Name the principal etiological agent of pulmonary crcinoma
what cause a greater incidence in lung carcinoma?
Name the principal oncogenic minerals, chemical and radiation
-Asbestos (dose related, multiplicative risk)
-Chloromethyl, methyl ether,polycyclic, aromatic hydrocarbons, mustard gas
-radon, uranium and other mines
What king od information do we get from a KRAS mutated lung cancer?
-patient probably a smoker
-It is an adverse predictive factor
-There may be a lack of benefit from TKI treatment
What kind of information do we get from a EGFR mutated lung cancer
-Patient probably a non smoker
-east asian woman
-Exon 19 and 21 predict response to TKI
What kind of information do we get from a ALK mutated lung cancer?
-About 2-5% of NSCLC
-high response and progression free survival with critoztinib
What are the squamous cell carcinoma pathological characteristics
-proximal (lombar, segmental airways)
-intraluminal popypoid growth
-central necrosis and cavitation
-better differentiated form tend to be linked to the thorax
-frequent subtype in superior sulcus
What are the small cell carcinoma's pathological characteristics and microscopic appearance
-Proximal (main, lobar) airways
-subucosa infiltration with compression
-regional lymph node and visceral metastases
-small cells, high N/C ratio and dispersed chromatin
What are the large cell carcinoma's pathological characteristics and microscopique appearance
-large cells with no evidence of differentiation
What is the most frequent cause of cancer death?
what% of patient present themselve with advanced or metastatic lung cancer?
what is the 5 years survival in different lung cancer patient's desease stage?
what % of lung cancer death is caused by cigarette?
What type of lung cancer is strongly associated with smoking?
SCLC (98% due to smoking)
Name some occupational cause of lung cancer
asbestos boiler and pipe insulation
Arsenic, formely used in pesticide
Bis(chloromethyl)ether, used in pesticid
cadmium, metal plating, electronics
chromium, used in alloys and metal plating
crystaline silica, sand blasting, stone cutting
nickel in nickel rafining
radon progeny, mining
soots, tars, and mineral oil inducstry
Define the effect of asbestos+smoking
multiplicative effects on th risk of lung cancer devellopement
toghether they increase the rick of lung cancer by 20-50 times
there is a lag period of 20-30 years in cancer devellopement
what is the goal and problem in lung cancer screening?
Reduce disease specific mortality.
survival data is misleading due to kead time bias
what kind of lung cancer have neuro-endocrine features?
Name the most common type of cancer in decroissant order
squamous cell (30%)
Large cell (9,4%)
Adenosquamous, carcinoid and others (2.5%)
mixed NSCLC/SCLC treated has SCLC
Define the caracteristic of SCLC
almost exclusively in smoker
Central tumours, originating within the brobchial wall
characterized by by hillar and mediastinal node involvement and early distant metastase
carries the worst prognostic of all the types the types of lung cancer
Define the caracteritics of Adenocarcinoma
tend to happen in the periphery of the lung
most common cancer in non-smoker
can mimic pleumonia on CXR by spreading on alveolar wall
can devellop in old sac ''scarcarcinoma''
tend to spread to nodes and distantly
intermediate prognosis between squamous cell and small cell
Define te caracteristic of squamous cell lung cancer
tend to arise in central location
tendency to cavitate on CXR
spread to local structure, then nodes
can be associated with hypercalcemia
Best relative prognosis
Define the caracteristic of large lung cll carcinoma
Location usually peripheral but variable
behavior similar to adenocarcinoma spread to nodes and distantly
name Lung cancer Loco regional symptoms
Cough, chest pain,hemoptusis, neck nodes, hoarsenessn(recurent larhyngial nerve), swallowing problem
SVCO syndrome: facial swelling, collateral veins
pancast syndrome: hand or arm pain from brachial plexus involvement, hornmers
dyspnea from pleural or pericardiale effusions
Name the paraneoplastic symptoms in lung cancer
SCLC: sushing's syndrome
NSCLC:hypercalcemia, hypertrophic osteoarthropathy and clubbing, and dermatomyositis
Name the disseminated desease symptom in lung cancer
weight loss, bony pain,headache
soft tissu masses
foca neurologic deficits
Name the hematological desease symptoms in lung cancer.
Thrombophlebitis and thromboembolic disease
What are the source of false positive and false negative in Lung cancer pet scan?
False positive: inflammatory lesion
False negative: bronchioalveolar cell, carcinoids less than 1cm
Define the treatment for the diffrent stage of NSCLC
1A: surgery alors/RT alone
1B:surgery/ +- CT
3A: CT+RT +- surgery
4:CT vs best supportive care
Deine the treatment for SCLC
limited disease:chemotherapy and radiation
extensive disease: chemotherapy
Name the following parts
Name some cause and consequence of pleuritis
Pleura is inflamme
Parieltal pleural is sensitive
pneumothorax (spontaneous or injury)
hemothorax:blood in the area
name the following parts
What are the following term?
the primitive gut with the BPM opening into the FG , MG and the more caudal HG which ends in the cloacal membrane
Complete the sentence
_______ beginning at the BPM (4th week) progresses to recanalize the gut at about the _____ week when the ________ is opened allowing amniotic fluid to circulate through the canalized gut into the _______.
Apoptosis beginning at the BPM (4th week) progresses to recanalize the gut at about the 7th week when the cloacal membrane is opened allowing amniotic fluid to circulate through the canalized gut into the amniotic cavity.