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Chapter 15
The Lungs (710-734)
24
Pathology
Professional
05/20/2012

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Term
Lung Adenocarcinoma
Definition
Metastasize widely and early
Glandular differentiation or mucin producing (worse type)
Most common in women and non-smokers
PERIPHERAL LOCATION
Term
Lung Adenocarcinoma mutations
Definition
KRAS
Amplification of EGFR (Asians, women, non-smokers)
Term
Bronchioalveolar carcinoma
Definition
MULTIPLE TUMOR THAT CAN COALESCE IN THE PERIPHERY
Lepidic growth (grow along pre-existing structures
Term
Nonmucinous bronchioalveolar carcinoma
Definition
Columnar, peg-shaped, or cuboidal cells
Term
Mucinous
Definition
Tall columnar cells with cytoplasmic and intra-alveolar mucin
Spread aerogenously, forming satellite tumors
Term
Squamous cell caricnoma
Definition
Men; MOST CLOSELY RELATED TO SMOKING
Keritinized or intercellular bridges
SQUAMOUS PEARLS
Term
Squamous cell carcinoma mutations
Definition
p53 mutations
Loss of RB1
p16/INK4 is inactivated
High incidence of HER2/NEU expression
Term
Small cell carcinoma
Definition
Scant cytoplasm, ill defined cell borders, absent nuclei
SALT AND PEPPER PATTERN
Neuroendocrine tumor with ectopic secretion
BOTH CENTRAL AND PERIPHERAL
MOST AGGRESSIVE
Term
Small cell carcinoma genetics
Definition
p53 and RB1 mutations
High levels of Bcl2, w/ low BAX
Term
Large cell carcinoma
Definition
Undifferentiated malignant epithelial tumor
Large nuclei, prominent nucleoli, moderate cyotplasm
Term
Squamous cell carcinoma (Secretion products)
Definition
Parathyroid hormone-related peptide (etc.)
Hypercalcemia
Term
Small cell carcinoma (secretion)
Definition
ACTH and ADH
Term
Neuroendocrine proliferations
Definition
Carcinoids
Tumorlets
Small-cell carcinoma
Term
Tumorlets
Definition
Small, inconsequential, hyperplastic, nest of neuroendocrine cells seen in scarring or chronic inflammation
Term
Carcinoid
Definition
Typical- no p53 or Bcl2 or BAX abnormalities
Atypical- Has those mutations; more likely to spread to lymph nodes on resection
Term
Carcinoid (Morphology)
Definition
Finger like or spherical masses
<3-4cm
Most main stem bronchi
COLLAR BUTTON LESION
Term
Carcinoid Syndrome
Definition
Intermittent attacks of diarrhea, flushing, and cyanosis
Term
Lung Hamartoma
Definition
Peripheral
Solitary and well-circumscribed
Term
Metastatic tumors
Definition
"CANNONBALL LESIONS" are scattered through all lobes: more in the periphery
Term
Solitary Fibrous Tumor
Definition
Mainly restricted to the surface of the lung
NOT ASSOCIATED WITH MESOTHELIOMA
Whorls of reticulin and collagen fibers
Term
Malignant Mesothelioma
Definition
STRONGLY TIRED TO ASBESTOS, WITHOUT INCREASED RISK AMONG ASBESTOS AND SMOKING
Spreads to the Hilar lymph nodes, then the liver
Term
Malignant mesothelioma (Genetics)
Definition
Deletions of chromosomes 1p, 3p, 6q, 9p, or 22q
p16 mutations
SV40 DNA has been found
Term
Malignant mesothelioma
Definition
Diffuse, wide spreading lesion
Extensive pleural effusion and direct invasion of thoracic structures
Grayish-pink tissue surrounding the lungs
NUMEROUS, LONG, AND SLENDER MICROVILLI
Term
Lung adenocarcinoma (Morph)
Definition
Short, plump microvilli
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