Upper And Lower Respiratory Tract Neoplasia

Front 1

What type of cancer is Laryngeal cancer?

Back 1

Squamous Cell Carcinoma (95%)

Front 2

2 main causes of Laryngeal cancer?

Back 2

1. Smoking
2. Booze

Front 3

Subsites of Laryngeal Carcinoma?

Back 3

Supraglottic (30%)
Glottic 65%(1 cm of room around true vocal cords)
Subglottic 5%

Front 4

5 year survival %'s based on subsite?

Back 4

Supra: 65%
Glottic: 85%
Subglottic: 40%

Front 5

Why does glottic have the best survival rate?

Back 5

Detected earlier cause it screws up your voice

Front 6

5 year survival for lung caner in general?

Back 6

15%

Front 7

Why so low?

Back 7

Late Dx

Front 8

how much does smoking increase your risk of lung cancer?

Back 8

10-20 fold

Front 9

Sx's of metastatic lung cancer?

Back 9

bone pain
weakness/numbness of extremities
dizzy/seizure
jaundice
lymphadenopathy

Front 10

Which nodes get hit first by lung metastases?

Back 10

Supraclavicular and neck region

Front 11

Malignant cells w/ intercellular bridges would indicate what type of cancer?

Back 11

Squamous cell carcinoma

Front 12

A mutation of what gene likely occured earliest in the development of lung Squamous cell carcinoma?

Back 12

p53

Front 13

4 main types of pulmonary neoplasms?

Back 13

Small Cell carcinoma
Squamous Cell carcinoma
Adenocarcinoma
Large Cell Carcinoma

cover 90-95% of all pulmonary cancer

Front 14

Relative distribution of 4 main types?

Back 14

Small Cell: 15-20%
Squamous Cell: 20-30%
Adeno: 40%
Large Cell: 10-15%

Front 15

Usual location of Small Cell?

Back 15

CENTRAL

big, around main stem bronchus

Front 16

Rx for Small Cell? why?

Back 16

Chemo instead of surgery b/c it's so aggressive and metastatic

Front 17

Usual location of Squamous Cell?

Back 17

Central!!!

lumen of bronchi

Front 18

Histo kickers for squamous cell?

Back 18

keratinization
intercellular bridges

Front 19

Usual location of adeno?

Back 19

Peripheral

Front 20

Dx criteria for adeno?

Back 20

Glandular Architecture
and/or
Mucin Production

Front 21

Patterns of Adenocarcinoma?

Back 21

Papillary
Acinar
BAC (Bronchoaveolar Carcinoma)
Poorly Diff

Front 22

3 criteria for BAC?

Back 22

Tumor cells grow on alveoli
Preserved lung architecture
Absence of Stromal Invasion

Front 23

Gross of BAC?

Back 23

Nodules/Foci of consolidation

Front 24

Micro of BAC?

Back 24

Mucinous or nonmucinous

Front 25

Large Cell Dx?

Back 25

Dx of exclusion...i.e. not the other ones

Front 26

Why are they divided into small cell and non-small cell carcinomas?

Back 26

Rx

Front 27

Stage 1 5 year survival vs stage 4?

Back 27

60%-->5%

Front 28

Rx for stage 1 and 2?

Back 28

Surgery

+/- radiation/chemo

Front 29

Rx for stage 3?

Back 29

Very variable

Front 30

Rx for stage 4?

Back 30

palliative chemo

Front 31

Small Cell stages?

Back 31

Limited (bad)

Extensive (badder)

Front 32

Limited Small Cell = ?

Back 32

One hemithorax

+/- nodes and effusion

Front 33

5 year survival of Limited?

Back 33

10-20%

Front 34

Definition of Extensive?

Back 34

anything more than limited

Front 35

5 year survival of extensive?

Back 35

2%

Front 36

Complications of lung carcinoma?

Back 36

Airway obstruction
Blood vessel erosion (hemoptysis)
Pleural Effusion
Compress/Invade neighbors
Metastasis
Paraneoplastic Syndromes

Front 37

Paraneoplastic Syndromes?

Back 37

ACTH-Cushings Syndrome
Inappropriate ADH secretion
Hypercalcemia

Front 38

Which cancers typically cause the paraneoplastic syndromes?

Back 38

ACTH-Cushings: small cell
ADH: small cell
Hypercalcemia: squamous cell

Front 39

Primary vs Metastatic Lung neoplasm Locations

Back 39

Metastatic: multiple, bilateral, peripheral

Primary: unilateral, solitary, central or peripheral

Front 40

What is the most common site of metastasis? why?

Back 40

THE LUNG

high blood flow
high lymph flow
favorable growth environment?

Front 41

Most common sources of metastatic lung cancer?

Back 41

Lung
Breast
Colon
Stomach
Pancreas
Kidney
Melanoma

Front 42

Which tumors don't spread to lungs?

Back 42

CNS (brain)

Front 43

General ways to determine difference between primary and metastatic?

Back 43

Basic histo
Immunohistochemical studies

Front 44

Which pulmonary neoplasm is TTF-1 Positive?

Back 44

Primary Lung Adenocarcinoma

Front 45

Metastatic Gastric Adenocarcinoma's marker profile?

Back 45

7-
20+
TTF-1 -

Front 46

Uncommon Lung Neoplasms

Back 46

Carcinoid Tumor
Hamartoma
Malignant Mesothelioma

Front 47

Differentiation seen in Carcinoid Tumors?

Back 47

Neuroendocrine
so secretory granules

Front 48

Patterns w/ carcinoid tumors?

Back 48

Nested
Trabecular
Papillary
Pseudoglandular

Front 49

most common benign pulmonary tumor?

Back 49

Hamartoma

Front 50

Origin of lung hamartoma?

Back 50

peribronchial mesenchyme

Front 51

Location of hamartoma?

Back 51

Parenchymal 80-90%
Endobronchial 10-20%

Front 52

Main Pleural Neoplasm?

Back 52

Malignant Mesothelioma

Front 53

Origin of Malignant Mesothelioma?

Back 53

pleural cells

Front 54

besides asbestos, other risk factor for Malignant Mesothelioma

Back 54

SV40 infection (simeon virus)

Front 55

Mortality rate for Malignant Mesothelioma?

Back 55

100%

Front 56

Malignant Mesothelioma growth patterns?

Back 56

Epitheliod
Sarcomatoid
Biphasic (both)

Front 57

Difference between adenocarcinoma and Malignant Mesothelioma based on calretinin stain?

Back 57

+ w/ Malignant Mesothelioma

- w/ adenocarcinoma