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Lung Cancer
Downstate > MS2 Respiratory Block > Lecture 6 Lung Cancer
50
Medical
Graduate
02/06/2011

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Cards

Term
What percentage of lung cancer is small cell vs. non-small cell?
Definition
20% small cell; 80% non small cell
Term
most common type of non-small cell carcinoma
Definition
adenocarcinoma
Term
strongest association with smoking
Definition
squamous cell carcinoma
Term
p53 mutations are uncommon in __
Definition
mesothelioma
Term
benzopyrene metabolites causes G->T mutation in what gene
Definition
p53
Term
loss of Rb is due to inactivation of ___
Definition
INK4
Term
genes found on 3p chromosome
Definition
FHIT, RasF1A, beta-catenin, SEMA3B
Term
mutations assc'd with non-small cell only
Definition
K-ras, EGFR, m-tor
Term
mutations assc'd with small cell carcinoma only
Definition
Myc, Bcl-2
Term
common mutations in exons 19, 20, 21; protein?
Definition
EGFR
Term
tyrosine kinase inhibitors (2)
Definition
erlotinib, gefitinib
Term
tumor growth into pleura cause ...
Definition
unilateral pleural effusion
Term
pt presents with swelling of face, arms, and neck and shows dilated upper body veins; dx?
Definition
SVC syndrome
Term
tumor impinges on ___ and causes hoarseness
Definition
recurrent laryngeal n.
Term
Horner's syndrome
Definition
ptosis, miosis, anhydrosis, enopthalmos
Term
Pancoast's syndrome
Definition
tumor growth in C8, T1, and T2 -> pain from shoulder to ulna, Horner's, and destruction of ribs 1 and 2
Term
excess ADH, ACTH; what cancer?
Definition
small cell
Term
hypercalcemia, excess prostaglandins; what cancer?
Definition
squamous cell carcinoma
Term
flushing, sweating, wheezing; what cancer?
Definition
carcinoid
Term
neuromuscular paraneoplastic syndrome
Definition
ataxia, vertigo, proximal m. weakness (Lambert-Eaton), peripheral neuropathy
Term
pathology of Lambert Eaton's syndrome
Definition
autoantibodies against Ca channels in neurons
Term
hypertrophic pulmonary osteoarthropathy
Definition
joint swelling, clubbing, edema, subperiosteal new bone
Term
metastasis sites in order of first to last
Definition
lymph node, other lung, brain, adrenals, liver, bone marrow, lower GI
Term
5y survival rate without surgery = __%
5y survival rate with surgery = __%
Definition
without = 15%
with = 48%
Term
1. hilar mass with cavitations; dx?
2. peripheral mass without necrosis/cavitations; dx?
3. peripheral mass with necrosis
Definition
1. squamous cell carcinoma
2. adenocarcinoma
3. large cell carcinoma
Term
1. cytokeratin5/6+, cytokeratin7-, TTF1-; dx? 2. cytokeratin7+, TTF1+; dx?
Definition
1. squamous cell carcinoma 2. adenocarcinoma
Term
keratin pearls; dx?
Definition
squamous cell carcinoma
Term
5 gross presentations of adenocarcinoma
Definition
pleural puckering, hilar, lobar, visceral pleura, scarring
Term
2 histological presentations of BAC
Definition

1. non-mucinous: Clara cells, type II epithelial cells; solitary

2. mucinous: mucus cells, mucicarmine+; diffuse

Term
tx for adenocarcinoma in Japanese females
Definition
tyrosine kinase inhibitor
Term
adenocarcinoma: signs of good vs. bad prognosis
Definition
good: Bcl-2, ground glass; bad: papillary histology
Term
neuroendocrine markers = ?; what cancers are they found in?
Definition
synaptophysin, chromogranin, CD56; small cell carcinoma, large cell neuroendocrine carcinoma
Term
1. salt and pepper chromatin; nuclear molding, ill-defined borders of cells; dx?
2. salt and pepper chromatin; no nuclear changes, uniform and polygonal cells; dx?
Definition
1. small cell carcinoma
2. carcinoid tumor
Term
crush artifact; dx?
Definition
small cell carcinoma
Term
Azzopardi effect; dx?
Definition
small cell carcinoma
Term
tx for small cell carcinoma
Definition
radiation, chemotherapy; NO SURGERY
Term
typical vs. atypical carcinoid tumor
Definition
typical: <2/HPF, bronchial location, no necrosis, better prognosis atypical: 2-10/HPF, peripheral location, necrosis, worse prognosis
Term
Kulchitsky cell; dx?
Definition
carcinoid tumor
Term
MEN1 mutation; dx?
Definition
carcinoid tumor
Term
P14 ARF mutation; dx?
Definition
atypical carcinoid tumor
Term
>60yo male coal miner presents with dyspnea, wheezing, coughing, and chest pain; dx?
Definition
mesothelioma
Term
asbestos types? most common?
Definition
crocodolite (most common), amosite, chrysolite
Term
CXR: calcified plaque on pleura or diaphragm indicates __
Definition
asbestos exposure
Term
ferruginous bodies; dx?
Definition
asbestos exposure--work up for mesothelioma
Term
NF2, GPC3 mutations; dx?
Definition
mesothelioma
Term
metastasis to lungs usually target [peripheral/hilar] sites
Definition
peripheral
Term
good prognostic signs for mesothelioma
Definition
female<50yo, epithelioid histology, no chest pain
Term
1. most aggressive cancer
2. metastasizes early and widely
Definition
1. small cell carcinoma
2. adenocarcinoma
Term
mutations assc'd with non small cell carcinoma only
Definition
EGFR, m-tor, K-ras
Term
Her-2, cox2, met mutations; cancer?
Definition
adenocarcinoma
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