Lung Tumors
1. Tx for small cell carcinoma? 2. what tumors can sometimes use surgery?
1. chemotherapy & radiation 2. squamous and adenocarcinoma tend to remain localized linger
1. what hormone do carcinoid tumors have? 2. how old are most patients with carcinoid tumor?
1. serotonin 2. younger than 40
familial clustering associated w/ what gene?
CYP1A1
what is the precursor lesion for small cell carcinoma?
Doesn't have one!
most common mutation in nonsmokers?
EGFR mutation
T/F most bronchial carcinoids do not have secretory activity and do not metastasize to distant sites but instead follow relatively benign course
True bro true
KRAS mutation most common in?
adenocarcinoma
malignant epithelial tumor w/ glandular differentiation or mucin production?
adenocarcinoma
most common type of lung cancer in women & nonsmokers?
adenocarcinoma
what is most common form of lung cancer in women?
adenocarcinoma
what tumors have the majority positive for thyroid transcription factor-1 (TTF1)?
adenocarcinoma
mucin production?
adenocarcinoma bronchioloalveolar carcinoma is a type of adenocarcinoma
almost always occurs in peripheral portions of lung as single nodule or multiple diffuse nodules producing pneumonia-like consolidation
bronchioloalveolar carcinoma
clara cells seen in what tumor?
bronchioloalveolar carcinoma
collar button lesion?
carcinoid tumor
precursor lesion: diffuse idiopathic neuroendocrine cell hyperplasia
carcinoid tumor
trabecular growth pattern?
carcinoid tumor
location of squamous cell carcinoma?
central lung/hilar. can migrate out to periphery over time. now can be seen in apex
bronchioloalveolar carcinoma arises from what cells?
clara cells, type II pneumocytes, mucin-secreting bronchioloalveolar cells
superior vena cava syndrome
compression or invasion of superior vena cava causing venous congestion & edema of head, arm, & ultimately circulatory compromise
what is carcinoid syndrome?
diarrhea, flushing, cyanosis
proliferation of spindle shaped fibroblasts & myofibroblasts, lymphocytes, plasma cells in children
inflammatory myofibroblastic tumor anaplastic lymphoma kinase (ALK) on 2p23
mix of epitheloid & sarcomoid components?
mesothelioma
prognosis of mucinous vs. nonmucinous bronchioloalveolar carcinomas
mucinous tend to spread aerogenously forming satellite tumors thus are less likely to be cured by surgery. aerogenously spread WITHIN lungs nonmucinous have rare spread so can be surgically removed...excellent 5 yr survival
lung harmatoma
non-malignant tumor. composed of tissue elements normally found at that site, but which are growing in a disorganized mass usually found incidentally on xray as a rounded focus of radio-opacity (coin lesion) cartilage is most common tissue
what eventually happens to bronchioloalveolar carcinomas? do they metastasize?
noninvasive tumors that do not metastasize. uness they are resected they will cause death by suffocation
Lambert-Eaton Myasthenic Syndrome
paraneoplastic syndrome. Muscle weakness is caused by autoantibodies directed to the neuronal calcium channel more common in lower extremities, worse in morning
Acanthosis Nigricans
paraneoplastic syndrome. dermatologic abnormality, darker, thick, velvety skin in body folds and creases.
characteristic growth along preexisting structures w/o destruction of alveolar architecture. seen in what tumor & whats name of growth pattern?
seen in bronchioloalveolar carcinoma referred to as lepidic
hyponatremia, elevated ACTH, & elevated ADH associated with...
small cell carcinoma
EM shows dense core neurosecretory granules
small cell carcinoma most commonly associated with ectopic hormone production
characterized by precursor lesion- squamous cell metaplasia/ dyplasia giving rise to carcinoma in situ
squamous cell carcinoma
intracellular bridges and squamous pearls
squamous cell carcinoma
tumor w/ highest frequency of p53 mutation?
squamous cell carcinoma
what creates PTH like hormone causing hyercalcemia?
squamous cell carcinoma
what enzyme is elevated in 80% of lung tumor tissue?
telomerase
typical vs. atypical carcinoid tumors
typical- have no p53 mutations or BCL2, BAX expression abnormalities. Have fewer than 2 mitoses per ten high power field. Lacks necrosis. atypical- can have p53 mutations, & BCL2 or BAX expression abnormalities. Have b/w 2-10 mitoses per ten high power field
is necrosis common in small cell carcinoma?
yes! azzopardi effect- basophilic staining of vascular walls d/t encrustation by DNA from necrotic cells