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57 Cards in this Set
- Front
- Back
What type of cancer is Laryngeal cancer?
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Squamous Cell Carcinoma (95%)
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2 main causes of Laryngeal cancer?
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1. Smoking
2. Booze |
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Subsites of Laryngeal Carcinoma?
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Supraglottic (30%)
Glottic 65%(1 cm of room around true vocal cords) Subglottic 5% |
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5 year survival %'s based on subsite?
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Supra: 65%
Glottic: 85% Subglottic: 40% |
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Why does glottic have the best survival rate?
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Detected earlier cause it screws up your voice
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5 year survival for lung caner in general?
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15%
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Why so low?
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Late Dx
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how much does smoking increase your risk of lung cancer?
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10-20 fold
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Sx's of metastatic lung cancer?
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bone pain
weakness/numbness of extremities dizzy/seizure jaundice lymphadenopathy |
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Which nodes get hit first by lung metastases?
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Supraclavicular and neck region
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Malignant cells w/ intercellular bridges would indicate what type of cancer?
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Squamous cell carcinoma
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A mutation of what gene likely occured earliest in the development of lung Squamous cell carcinoma?
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p53
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4 main types of pulmonary neoplasms?
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Small Cell carcinoma
Squamous Cell carcinoma Adenocarcinoma Large Cell Carcinoma cover 90-95% of all pulmonary cancer |
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Relative distribution of 4 main types?
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Small Cell: 15-20%
Squamous Cell: 20-30% Adeno: 40% Large Cell: 10-15% |
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Usual location of Small Cell?
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CENTRAL
big, around main stem bronchus |
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Rx for Small Cell? why?
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Chemo instead of surgery b/c it's so aggressive and metastatic
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Usual location of Squamous Cell?
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Central!!!
lumen of bronchi |
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Histo kickers for squamous cell?
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keratinization
intercellular bridges |
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Usual location of adeno?
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Peripheral
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Dx criteria for adeno?
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Glandular Architecture
and/or Mucin Production |
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Patterns of Adenocarcinoma?
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Papillary
Acinar BAC (Bronchoaveolar Carcinoma) Poorly Diff |
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3 criteria for BAC?
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Tumor cells grow on alveoli
Preserved lung architecture Absence of Stromal Invasion |
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Gross of BAC?
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Nodules/Foci of consolidation
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Micro of BAC?
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Mucinous or nonmucinous
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Large Cell Dx?
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Dx of exclusion...i.e. not the other ones
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Why are they divided into small cell and non-small cell carcinomas?
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Rx
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Stage 1 5 year survival vs stage 4?
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60%-->5%
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Rx for stage 1 and 2?
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Surgery
+/- radiation/chemo |
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Rx for stage 3?
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Very variable
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Rx for stage 4?
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palliative chemo
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Small Cell stages?
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Limited (bad)
Extensive (badder) |
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Limited Small Cell = ?
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One hemithorax
+/- nodes and effusion |
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5 year survival of Limited?
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10-20%
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Definition of Extensive?
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anything more than limited
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5 year survival of extensive?
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2%
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Complications of lung carcinoma?
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Airway obstruction
Blood vessel erosion (hemoptysis) Pleural Effusion Compress/Invade neighbors Metastasis Paraneoplastic Syndromes |
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Paraneoplastic Syndromes?
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ACTH-Cushings Syndrome
Inappropriate ADH secretion Hypercalcemia |
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Which cancers typically cause the paraneoplastic syndromes?
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ACTH-Cushings: small cell
ADH: small cell Hypercalcemia: squamous cell |
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Primary vs Metastatic Lung neoplasm Locations
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Metastatic: multiple, bilateral, peripheral
Primary: unilateral, solitary, central or peripheral |
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What is the most common site of metastasis? why?
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THE LUNG
high blood flow high lymph flow favorable growth environment? |
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Most common sources of metastatic lung cancer?
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Lung
Breast Colon Stomach Pancreas Kidney Melanoma |
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Which tumors don't spread to lungs?
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CNS (brain)
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General ways to determine difference between primary and metastatic?
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Basic histo
Immunohistochemical studies |
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Which pulmonary neoplasm is TTF-1 Positive?
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Primary Lung Adenocarcinoma
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Metastatic Gastric Adenocarcinoma's marker profile?
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7-
20+ TTF-1 - |
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Uncommon Lung Neoplasms
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Carcinoid Tumor
Hamartoma Malignant Mesothelioma |
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Differentiation seen in Carcinoid Tumors?
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Neuroendocrine
so secretory granules |
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Patterns w/ carcinoid tumors?
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Nested
Trabecular Papillary Pseudoglandular |
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most common benign pulmonary tumor?
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Hamartoma
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Origin of lung hamartoma?
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peribronchial mesenchyme
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Location of hamartoma?
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Parenchymal 80-90%
Endobronchial 10-20% |
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Main Pleural Neoplasm?
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Malignant Mesothelioma
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Origin of Malignant Mesothelioma?
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pleural cells
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besides asbestos, other risk factor for Malignant Mesothelioma
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SV40 infection (simeon virus)
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Mortality rate for Malignant Mesothelioma?
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100%
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Malignant Mesothelioma growth patterns?
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Epitheliod
Sarcomatoid Biphasic (both) |
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Difference between adenocarcinoma and Malignant Mesothelioma based on calretinin stain?
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+ w/ Malignant Mesothelioma
- w/ adenocarcinoma |