أسئلة المحاضرة السابعة باثولوجي RESP (قبل التعديل)
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Questions and Answers

Which mutation type is commonly associated with adenocarcinoma found in cigarette smokers?

  • P53 mutations
  • ALK rearrangements
  • RET translocations
  • EGFR mutations (correct)

What characterizes squamous cell carcinoma in terms of its common mutation?

  • P53 mutations (correct)
  • BRAF mutations
  • EGFR mutations
  • RET translocation

What type of lung carcinoma is most likely to affect young non-smokers?

  • Large cell neuroendocrine carcinoma
  • Adenocarcinoma (correct)
  • Squamous cell carcinoma
  • Small cell carcinoma

Which of the following occupational exposures is linked to lung cancer?

<p>Asbestos (D)</p> Signup and view all the answers

What is a common characteristic of central type lung tumors?

<p>They tend to be greyish white and hard. (D)</p> Signup and view all the answers

Which combination of mutations is often seen in lung squamous cell carcinoma?

<p>EGFR and MET (C)</p> Signup and view all the answers

Which type of neuroendocrine tumor is associated with large cell carcinoma?

<p>Combined small cell carcinoma (D)</p> Signup and view all the answers

What is a distinct feature of tumors in the right lung compared to the left lung?

<p>The right lung is more affected. (B)</p> Signup and view all the answers

What is the most common cause of cancer mortality worldwide?

<p>Lung cancer (B)</p> Signup and view all the answers

At the time of diagnosis, what percentage of lung cancer patients typically have distant metastatic disease?

<p>More than 50% (D)</p> Signup and view all the answers

What is the primary risk factor for developing lung cancer?

<p>Cigarette smoking (D)</p> Signup and view all the answers

Which statement about lung cancer and smoking is true?

<p>Heavy smokers have a higher risk, but not all will develop lung cancer. (B)</p> Signup and view all the answers

Which age group is most often affected by lung cancer?

<p>Adults between 55 and 84 (A)</p> Signup and view all the answers

What factor complicates the prediction of lung cancer development in smokers?

<p>Genetic factors that modify mutagenic effects (B)</p> Signup and view all the answers

What is known about the long-term effects of electronic cigarette aerosols?

<p>Their long-term effects are still unknown. (C)</p> Signup and view all the answers

What characterizes lung adenocarcinoma?

<p>Sex, age, and smoking status affect the frequency of mutational alterations. (B)</p> Signup and view all the answers

What type of lung tumor arises from the peripheral bronchus and can present as single or multiple nodules?

<p>Adenocarcinoma (C)</p> Signup and view all the answers

Which of the following cancers is classified as a small cell carcinoma?

<p>Small Cell Carcinoma (A)</p> Signup and view all the answers

Which type of adenocarcinoma is characterized by cells growing along pre-existing alveolar septa and is less than 3 cm in size?

<p>Adenocarcinoma in Situ (D)</p> Signup and view all the answers

What are the high-grade patterns associated with adenocarcinomas?

<p>Micropapillary, Solid, Cribriform (D)</p> Signup and view all the answers

Which type of non-small cell lung carcinoma is most commonly diagnosed?

<p>Adenocarcinoma (D)</p> Signup and view all the answers

What characteristic defines atypical adenomatous hyperplasia in lung pathology?

<p>Dysplastic pneumocytes lining alveolar walls (A)</p> Signup and view all the answers

What grading classification is assigned to lepidic predominant tumors with no invasive characteristics?

<p>Grade 1 (A)</p> Signup and view all the answers

Which of the following types of lung tumors shows massive infiltration of a lobe or the whole lung?

<p>Diffuse Type Adenocarcinoma (A)</p> Signup and view all the answers

What is the most significant risk factor for lung cancer development?

<p>Cigarette smoking (D)</p> Signup and view all the answers

Which statement accurately describes the correlation between smoking and lung cancer risk?

<p>A linear correlation exists between pack-years of smoking and lung cancer incidence. (D)</p> Signup and view all the answers

What percentage of lung cancer patients are typically diagnosed with distant metastatic disease?

<p>Around 50% (C)</p> Signup and view all the answers

Which demographic is most likely to be diagnosed with lung cancer?

<p>Adults between 55 and 84 years (D)</p> Signup and view all the answers

Which group is noted to have a higher susceptibility to the carcinogenic effects of tobacco?

<p>Women compared to men (B)</p> Signup and view all the answers

What is a potential risk associated with secondhand smoke exposure?

<p>Contains numerous human carcinogens (C)</p> Signup and view all the answers

What has been observed about the molecular characterization of lung adenocarcinoma?

<p>It identifies oncogenic mutations with variations by demographic factors. (D)</p> Signup and view all the answers

Which long-term effect remains uncertain regarding electronic cigarettes?

<p>The long-term effects of their aerosols are unknown. (C)</p> Signup and view all the answers

Which type of lung carcinoma is often associated with younger patients who are non-smokers?

<p>Adenocarcinoma (B)</p> Signup and view all the answers

In which type of lung carcinoma are P53 mutations most commonly found?

<p>Squamous cell carcinoma (B)</p> Signup and view all the answers

What is a significant occupational exposure linked to the development of lung cancer?

<p>Asbestos (A)</p> Signup and view all the answers

Which lung carcinoma subtype is characterized by a combination of neuroendocrine features?

<p>Large cell neuroendocrine carcinoma (D)</p> Signup and view all the answers

Which alteration is typically linked to RET translocations in lung cancer?

<p>Light or never smokers (A)</p> Signup and view all the answers

What distinguishes invasive mucinous adenocarcinoma from typical adenocarcinoma?

<p>Specific cell growth patterns (B)</p> Signup and view all the answers

Which histological subtype of lung cancer can display both keratinizing and non-keratinizing features?

<p>Squamous cell carcinoma (A)</p> Signup and view all the answers

Which of the following best describes the growth pattern of adenocarcinomas?

<p>Characterized by lepidic, micropapillary, and solid patterns (D)</p> Signup and view all the answers

What is a significant histological characteristic of high-grade patterns in adenocarcinomas?

<p>Presence of solid and micropapillary patterns (C)</p> Signup and view all the answers

Adenocarcinoma in situ is characterized by which of the following traits?

<p>Dysplastic cells growing along pre-existing alveolar septa (B)</p> Signup and view all the answers

What is the primary distinction between atypical adenomatous hyperplasia and adenocarcinoma in situ?

<p>Size and degree of cellular dysplasia (A)</p> Signup and view all the answers

What percentage of non-small cell lung carcinoma cases is typically classified as adenocarcinoma?

<p>50% (C)</p> Signup and view all the answers

Which feature is most commonly associated with the peripheral type of adenocarcinoma?

<p>Presence of solitary or multiple nodules (C)</p> Signup and view all the answers

How is invasive nonmucinous adenocarcinoma primarily graded?

<p>By growth patterns such as lepidic predominance (D)</p> Signup and view all the answers

Which of the following statements correctly describes the nature of squamous cell carcinoma compared to adenocarcinoma?

<p>Squamous cell carcinoma originates more often in the central airways. (A)</p> Signup and view all the answers

Flashcards

Lung Cancer Prevalence

Lung cancer is the most common cause of cancer death globally, diagnosed frequently, and often has advanced metastasis at diagnosis.

Lung Cancer Risk Factor

Smoking is the major risk factor for lung cancer, causing mutations.

Lung Cancer and Smoking History

About 80% of lung cancers occur in/or recently former smokers, with a direct correlation between smoking frequency and lung cancer

Lung Cancer Gender Susceptibility

Women tend to be more susceptible to tobacco carcinogens than men, increasing the cancer risk for women.

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Smoking Alternatives and Risk

Other tobacco products (pipes, cigars, chewing tobacco) and second-hand smoke also pose a serious lung cancer risk.

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E-cigarettes and Risk

Long-term effects of e-cigarette use are not fully understood and may present similar risks.

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Lung Cancer Molecular Basis

Molecular analysis of lung adenocarcinoma reveals oncogenic mutations, variations influenced by smoking, age, gender, and geography.

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Lung Adenocarcinoma Genetic Analysis

Studying the frequency of genetic mutations related to lung adenocarcinoma is crucial in understanding and potentially treating the disease.

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Lung Adenocarcinoma

A type of lung cancer that starts in the cells lining the air sacs of the lung.

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EGFR Mutations

Changes in the EGFR gene, often found in lung adenocarcinoma, especially in younger women.

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Squamous Cell Carcinoma

A type of lung cancer that arises from squamous cells lining the airways.

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Small Cell Carcinoma

A highly aggressive type of lung cancer that grows quickly and spreads rapidly.

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Central Lung Tumors

Lung tumors that grow in the central area of the lung (hilar region).

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P53 Mutation

A common mutation in lung tumours (adenocarcinomas and squamous cell carcinomas) that inhibits the tumor suppressor protein P53.

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Neuroendocrine Tumors

Lung tumors that arise from neuroendocrine cells in the airways and affect hormones like carcinoid tumors.

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Adenocarcinoma (Lung Cancer)

A type of lung cancer that originates from the peripheral bronchus and often presents as single or multiple nodules.

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Peripheral Type Adenocarcinoma

Adenocarcinoma that develops from the peripheral bronchus, often appearing as single or multiple nodules.

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Diffuse Type Adenocarcinoma

A rare form of adenocarcinoma characterized by widespread and extensive infiltration of a lobe or the whole lung.

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Atypical Adenomatous Hyperplasia

A small precursor lesion (≤5mm) that shows dysplastic pneumocytes along alveolar walls, which may be single or multiple.

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Adenocarcinoma in situ

A lung lesion less than 3cm, composed of dysplastic cells growing along pre-existing alveolar septa, a significant step towards an invasive tumor.

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Non-Small Cell Lung Cancer (NSCLC)

A broad category encompassing various types of lung cancer, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

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Invasive malignant epithelial tumor

A cancerous growth that has broken through the lining of the lung tissue, meaning it can spread.

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Grading of Invasive Non-Mucinous Adenocarcinomas

A classification system of adenocarcinoma, distinguishing tumors based on their microscopic appearances associated with the level of differentiation (Grade 1 is the least aggressive and Grade 3 the most).

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Lung Cancer Mortality

Lung cancer is the leading cause of cancer death globally, surpassing the combined deaths from colon, breast, and prostate cancers.

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Lung Cancer Age Group

The majority of lung cancer cases affect individuals between the ages of 55 and 84 years.

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Smoking and Lung Cancer

Cigarette smoking serves as a major risk factor for lung cancer, causing mutations that lead to its development.

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Women and Lung Cancer

Women appear to be more susceptible to the carcinogenic effects of tobacco than men.

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Lung Adenocarcinoma Mutations

Molecular analysis of lung adenocarcinoma reveals the presence of oncogenic mutations, whose frequencies vary based on factors such as sex, age, smoking status, and geographical location.

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Lung Cancer Risk: Alternatives

Pipe and cigar smoking, chewing tobacco, and second-hand smoke all carry an increased risk for developing lung cancer.

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E-cigarette Risk

The long-term health impacts of electronic cigarette aerosols are still unknown due to their recent emergence.

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Lung Cancer - Most Common Type

Squamous cell carcinoma is the most prevalent type of lung cancer found in the central (hilar) region.

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Lung Cancer Location - Central

Central lung tumors, typically squamous cell carcinomas, originate from the main bronchus and can spread to the surrounding area.

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Lung Cancer Growth Pattern - Central

Central lung tumors can grow in different ways including fungating, infiltrating, or ulcerating.

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Lung Cancer Appearance - Central

Central lung tumors often have a hard, greyish-white appearance with areas of hemorrhage or necrosis creating a red or yellow-white mottling.

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Lung Cancer - Right vs. Left

The right lung is more commonly affected by lung cancer than the left lung.

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Lung Cancer - Necrotic Foci

Necrotic areas (dead tissue) in central lung tumors can sometimes form cavities.

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Lung Cancer - P53 Mutation

The P53 gene is frequently mutated in lung tumors, inhibiting the tumor suppressor protein, which can contribute to cancer development.

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Lung Cancer - Occupational Exposure

Exposure to certain substances like asbestos, arsenic, chromium, uranium, nickel, and radiation can increase the risk of small cell lung carcinoma.

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Adenocarcinoma

A type of lung cancer that originates from the cells lining the air sacs of the lung and often presents as single or multiple nodules in the peripheral bronchus.

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Micropapillary, Solid, & Cribriform Patterns

These are high-grade patterns of adenocarcinoma, indicating a more aggressive and less differentiated form.

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Study Notes

Lung Tumors - Incidence and Epidemiology

  • Lung cancer is the most frequently diagnosed major cancer and the most common cause of cancer mortality worldwide.
  • At diagnosis, over 50% of patients already have distant metastatic disease.
  • Each year, lung cancer deaths exceed those from colon, breast, and prostate cancer combined.
  • Lung cancer is mainly a disease of older adults, typically between 55 and 84 years of age.

Lung Tumors - Etiology and Pathogenesis

  • Smoking is a major carcinogen and the most significant risk factor for lung cancer.
  • Smoking is responsible for the mutations that lead to lung cancer, and its prevalence correlates strongly with cancer risk.
  • Approximately 80% of lung cancers occur in current or recent smokers, with a strong linear relationship between smoking frequency and cancer risk.
  • Not all heavy smokers develop lung cancer, suggesting other genetic or environmental factors play a role.
  • Tobacco use in various forms (cigarettes, pipes, cigars, chewing tobacco) increases the risk.
  • Women are typically more susceptible to the carcinogenic effects in tobacco than men.
  • Exposure to secondhand smoke or environmental tobacco smoke also elevates lung cancer risk.
  • Electronic cigarettes (vaping) have unknown long-term effects regarding lung cancer and safety, particularly due to the presence of carcinogenic chemicals whose safe exposure levels have not been defined (or established).

Lung Cancer Molecular Background

  • Molecular characterizations of lung adenocarcinoma often identify oncogenic mutations.
  • The occurrence rate of these alterations varies based on factors such as sex, age, smoking history, and location.
  • KRAS mutations are observed in cigarette smokers, while EGFR, ALK, ROS1, and RET alterations are more commonly found in non- or light smokers.
  • EGFR and MET mutations, along with ALK or ROS1 rearrangements, can be present in lung squamous cell carcinoma, particularly in young non-smokers.
  • Specific mutations are associated with specific risk factors, such as smoking or patient age.
  • Occupational exposure to asbestos, arsenic, chromium, uranium, nickel, and radiation might contribute to lung cancer development.

Lung Tumor Classification

  • Adenocarcinoma: This subtype includes lepidic, acinar, micropapillary, papillary, and solid patterns.
  • Squamous Cell Carcinoma: Features include keratinization, or intercellular bridges, that are more present in well-differentiated tumors.
  • Small Cell Carcinoma: Characterized by small cells, scant cytoplasm, indistinct cell borders, and a salt-and-pepper chromatin pattern.
  • Large Cell Carcinoma: A diagnosis of exclusion, characterized by abundant cytoplasm, large nuclei, and prominent nucleoli.
  • Neuroendocrine Tumors: Includes combined small cell, large cell neuroendocrine carcinoma and carcinoid tumor.
  • Other types: Less common types include sarcomatoid carcinoma. others, such as lymphoepithelioma-like carcinoma, NUT carcinoma and Thoracic SMARCA4-deficient undifferentiated tumor are also of note.

Histological Types of Lung Cancer

  • Non-small cell carcinoma (NSCLC): Notably encompasses adenocarcinoma (approx. 50%), squamous cell carcinoma (approx. 20%), and large cell carcinoma (approx. 2%).
  • Small cell carcinoma (SCLC): A rare and aggressive type.

Grading of Invasive Non-Mucinous Adenocarcinomas

  • Lung adenocarcinomas are graded on patterns of differentiation.
  • Grade 1 (well-differentiated) includes predominantly lepidic patterns.
  • Grade 2 (moderately differentiated) predominantly contains acinar/papillary patterns.
  • Grade 3 (poorly differentiated) occurs with higher percentages of high-grade patterns.

Squamous Cell Carcinoma Characteristics

  • Distinguished by keratinization or intercellular bridges, usually evident in well-differentiated tumors.
  • Keratinizing or squamous pearls and cells with eosinophilic cytoplasm are notable features.

Neuroendocrine Tumors

  • Comprised of relatively small cells, with scant cytoplasm, indistinct cell borders, and finely granular nuclear chromatin (salt and pepper pattern), often lacking cytologic characteristics of other lung cancer types.

SMARCA4-Deficient Undifferentiated Thoracic Tumor

  • A recently recognized high-grade lung malignancy, characterized by undifferentiated or rhabdoid phenotypes and SMARCA4 deficiency.
  • Primarily affects young to middle-aged adults, often with a male predilection, and a strong smoking history.
  • Characterized by eosinophilic cytoplasm and eccentric nuclei suggestive of rhabdoid cytology.

Clinical Features of Lung Cancer

  • Lung cancer is often insidious, with symptoms developing over several months.
  • Common symptoms include cough (75%), weight loss (40%), chest pain (40%), and dyspnea (20%).
  • Spread impacts clinical presentation through metastases to various sites, such as bone, brain, characterized by related symptoms.
  • Local effects of spread can cause various issues like cough, hemoptysis, chest pain, pneumonia, and others, depending on specific tissue affected.

Paraneoplastic Syndromes

  • Lung cancer can be linked to paraneoplastic syndromes, presenting with hormonal abnormalities or other systemic issues before a primary lung tumor is apparent or readily detectable.
  • Several hormones or hormone-like factors might be implicated: ADH, ACTH, parathyroid hormone-related peptide, calcitonin, gonadotropins, serotonin, and bradykinin.

Metastatic Lung Tumors

  • Secondary lung tumors (mets) are more common than primary lung cancers.
  • The lung is a frequent site for metastases, originating from various primary cancers like esophageal, breast, or abdominal cancers.
  • Metastatic nodules might manifest as multiple, discrete nodules of variable sizes, often distributed sub-pleurally.
  • Sometimes, specific primary cancers like hypernephroma are associated with certain patterns in X-ray imaging.

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