carcinoma

Front 13

What percent of Squamous cell carcinoma is found in the proximal airways?
What percent will have cavitation?

Back 13

60-80%

25%

Front 14

How do you diagnose and treat Squamous cell carcinoma?

Back 14

Dx: sputum cytology or bronchoscopy w/ biopsy
Tx: Surgery, chemo and radiation.

Front 15

T or F
Squamous cell carcinoma has a tendency to spread locally/regionally and the prognosis is slightly better than adenocarcinoma.

Back 15

True

Front 16

Squamous cell carcinoma lymph node mets lowers survival by __%

Back 16

50%
Cervical lymph nodes are typically first

Front 17

Precursor lesions of Squamous cell carcinoma are

Back 17

keratosis and dysplasia

Front 18

Predisposing factors of Squamous cell carcinoma are (4)

Back 18

Smoking
ETOH
Asbestos
HPV 16 and 18

Front 19

"Keratin pearl and invasive tongues of epithelial cells"

Back 19

Squamous cell carcinoma

Front 20

Describe Large cell carcinoma

Back 20

Undifferentiated large neoplastic cells, ugly, can appear oval, clear or bizarre giant cells.

Front 21

Large cell carcinoma, peripheral or interstitial? Where does it typically metastasize to?
What is the 5 year survival rate?

Back 21

peripheral
Typically metastasizes to unusual places.
10%

Front 22

Name that carcinoma:
Cuboidal to columnar cells with or without mucin appears to be growing along alveolar septa with glandular elements, and without destructive fibrosis.

Back 22

Bronchioloalveolar carcinoma

Front 23

Does adenocarcinoma have glandular tissue and destructive fibrosis?

Back 23

Yes

Bronchioloalveolar doesn't have destructive fibrosis.

Front 24

Mets are regional, distant lymph nodes, brain, liver, adrenal and bone, with a 5yr survival rate of 20%

Back 24

adenocarcinoma

Front 25

Name that carcinoma!!!!!!
Long term survival is <5%
Median survival is <3 months

Back 25

Small Cell Carcinoma...the worst lung cancer.

Front 26

What are the three positive neuroendocrine markers for small cell carcinoma?

Back 26

CD56 (NCAM)
Synaptophysin
TTF-1

Front 27

Name that carcinoma!!!!!!
Has usually metastasized (to just about anywhere) by the time it is diagnosed. Surgery does not help.

Back 27

Small Cell Carcinoma aka small undiff carcinoma, oat cell carcinoma, high grade neuroendocrine carcinoma.

70% present w/ overt mets.
Very chemo responsive, but returns.

Front 28

Third most common type of lung cancer.

Back 28

Small Cell Carcinoma

Front 29

Name that carcinoma!!!!!!
Unilateral rapid growth, 80% hilar location, smokers and titanium miners, rare in non smokers,

Back 29

Small Cell Carcinoma

Front 30

What percent of people with mesotheliomas were exposed to asbestos? Would smoking have increased the likelihood they would have had mesotheliomas?

Back 30

80%
No

Front 31

Post exposure to asbestos, how long would it take to develop a mesothelioma?
Sx:

Back 31

40 yrs

Sx: Dyspnea, chest wall pain, effusion (bloody), thrombocytosis, clubbing, pleural thickening, calcification, effusion.

Front 32

How do you treat mesotheliomas?
Medial survival is

Back 32

Surgery, chemo, radiation.
Medial survival is <1yr

Front 33

What is the following describing?
young adults
Increased ACTH: cushing, HTN
Increased PTH: Hypercalcemia
Mostly well differentiated and indolent

Back 33

Carcinoid Tumor

Front 34

Carcinoid syndrome only occurs in <1% of folks w/ carcinoid tumor, but it consists of 3 clinical findings.

Back 34

Flushing
Diarrhea
Cyanosis
* often have cough and hemoptysis as well

Front 35

Where do Carcinoid Tumors most commonly occur? What do they produce?

Back 35

GI, then lungs
Serotonin bc they are neuroendocrine in origin.

Front 36

Serum A2 (blood test) aids in the diagnosis of

Back 36

Carcinoid Tumor, a histological tissue diagnosis is required.

Front 37

What percent of patients with lung cancer present with symptoms?
What is the number one symptom and what types is it more likely in?

Back 37

95%
Cough, small cc, and sq cc

Front 38

Describe a pancoast tumor:

Back 38

Shoulder pain
Pain with ulnar distribution (T1 C8)
Rib involvement
35% cure with surgery and radiation
Possible Horner's Syndrome

Front 39

Describe Horners syndrome

Back 39

Ptosis
Myosis (constriction on tumor side)
Anhydrosis (loss of sweating on affected side)

Front 40

-Etiology: 90% of the time cancer
• -Lung: 65%
• -Lymphoma 25%
• -Others
• Signs and symptoms:
• Facial edema
• Plethora (An excess of blood in the circulatory system or in one organ or area)
• Distended veins in neck and chest
• Right central chest mass by x-ray
• Treatment: may require emergency radiation treatment- need histological diagnosis

Back 40

Superior Vena Cava syndrome

Front 41

Do paraneoplastic syndromes preclude potentially currative treatment?

Back 41

No

Front 42

Adenocarcinoma is more common in which gender?
What are the 4 common mutations?

Back 42

Females
K-RAS
p53
RB
p16

Front 43

Squamous cell carcinoma is more common in which gender?
What are the 4 common mutations?

Back 43

Males
p53
HER2/Neu
p16 ink4
RB

Front 44

Small cell carcinoma is associated with what two mutations?

Back 44

Leu7
BCL2

Front 45

Peripheral lung CA

Back 45

Adeno
Large Cell

Front 46

Cavitation in 25%

Back 46

Large Cell
Sq Cell

Front 47

Hypercalcemia

Back 47

Sq cell
Carcinoid

Front 48

Hypocalemia

Back 48

Sq Cell
Adeno

Front 49

Increased FSH

Back 49

Large Cell
Adeno

Front 50

Ataxia

Back 50

Sq cell