Pathology of Lung Carcinoma
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Questions and Answers

What is the primary cause of lung cancer in nonsmoking women?

  • Genetic mutations
  • Radon exposure
  • Asbestos exposure (correct)
  • Exposure to radiation

    • Which of the following genes is not associated with lung cancer?

  • EGFR
  • BRCA1 (correct)
  • ROS1
  • ALK

    • What is the effect of asbestos exposure on the risk of developing lung cancer?

  • It increases the risk by 5-fold (correct)
  • It reduces the risk by 50%
  • It has no effect on the risk
  • It decreases the risk by 20%

    • Which of the following is an example of a personalized lung cancer treatment?

    <p>Targeted therapy based on genetic mutations</p> Signup and view all the answers

    What is the risk of developing lung cancer in smokers exposed to asbestos?

    <p>55-fold</p> Signup and view all the answers

    What is the role of genetic mutations in lung cancer?

    <p>They increase the risk of lung cancer</p> Signup and view all the answers

    Which of the following is a risk factor for lung cancer?

    <p>All of the above</p> Signup and view all the answers

    What is the effect of tobacco smoke on the risk of developing lung cancer?

    <p>It increases the risk</p> Signup and view all the answers

    What is the primary reason why per-pulp checkpoint inhibitors produce responses in some tumors?

    <p>Because they have a high rate of tumor neoantigens</p> Signup and view all the answers

    Which of the following is a characteristic of carcinogen-induced mutations?

    <p>They are typically characterized by a high rate of tumor neoantigens</p> Signup and view all the answers

    What is the primary difference between pulmonary carcinoids and small cell lung cancers?

    <p>Pulmonary carcinoids are characterized by asymptomatic symptoms</p> Signup and view all the answers

    What is the prognosis for pulmonary carcinoids?

    <p>Surgical resection is not an option</p> Signup and view all the answers

    What is a common symptom of pulmonary carcinoids?

    <p>All of the above</p> Signup and view all the answers

    Why are pulmonary carcinoids often diagnosed at an advanced stage?

    <p>Because they are asymptomatic</p> Signup and view all the answers

    What is the relationship between smoking and pulmonary carcinoids?

    <p>Smoking is a major risk factor for pulmonary carcinoids</p> Signup and view all the answers

    What is the main difference between carcinogen-induced mutations and small cell lung cancers?

    <p>Small cell lung cancers have a higher rate of tumor neoantigens</p> Signup and view all the answers

    What is the primary cause of lung carcinoma as indicated in the content?

    <p>Exposure to carcinogens in tobacco smoke</p> Signup and view all the answers

    Which method is mentioned as a routine staining technique for visualizing organisms in lung carcinoma?

    <p>Hematoxylin and Eosin (H&amp;E) stain</p> Signup and view all the answers

    What does the phrase 'fungal' refer to in the context of this content?

    <p>A group of microorganisms</p> Signup and view all the answers

    How many new cases of lung cancer were estimated for 2019 according to the content?

    <p>228,820</p> Signup and view all the answers

    What is implied by the term 'budding yeast' in the content's context?

    <p>An early stage of tumor growth</p> Signup and view all the answers

    What type of diagnostic cue are 'pseudohyphae' related to?

    <p>Lung carcinoma</p> Signup and view all the answers

    Which of the following does NOT represent a type of staining technique mentioned?

    <p>Acid-fast staining</p> Signup and view all the answers

    What total death toll was estimated for lung cancer in 2019 according to the content?

    <p>135,720</p> Signup and view all the answers

    What percentage of pulmonary neoplasms do bronchiolar carcinoids represent?

    <p>5%</p> Signup and view all the answers

    Which of the following is NOT a characteristic of bronchiolar carcinoids?

    <p>They are frequently associated with extensive necrosis.</p> Signup and view all the answers

    What is the average age of individuals affected by bronchiolar carcinoids?

    <p>40 years</p> Signup and view all the answers

    What is the "Azzopardi effect"?

    <p>A characteristic histological feature of bronchiolar carcinoids.</p> Signup and view all the answers

    Which of the following terms refers to the spread of bronchiolar carcinoids to distant sites?

    <p>Metastasis</p> Signup and view all the answers

    What is the significance of the "coar-button lesion" in bronchiolar carcinoids?

    <p>It reflects the tumor's tendency to spread through the bronchi.</p> Signup and view all the answers

    What is the primary site of origin for bronchiolar carcinoids?

    <p>Bronchioles</p> Signup and view all the answers

    Which of the following is NOT a typical histological feature of bronchiolar carcinoids?

    <p>Large, pleomorphic cells</p> Signup and view all the answers

    Which of the following is NOT a characteristic of non-small cell carcinoma, based on the provided text?

    <p>It can be acquired by inhalation of aerosolized contaminated soil or bird droppings.</p> Signup and view all the answers

    Based on the provided text, which of the following statements about the immune response to lung cancer is most accurate?

    <p>The immune response can vary significantly depending on the individual's immune status and the type of cancer.</p> Signup and view all the answers

    Which type of lung cancer is most commonly associated with adeno-carcinoma, according to the text?

    <p>Non-small cell carcinoma</p> Signup and view all the answers

    What is the primary route of acquisition for Cryptococcus species that cause lung cancer, as indicated by the text?

    <p>Inhalation of aerosolized contaminated soil or bird droppings</p> Signup and view all the answers

    Based on the text, what is the primary site of infection for Cryptococcus species in the body?

    <p>The lungs</p> Signup and view all the answers

    The text mentions that Cryptococcus species may cause tumors that differ from small cell carcinomas in their behavior and treatment. What is the primary reason for this difference?

    <p>Cryptococcus species are primarily fungal infections, while small cell carcinomas are cancers.</p> Signup and view all the answers

    The text describes a difference in immune response between individuals with a compromised immune system and those with a more reactive immune system. What are the key differences in immune response described in the text?

    <p>Compromised immune systems exhibit minimal immune response, while reactive immune systems exhibit a granulomatous response.</p> Signup and view all the answers

    Based on the provided text, what is the primary association between smoking and lung cancer?

    <p>Smoking is strongly associated with non-small cell carcinoma, but there is also an association with adeno-carcinoma.</p> Signup and view all the answers

    Vaginants is extremely common in women, especially those who are diagnosed with CMV infection.

    <p>True</p> Signup and view all the answers

    Esophagitis is rare in patients with AIDS.

    <p>False</p> Signup and view all the answers

    PCR assay-based detection of CMV DNA is not a common diagnostic method.

    <p>False</p> Signup and view all the answers

    CMV infection is not a common complication in pregnant women.

    <p>False</p> Signup and view all the answers

    CMV infection can be diagnosed by culturing the virus.

    <p>True</p> Signup and view all the answers

    Esophagitis is only seen in patients with compromised immune systems.

    <p>False</p> Signup and view all the answers

    CMV infection can cause hematological malignancies.

    <p>True</p> Signup and view all the answers

    PCR assay-based detection of CMV DNA is a slow and labor-intensive process.

    <p>False</p> Signup and view all the answers

    Squamous cell carcinomas often undergo cental necrosis, giving rise to cavitation.

    <p>True</p> Signup and view all the answers

    Carcinogen-induced mutations can be effectively treated with checkpoint inhibitors.

    <p>False</p> Signup and view all the answers

    Exposure to tobacco smoke increases the risk of developing lung cancer by more than 10-fold.

    <p>True</p> Signup and view all the answers

    Bronchiolar carcinoids are typically diagnosed at an early stage.

    <p>False</p> Signup and view all the answers

    Some mutations drive lung cancer growth by activating kinases, which are excellent drug targets.

    <p>True</p> Signup and view all the answers

    Smoking is a major risk factor for developing squamous cell carcinomas.

    <p>True</p> Signup and view all the answers

    Asbestos exposure has no effect on the risk of developing lung cancer.

    <p>False</p> Signup and view all the answers

    Chromosomal breakage is a common consequence of exposure to tobacco smoke.

    <p>True</p> Signup and view all the answers

    Opportunistic microbes typically cause disease in individuals with suppressed immune systems.

    <p>True</p> Signup and view all the answers

    A common characteristic of opportunistic infections is the presence of a foamy exudate.

    <p>True</p> Signup and view all the answers

    Cytomegalovirus is an example of an opportunistic pathogen.

    <p>True</p> Signup and view all the answers

    The diagnosis of opportunistic infections should be considered in individuals with healthy immune systems.

    <p>False</p> Signup and view all the answers

    Opportunistic infections are characterized by the presence of round or cup-shaped cysts with a diameter of approximately $10$ μm.

    <p>True</p> Signup and view all the answers

    The presence of a foamy exudate is a diagnostic marker for the presence of cytomegalovirus infections.

    <p>False</p> Signup and view all the answers

    Individuals with healthy immune systems are highly susceptible to opportunistic infections.

    <p>False</p> Signup and view all the answers

    Opportunistic infections are primarily caused by bacteria.

    <p>False</p> Signup and view all the answers

    Chronic cavitary pulmonary disease does not resemble the secondary form of tuberculosis.

    <p>False</p> Signup and view all the answers

    Infections in immunocompromised individuals can lead to disseminated disease characterized by splenomegaly.

    <p>True</p> Signup and view all the answers

    Symptoms of chronic cavitary pulmonary disease may include night sweats and fatigue.

    <p>False</p> Signup and view all the answers

    Bronchogenic carcinoma is not a differential diagnosis for mass lesions in the lungs caused by infections.

    <p>False</p> Signup and view all the answers

    Cytomegalovirus infection of the lung is marked by distinct nuclear and multiple cytoplasmic inclusions.

    <p>True</p> Signup and view all the answers

    Dysregulation of blood cell production in disseminated disease can lead to thrombocytopenia and leukocytosis.

    <p>False</p> Signup and view all the answers

    The treatment of disseminated disease is uncomplicated and often effective.

    <p>False</p> Signup and view all the answers

    Hemoptysis is not a common symptom of chronic cavitary pulmonary disease.

    <p>False</p> Signup and view all the answers

    Bronchial carcinoids account for approximately 10% of all pulmonary neoplasms.

    <p>False</p> Signup and view all the answers

    The Azzopardi effect refers to the necrotic tumor cells encrusting distant lymph nodes.

    <p>True</p> Signup and view all the answers

    The average age of individuals diagnosed with bronchial carcinoids is 60 years.

    <p>False</p> Signup and view all the answers

    Bronchial carcinoids primarily originate in the lung periphery.

    <p>False</p> Signup and view all the answers

    Areas of necrosis are found in about 5% to 15% of carcinoids.

    <p>True</p> Signup and view all the answers

    The coar-button lesion is a distinct feature of peripheral lung carcinoma.

    <p>False</p> Signup and view all the answers

    Bronchial carcinoids can manifest as an obstructing polypoid mass in the lungs.

    <p>True</p> Signup and view all the answers

    The diagnosis of bronchiolar carcinoids is often delayed due to unclear symptoms.

    <p>True</p> Signup and view all the answers

    What characteristic distinguishes opportunistic infections in individuals with compromised immune systems?

    <p>They cause serious diseases in individuals whose immune systems are suppressed by disease or therapy.</p> Signup and view all the answers

    What is the significance of the 'cotton candy' exudate in relation to opportunistic infections?

    <p>It is a characteristic appearance of opportunistic infections in immune-compromised individuals, seen in H&amp;E stained tissue sections.</p> Signup and view all the answers

    How do opportunistic pulmonary pathogens, such as cytomegalovirus, affect individuals with compromised immune systems?

    <p>They can cause serious diseases in individuals whose immune systems are suppressed by disease or therapy.</p> Signup and view all the answers

    What is the importance of considering opportunistic infections in the diagnosis of diseases in immune-compromised individuals?

    <p>It is crucial to consider opportunistic infections in the diagnosis of diseases in immune-compromised individuals because they can cause serious diseases.</p> Signup and view all the answers

    What is the relationship between the immune system and the development of opportunistic infections?

    <p>Opportunistic infections develop when the immune system is compromised, allowing opportunistic microbes to cause disease.</p> Signup and view all the answers

    What is the significance of H&E staining in the diagnosis of opportunistic infections?

    <p>It helps to visualize organisms in tissue sections, aiding in the diagnosis of opportunistic infections.</p> Signup and view all the answers

    What is the characteristic appearance of cysts in tissue sections of opportunistic infections?

    <p>Round or cup-shaped cysts with a diameter of approximately 10 μm.</p> Signup and view all the answers

    Why are opportunistic infections important to consider in the context of lung disease?

    <p>They can cause serious diseases in individuals whose immune systems are suppressed by disease or therapy, particularly in the context of lung disease.</p> Signup and view all the answers

    What is the characteristic feature of lung adenocarcinoma as depicted in Fig. 10.18, and what is the significance of TTF-1 positivity?

    <p>The characteristic feature is early in situ growth along alveolar septae, and TTF-1 positivity is seen in a majority of cases.</p> Signup and view all the answers

    Describe the histological features of squamous cell carcinoma as shown in Fig. 10.19B.

    <p>The histological features are well-differentiated, showing keratinization and pearls.</p> Signup and view all the answers

    What is the significance of the term 'invasive' in the context of lung adenocarcinoma depicted in Fig. 10.19A?

    <p>The term 'invasive' indicates that the tumor has broken through the basement membrane and is invading adjacent tissues.</p> Signup and view all the answers

    What is the difference between the lung adenocarcinoma shown in Fig. 10.18 and the squamous cell carcinoma shown in Fig. 10.19?

    <p>The lung adenocarcinoma is early in situ and grows along alveolar septae, whereas the squamous cell carcinoma is invasive and shows keratinization and pearls.</p> Signup and view all the answers

    What is the significance of Fig. 10.18A in the context of lung adenocarcinoma?

    <p>It shows the early in situ growth pattern of lung adenocarcinoma along alveolar septae.</p> Signup and view all the answers

    What is the difference between the growth patterns of the lung adenocarcinoma shown in Fig. 10.18 and the squamous cell carcinoma shown in Fig. 10.19A?

    <p>The lung adenocarcinoma grows along alveolar septae, whereas the squamous cell carcinoma grows as a central mass that invades contiguous parenchyma.</p> Signup and view all the answers

    What is the significance of the term 'well-differentiated' in the context of squamous cell carcinoma shown in Fig. 10.19B?

    <p>It indicates that the tumor cells resemble normal cells and are less aggressive.</p> Signup and view all the answers

    What is the difference between the staining characteristics of lung adenocarcinoma and squamous cell carcinoma?

    <p>Lung adenocarcinoma is TTF-1 positive, whereas squamous cell carcinoma does not show TTF-1 positivity.</p> Signup and view all the answers

    Based on the provided text, what is the primary route of acquisition for Cryptococcus species that cause lung cancer?

    <p>Inhalation of aerosolized Cryptococcus species from contaminated soil or bird droppings.</p> Signup and view all the answers

    What type of lung cancer, according to the text, is most commonly associated with an association with adeno-carcinoma?

    <p>Small cell lung carcinoma.</p> Signup and view all the answers

    The text describes a difference in immune response between individuals with a compromised immune system and those with a more reactive immune system. What are the key differences in immune response described in the text?

    <p>Individuals with compromised immune systems (immunodeficient) have a minimal immune response, while individuals with a more reactive immune system exhibit a granulomatous response.</p> Signup and view all the answers

    Based on the provided text, what is the primary association between smoking and lung cancer?

    <p>Smoking has the strongest association with squamous cell and small cell lung carcinomas.</p> Signup and view all the answers

    The text mentions that Cryptococcus species may cause tumors that differ from small cell carcinomas in their behavior and treatment. What is the primary reason for this difference?

    <p>The text does not explicitly state the reason for the difference in behavior and treatment between Cryptococcus-induced tumors and small cell carcinomas. However, it can be inferred that this difference might be due to the distinct biological characteristics of Cryptococcus and the way it interacts with the host's immune system.</p> Signup and view all the answers

    Based on the text, what is the primary site of infection for Cryptococcus species in the body?

    <p>The lungs.</p> Signup and view all the answers

    What is the primary route of acquisition for Cryptococcus species that cause lung cancer, as indicated by the text?

    <p>Inhalation of aerosolized Cryptococcus species from contaminated soil or bird droppings.</p> Signup and view all the answers

    Based on the text, which of the following statements about the immune response to lung cancer is most accurate?

    • Individuals with a compromised immune system exhibit a robust immune response to Cryptococcus infection.

    • The immune response to Cryptococcus infection can vary significantly depending on the individual's immune status.

    • The immune response to Cryptococcus infection is always minimal, regardless of the individual's immune status.

    • The immune response to Cryptococcus infection is typically characterized by the formation of abscesses.

    <p>The immune response to Cryptococcus infection can vary significantly depending on the individual's immune status.</p> Signup and view all the answers

    What is the main area of the body affected by Pneumocystis infection?

    <p>The lungs.</p> Signup and view all the answers

    How does Pneumocystis pneumonia manifest in tissue sections?

    <p>It shows foamy acellular exudate filled with cysts.</p> Signup and view all the answers

    What type of pneumonia is associated with Pneumocystis in immunocompromised individuals?

    <p>Pneumocystis pneumonia.</p> Signup and view all the answers

    What staining technique is mentioned for visualizing Pneumocystis cysts?

    <p>Silver stain.</p> Signup and view all the answers

    Which forms are demonstrated by C. albicans in tissue sections?

    <p>Yeast-like forms, pseudohyphae, and true hyphae.</p> Signup and view all the answers

    How is the development of invasive Pneumocystis disease related to immunocompromised states?

    <p>Immunocompromised individuals are more prone to developing invasive disease.</p> Signup and view all the answers

    What critical histological feature may indicate a Pneumocystis infection?

    <p>Presence of characteristic foamy acellular exudate.</p> Signup and view all the answers

    Describe the potential health risks associated with inhaling fungal spores from bird droppings, especially focusing on the context of the provided text.

    <p>Inhaling fungal spores from bird droppings can lead to various respiratory complications, including allergic reactions, asthma exacerbations, and even severe infections. The text highlights the potential for these spores to cause &quot;acute respiratory distress syndrome,&quot; a serious condition characterized by inflammation and fluid buildup in the lungs. Additionally, these spores can contribute to the growth of harmful bacteria, such as <em>Staphylococcus aureus</em>, which can further worsen respiratory issues.</p> Signup and view all the answers

    In which patient population is Pneumocystis pneumonia particularly problematic?

    <p>Patients with compromised immune systems, such as those with AIDS.</p> Signup and view all the answers

    The text describes a specific geographic region known for its high incidence of coccidioidomycosis. What is this region and what is the common name for the disease there?

    <p>The San Joaquin Valley in California is known for its high incidence of coccidioidomycosis. This region is known for having high rates of the disease, leading to a nickname of “Valley Fever” for coccidioidomycosis in the area.</p> Signup and view all the answers

    Explain how the text suggests the spread of coccidioidomycosis.

    <p>The text indicates that coccidioidomycosis is more common in certain regions but can spread through outbreaks, or 'epidemics,' when conditions are favorable. This suggests that the fungus that causes the disease, <em>Coccidioides immitis</em>, is typically present in the environment but requires specific conditions for its spores to become airborne and cause infection.</p> Signup and view all the answers

    What is the significance of the term "recombination of RNA" in the context of the text?

    <p>The text mentions &quot;recombination of RNA&quot; in the context of influenza viruses. This process allows influenza viruses to evolve and change rapidly, generating new strains with different properties, making it difficult to develop effective long-term vaccines and treatments.</p> Signup and view all the answers

    Based on the text, what are some of the ways coccidioidomycosis can affect the respiratory system?

    <p>The text describes coccidioidomycosis as potentially causing &quot;acute respiratory distress syndrome&quot; (ARDS), which is a severe form of lung injury. Additionally, the text mentions that infections can be complicated by &quot;superimposed bacterial pneumonia,&quot; suggesting that coccidioidomycosis can weaken the respiratory system, making it more vulnerable to bacterial infections.</p> Signup and view all the answers

    What does the text imply about the prevalence of coccidioidomycosis compared to other infectious diseases?

    <p>The text suggests that while coccidioidomycosis is endemic in specific regions, it is not as widespread as &quot;epidemics&quot; of other infectious diseases. This implies that it is less contagious and may require specific environmental conditions for its spread.</p> Signup and view all the answers

    Describe the significance of Staphylococcus aureus in the context of coccidioidomycosis.

    <p>The text mentions <em>Staphylococcus aureus</em> as a potential complication of coccidioidomycosis. The presence of this bacterium in the respiratory system can lead to &quot;superimposed bacterial pneumonia&quot;, worsening the condition and increasing the risk of severe respiratory distress.</p> Signup and view all the answers

    What is the connection between the San Joaquin Valley and the term "Valley Fever"?

    <p>The San Joaquin Valley is a region known for its high incidence of coccidioidomycosis, a fungal infection. Due to its prevalence in the valley, coccidioidomycosis is commonly referred to as &quot;Valley Fever&quot; in this region.</p> Signup and view all the answers

    Opportunistic microbes do not cause disease in ______ individuals, but may cause serious infections in those whose immune systems are suppressed.

    <p>healthy</p> Signup and view all the answers

    Opportunistic ______ include cytomegalovirus and certain fungi, which are discussed further below.

    <p>pulmonary</p> Signup and view all the answers

    The diagnosis should be considered in any immunocompromised individual with ______ infiltrates.

    <p>pulmonary</p> Signup and view all the answers

    On ______ stain (common candy exudate) (Fig. 10.16A).

    <p>H&amp;E</p> Signup and view all the answers

    Severe staining of ______ sections reveals round or cup-shaped cysts (4 to 10 μm in diameter) within the alveolar exudates (Fig. 10.16B).

    <p>tissue</p> Signup and view all the answers

    Opportunistic pulmonary pathogens include cytomegalovirus and certain ______.

    <p>fungi</p> Signup and view all the answers

    Severe staining of tissue sections reveals round or cup-shaped cysts (4 to 10 μm in diameter) within the ______ exudates (Fig. 10.16B).

    <p>alveolar</p> Signup and view all the answers

    The diagnosis should be considered in any immunocompromised individual with pulmonary ______.

    <p>infiltrates</p> Signup and view all the answers

    Systemic dissemination, especially to the ______, is a common complication of lung cancer.

    <p>brain</p> Signup and view all the answers

    The morphology of ______ infections can vary.

    <p>fungal</p> Signup and view all the answers

    Candida organisms have ______ and budding yeasts.

    <p>pseudohyphae</p> Signup and view all the answers

    Invasive aspergillosis is a serious fungal infection that can affect the ______ in immunocompromised individuals.

    <p>lungs</p> Signup and view all the answers

    Gomori methenamine–silver (GMS) stain shows septate hyphae with acute-angle branching, consistent with ______.

    <p>Aspergillus</p> Signup and view all the answers

    Cryptococcosis of the lung can occur in patients with ______.

    <p>AIDS</p> Signup and view all the answers

    Cryptococcus organisms are somewhat variable in ______.

    <p>size</p> Signup and view all the answers

    Squamous cell carcinomas often undergo central ______, giving rise to cavitation.

    <p>necrosis</p> Signup and view all the answers

    Per-pulp checkpoint inhibitors produce responses in some ______, particularly era-related tumors.

    <p>humors</p> Signup and view all the answers

    [Blank] carcinogen-induced mutations create more tumor neoantigens.

    <p>Carcinogen</p> Signup and view all the answers

    Pulmonary carcinoids are characterized by ______ symptoms, and are often discovered incidentally.

    <p>asymptomatic</p> Signup and view all the answers

    Carcinogen-induced mutations are characterized by ______ attacks on DNA, and cyano-.

    <p>intermen</p> Signup and view all the answers

    Surgery is often not an option for pulmonary carcinoids because they ______ spread before diagnosis.

    <p>invariably</p> Signup and view all the answers

    The prognosis for pulmonary carcinoids is ______ because they often spread before diagnosis.

    <p>poor</p> Signup and view all the answers

    Pulmonary carcinoids are often diagnosed at an advanced stage because they ______ before diagnosis.

    <p>invariably spread</p> Signup and view all the answers

    The 5- and 10-year survival rates for pulmonary carcinoids are ______.

    <p>reported</p> Signup and view all the answers

    Bronchiolar carcinoids occur in young adults (mean _____ years)

    <p>40</p> Signup and view all the answers

    Bronchiolar carcinoids represent about _____% of all pulmonary neoplasms.

    <p>5</p> Signup and view all the answers

    The primary site of origin for bronchiolar carcinoids is in the main _____ .

    <p>bronchus</p> Signup and view all the answers

    Areas of _____ are noted in 5% to 15% of carcinoids.

    <p>necrosis</p> Signup and view all the answers

    The _____ effect relates to encrustation by DNA from necrotic tumor cells.

    <p>Azzopardi</p> Signup and view all the answers

    Carcinoids can appear as an obstructing polypoid, spherical, intra-____ mass.

    <p>luminal</p> Signup and view all the answers

    The peripheral tissue where carcinoids may extend is referred to as _____ tissue.

    <p>peribranchial</p> Signup and view all the answers

    Small cell carcinoma is characterized by small deeply _____ cells.

    <p>basophilic</p> Signup and view all the answers

    Following normal oral cavity, gas tron es na l, and vag na l n ection, the v rus remains hidden w ith in the leukocy tes, the major reser-

    <p>Cand</p> Signup and view all the answers

    Cand d as s can n volve the mucous membranes, sk n, and deep organs

    <p>invade</p> Signup and view all the answers

    Super i cal in fection on muc osa sur faces of the ora l cav ity

    <p>ficial</p> Signup and view all the answers

    CMV n fection may be re ac tiv ated or, less common ly, pr imary

    <p>primary</p> Signup and view all the answers

    W hen T - c ell im munity is su p p res sed

    <p>suppressed</p> Signup and view all the answers

    H ema to po ie tic stem cells and pa ti ents w ith AIDS

    <p>transplant</p> Signup and view all the answers

    CMV in fection may be re ac tiv ated or, less common ly, pr imary CMV

    <p>infection</p> Signup and view all the answers

    Match the following types of lung cancer with their characteristics:

    <p>Squamous cell carcinoma = Often undergoes central necrosis, giving rise to cavitation Adenocarcinoma = Most commonly associated with smoking Small cell carcinoma = May cause tumors that differ from Cryptococcus species in behavior and treatment Bronchiolar carcinoma = Often diagnosed at an advanced stage</p> Signup and view all the answers

    Match the following organisms with their modes of acquisition:

    <p>Cryptococcus species = Acquired through aerosolized bird droppings CMV = Acquired through vertical transmission during pregnancy Asbestos = Acquired through inhalation of contaminated air Fungal species = Acquired through skin contact with contaminated soil</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Granuloma = A type of immune response characterized by the formation of granules Immune response = The body's natural defense against pathogens Carcinogen-induced mutations = Mutations caused by exposure to carcinogenic substances Adeno-carcinoma = A type of lung cancer characterized by glandular structures</p> Signup and view all the answers

    Match the following statements with their corresponding types of lung cancer:

    <p>Associated with smoking = Adenocarcinoma Often diagnosed at an advanced stage = Bronchiolar carcinoma May cause tumors that differ from Cryptococcus species in behavior and treatment = Small cell carcinoma Characterized by glandular structures = Adeno-carcinoma</p> Signup and view all the answers

    Match the following immune responses with their corresponding characteristics:

    <p>Immunodeficent response = Characterized by minimal immune response Reactive immune response = Characterized by a strong immune response Granulomatous response = Characterized by the formation of granulomas Humoral response = Characterized by the production of antibodies</p> Signup and view all the answers

    Match the following terms with their corresponding meanings:

    <p>Pseudohyphae = A type of fungal structure Budding yeast = A type of fungal reproduction Coar-button lesion = A type of histological feature of bronchiolar carcinoids Azzopardi effect = A type of diagnostic cue for fungal infections</p> Signup and view all the answers

    Match the following lung cancer types with their primary sites of origin:

    <p>Bronchiolar carcinoma = Lung parenchyma Adenocarcinoma = Alveolar epithelium Small cell carcinoma = Neuroendocrine cells Squamous cell carcinoma = Bronchial epithelium</p> Signup and view all the answers

    Match the following statements with their corresponding types of lung cancer:

    <p>Characterized by central necrosis and cavitation = Squamous cell carcinoma Often associated with Cryptococcus species = Small cell carcinoma Typically diagnosed in the early stages = Bronchiolar carcinoma Strongly associated with smoking = Adenocarcinoma</p> Signup and view all the answers

    Match the following types of lung cancer with their associated characteristics:

    <p>Small cell lung cancer = Often associated with paraneoplastic syndromes Mesothelioma = Strongly linked to asbestos exposure Pulmonary carcinoids = Can be associated with the 'Azzopardi effect' Bronchiolar carcinoids = May exhibit 'coar-button lesions'</p> Signup and view all the answers

    Match the following types of lung cancer with their characteristics:

    <p>Mucormycosis = A type of invasive fungal infection Bronchiolar carcinoids = A type of non-small cell carcinoma Aspergillosis = A type of fungal infection that is a risk factor for lung cancer Small cell carcinoma = A type of lung cancer that is often diagnosed at an advanced stage</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Carcinogen-induced mutations = A type of mutation that is caused by exposure to carcinogens Cavitary lesions = A type of lesion that forms cavities in the lung Checkpoint inhibitors = A type of treatment that targets genetic mutations Pseudohyphae = A type of diagnostic cue for fungal infections</p> Signup and view all the answers

    Match the following risk factors with their effects on lung cancer:

    <p>Smoking = Increases the risk of developing lung cancer Asbestos exposure = Increases the risk of developing lung cancer Passive smoking = Has no effect on the risk of developing lung cancer Fungal infections = Decreases the risk of developing lung cancer</p> Signup and view all the answers

    Match the following types of infections with their effects on the lung:

    <p>Cryptococcus species = Can cause tumors that differ from small cell carcinomas in their behavior and treatment Aspergillosis = Can cause invasive infections in the lung Mucormycosis = Can cause fungal pneumonia CMV infection = Can cause esophagitis in patients with compromised immune systems</p> Signup and view all the answers

    Match the following types of lung cancer with their histological features:

    <p>Bronchiolar carcinoids = Often have a 'budding yeast' appearance Small cell carcinoma = Often have a 'salt and pepper' appearance Non-small cell carcinoma = Often have a 'coar-button lesion' appearance Squamous cell carcinoma = Often undergo central necrosis, giving rise to cavitation</p> Signup and view all the answers

    Match the following terms with their associations with lung cancer:

    <p>Genetic mutations = Are a risk factor for lung cancer Immune response = Is altered in individuals with lung cancer Smoking = Is a primary risk factor for lung cancer Fungal infections = Are a rare complication of lung cancer</p> Signup and view all the answers

    Match the following types of diagnostic techniques with their uses in lung cancer diagnosis:

    <p>PCR assay-based detection of CMV DNA = Is a common diagnostic method for CMV infection Culturing the virus = Is a method of diagnosing CMV infection Staining techniques = Are used to visualize organisms in lung carcinoma Routine staining = Is a technique used to diagnose fungal infections</p> Signup and view all the answers

    Match the following types of lung cancer with their prognoses:

    <p>Pulmonary carcinoids = Have a good prognosis Small cell carcinoma = Have a poor prognosis Non-small cell carcinoma = Have a variable prognosis Squamous cell carcinoma = Have a poor prognosis</p> Signup and view all the answers

    Match the fungal species with their corresponding characteristics based on the provided information.

    <p>Histoplasma capsulatum = Fills phagocytes in a lymph node of a patient with disseminated histoplasmosis Coccidioidomycosis = Intact spherules within multinucleated giant cells Blastomycosis = Rounded budding yeasts, larger than neutrophils with a thick wall and nuclei Cryptococcus neoformans = A common cause of lung cancer, often presenting as a 'granuloma' in the lungs</p> Signup and view all the answers

    Match the histological features with their corresponding fungal species based on the provided information.

    <p>Broad-based budding = Blastomyces immitis Yeast forms filling phagocytes = Histoplasma capsulatum Intact spherules = Coccidioidomycosis Capsule = Cryptococcus neoformans</p> Signup and view all the answers

    Match the clinical manifestations with their corresponding fungal species based on the provided information.

    <p>Disseminated histoplasmosis = Histoplasma capsulatum Coccidioidomycosis with intact spherules = Coccidioidomycosis Blastomycosis with rounded budding yeasts = Blastomycosis Lung cancer with 'granulomas', often caused by a capsule-forming fungus = Cryptococcus neoformans</p> Signup and view all the answers

    Match the staining techniques with their corresponding descriptions based on the provided information.

    <p>Silver stain = Highlights the broad-based budding seen in Blastomyces immitis Gram stain = Not specifically mentioned in the context of the provided information Acid-fast stain = Not specifically mentioned in the context of the provided information Giemsa stain = Not specifically mentioned in the context of the provided information</p> Signup and view all the answers

    Match the clinical presentations with their corresponding fungal species based on the provided information.

    <p>Disseminated histoplasmosis = Histoplasma capsulatum Coccidioidomycosis with spherules = Coccidioidomycosis Blastomycosis with budding yeasts = Blastomycosis Lung cancer with 'granulomas', often caused by a capsule-forming fungus = Cryptococcus neoformans</p> Signup and view all the answers

    Match the characteristics with their corresponding fungal species based on the provided information.

    <p>Yeast forms = Histoplasma capsulatum Spherules = Coccidioidomycosis Capsule = Cryptococcus neoformans Broad-based budding = Blastomyces immitis</p> Signup and view all the answers

    Match the clinical features with their corresponding fungal species based on the provided information.

    <p>Disseminated infection = Histoplasma capsulatum Pulmonary infection = Histoplasma capsulatum Granuloma formation = Histoplasma capsulatum Lung cancer = Cryptococcus neoformans</p> Signup and view all the answers

    Match the fungal species with their corresponding clinical presentations based on the provided information.

    <p>Histoplasma capsulatum = Disseminated histoplasmosis Coccidioidomycosis = Coccidioidomycosis with spherules Blastomycosis = Blastomycosis with budding yeasts Cryptococcus neoformans = Lung cancer with granulomas</p> Signup and view all the answers

    Match the following conditions with their associated features:

    <p>Diabetes = Comorbidity with lung disease Immunosuppression = Increased risk of severe infections Fungal infections = Common in patients with weak immune systems Neurological disorders = Associated with increased risk for specific lung diseases</p> Signup and view all the answers

    Match the following fungal forms with their characteristics:

    <p>H. capsulatum = Round to oval, small yeast forms measuring 2 to 5 μm C. immitis = Thick-walled, nonbudding spores measuring 20 to 60 μm A. fumigatus = Filamentous fungus with conidiophore structure Z. species = Associated with rapid growth and opportunistic infections</p> Signup and view all the answers

    Match the following treatment strategies with their roles:

    <p>Supportive care = Primary approach for managing complications Antifungal therapy = Used in cases of confirmed fungal infections Immunotherapy = Targets immune response for treatment Surgical intervention = Indicated for localized lung lesions</p> Signup and view all the answers

    Match the following diagnostic methods with their applicable conditions:

    <p>Culturing = Used for diagnosing viral infections like CMV PCR Assay = Detects specific DNA sequences in infections Histopathology = Identifies tumor characteristics in lung cancer Radiology = Visualizes lung structures and potential lesions</p> Signup and view all the answers

    Match the following pathogens with the diseases they cause:

    <p>C. neoformans = Cryptococcosis M. tuberculosis = Tuberculosis P. jirovecii = Pneumocystis pneumonia H. capsulatum = Histoplasmosis</p> Signup and view all the answers

    Match the following symptoms with the corresponding associated conditions:

    <p>Cough = Common in respiratory infections and lung diseases Hemoptysis = Usually indicates serious pulmonary issues Fever = A systemic response often accompanying infections Weight loss = Often seen in chronic illnesses including cancers</p> Signup and view all the answers

    Match the following clinical features with their classifications:

    <p>Thick-walled lesions = Associated with chronic fungal infections Granulomatous inflammation = Often a response to persistent infections Cavitary lesions = Typical in specific types of lung malignancies Ground-glass opacities = Indicate interstitial lung disease or infection</p> Signup and view all the answers

    Match the following risk factors with their associated outcomes:

    <p>Smoking = Increases lung cancer probability Immunosuppression = Raises chances of opportunistic infections Diabetes prevalence = Can exacerbate respiratory conditions Age above 65 = Higher incidence of lung-related diseases</p> Signup and view all the answers

    Study Notes

    Lung Carcinoma Overview

    • Lung carcinoma is a leading type of cancer and a major cause of cancer-related deaths.
    • Pseudohyphae serve as an important diagnostic clue for certain lung conditions.

    Primary Causes

    • The primary cause is exposure to carcinogens in tobacco smoke.
    • Other carcinogenic exposures include asbestos, radiation (especially in uranium miners), and inhalation of contaminated dust containing arsenic and chromium.

    Lung Cancer Statistics

    • In 2019, approximately 228,820 new cases of lung cancer were reported, with 135,720 deaths.
    • Adenocarcinoma is the most common subtype of lung cancer.
    • Squamous cell carcinoma and small cell carcinoma are also prevalent but have a distinct progression.

    Risk Factors

    • Smoking dramatically increases lung cancer risk; asbestos exposure elevates risk five-fold.
    • Smokers exposed to asbestos have a risk of developing lung cancer that is approximately 55-times greater.
    • Nonsmokers exposed to various carcinogens also face significant risks.

    Tumor Characteristics

    • Lung tumors can spread to other sites, particularly the meninges.
    • Neuroendocrine tumors, including carcinoids, are relatively rare, making up about 5% of pulmonary neoplasms.

    Diagnosis and Treatment

    • Morphology of bronchoalveolar carcinoids includes polypoid or infiltrative masses that affect the bronchial wall.
    • Small cell carcinoma malignant cells are typically small, highly basophilic, and well-demarcated.
    • Treatment approaches for lung cancer include personalized therapies targeting specific genetic mutations, such as EGFR, ALK, ROS1, HER2, and c-MET.

    Notable Complications

    • Carcinoids can induce a syndrome characterized by gastrointestinal issues such as diarrhea and flushing, though this is rare.
    • Symptoms like coughing and difficulty breathing may be indicative of more advanced disease at diagnosis.

    Prognosis

    • Surgical resection is not a viable option for many patients due to the advanced stage of the disease at diagnosis.
    • Five- and ten-year survival rates vary widely based on cancer subtype, stage, and treatment approach.

    Chronic Cavitary Pulmonary Disease

    • Develops in vulnerable hosts with a tendency toward upper lobe involvement.
    • Resembles the secondary form of tuberculosis, leading to mass lesions resembling bronchogenic carcinoma.
    • Symptoms include cough, hemoptysis, dyspnea, and chest pain.

    Disseminated Disease

    • Particularly affects infants and immunocompromised adults, especially those with HIV.
    • Characterized by symptoms like severe ill health, hepatosplenomegaly, anemia, leukopenia, and thrombocytopenia.
    • More challenging to treat and can be fatal.

    Cytomegalovirus (CMV) Infection

    • Features distinct nuclear inclusions and multiple cytoplasmic inclusions in affected lung cells.
    • Opportunistic infections, including CMV, occur primarily in individuals with suppressed immune systems.
    • Diagnosis incorporates histological examination, viral culture, and PCR assay to detect CMV DNA.

    Opportunistic Microbes

    • Infect healthy individuals rarely but can cause severe disease in immunocompromised patients.
    • Lung pathogens include CMV and certain fungi, prevalent in patients with advanced immunosuppression.

    Cancer Risks

    • Individuals with chromosomal abnormalities from immunosuppression potentially develop malignancies.
    • Heavy smokers exhibit a significantly heightened risk (over 10-fold) of lung cancer associated with specific gene mutations.

    Tumor Characteristics

    • Squamous cell carcinomas often present near bronchi or lymph nodes, capable of necrosis and cavitation.
    • Bronchial carcinoids primarily occur in younger adults (average age 40) and constitute around 5% of pulmonary neoplasms.
    • Two morphological presentations include obstructive polypoid masses and infiltrative plaques penetrating bronchial walls.

    Histological Features

    • Tumors display basophilic staining and vascular wall changes, contributing to their demarcation.
    • Areas of necrosis are common in carcinoids, with evidence of metastasis identified in lymph nodes at diagnosis.

    Treatment Considerations

    • Close monitoring is essential for patients post-transplantation or those with underlying malignancies.
    • Careful consideration of the timing and type of therapeutic interventions is crucial given the propensity for secondary infections and cancer development.

    Infections and Respiratory Damage

    • Infections can cause respiratory distress syndrome and diffuse alveolar damage.
    • Warm, moist soils with droppings from bats and birds can harbor bacteria leading to pneumonia.
    • Superimposed infections complicate respiratory conditions, particularly from organisms like Staphylococcus aureus and Cryptococcus species.

    Coccidioidomycosis (Valley Fever)

    • Coccidioides infection is endemic in the southwestern United States, especially in California’s San Joaquin Valley.
    • Symptoms may include fever and respiratory issues.
    • The term "valley fever" refers to this condition, which can result from inhaling airborne spores.

    Opportunistic Infections

    • Opportunistic pathogens typically cause serious infections in immunocompromised individuals.
    • Healthy individuals generally do not get sick from these microbes.
    • Silver staining reveals round or cup-shaped cysts indicative of Pneumocystis pneumonia, which primarily affects lung tissue.

    Histological Characteristics

    • Histopathological examination reveals acellular exudates and cysts in lung tissue.
    • Cysts have a diameter of approximately 10 μm and present as foamy exudates in alveoli, critical for diagnosis.

    Lung Tumors

    • Lung tumors categorized under "non-small cell carcinoma" include squamous cell carcinoma and adenocarcinoma.
    • Adenocarcinoma is the most prevalent lung cancer and shows various differentiation patterns.
    • Smoking significantly increases lung cancer risk and is particularly associated with squamous cell carcinoma.

    Invasive Characteristics

    • Squamous and small cell carcinomas display different behaviors and treatment options compared to adenocarcinoma.
    • Early lung adenocarcinoma can grow along alveolar septae and may form invasive glandular structures.

    Diagnostic Indicators

    • Tumors may express thyroid transcription factor 1 (TTF-1), particularly in adenocarcinomas.
    • Histological presentations include keratinization in well-differentiated squamous cell carcinomas, providing critical information for diagnosis.

    Opportunistic Infections Overview

    • Opportunistic infections arise from microbes that do not typically harm healthy individuals but can cause serious disease in immunocompromised patients.
    • Affected populations include those undergoing organ transplants, individuals with AIDS, and patients on immunosuppressive therapy.

    Microbial Characteristics

    • Common pathogens include Cytomegalovirus (CMV), certain fungi such as Candida and Aspergillus.
    • Infections can involve various body sites, including mucous membranes, skin, and deep organs like the lungs.

    Diagnostic Indicators

    • Hematoxylin and eosin (H&E) staining reveals pink, foamy exudates in tissues indicative of opportunistic infections.
    • Silver staining shows round or cup-shaped cysts (approximately 10 μm in diameter) within alveolar exudates.

    Specific Conditions

    • Candidiasis can manifest as oral thrush or invasive candidiasis affecting deeper tissues and organs.
    • CMV infections can reactivate in immunocompromised patients and may lead to systemic dissemination, particularly affecting the brain.

    Pathogen Morphology

    • Fungal organisms appear as pseudohyphae and budding yeasts when stained, with invasive forms showing septate hyphae and acute-angle branching under Gomori methenamine-silver (GMS) stain.

    Pulmonary Carcinoids

    • Carcinoid tumors primarily affect the bronchus and are more common in young adults, accounting for approximately 5% of pulmonary neoplasms.
    • Tumors may present as obstructive polyps or infiltrating masses in lung tissue.

    Clinical Considerations

    • Opportunistic infections require heightened diagnostic consideration in patients with compromised immune systems.
    • Symptoms can vary widely, necessitating tailored clinical responses based on underlying health conditions and potential risk factors.

    Fungal Infections and Diseases

    • Histoplasma capsulatum: Yeast forms are small, measuring 2 to 5 μm in diameter; associated with disseminated histoplasmosis in immunocompromised patients.
    • Coccidioidomycosis: Features intact spherules within multinucleated giant cells; spherules range from 20 to 60 μm in diameter.
    • Blastomyces: Notable for rounded budding yeasts larger than neutrophils; characterized by thick walls and visible nuclei.
    • Common clinical manifestations include acute pulmonary infection, chronic granulomatous disease, or disseminated miliary disease resembling “flu-like” symptoms.

    Clinical Presentation

    • In immunocompromised patients: Granulomas are absent, leading to widespread dissemination of the infection with localized collections of macrophages containing yeast forms in multiple organs.
    • Symptoms of primary infections typically self-resolve.

    Cancer Associations and Risk Factors

    • Squamous Cell and Small Cell Carcinomas: Associated with smoking; small cell carcinoma has a strong tendency to disseminate to other sites, including the meninges.
    • Adenocarcinoma: Most common type of lung cancer, often presents in more reactive tissue environments.
    • Malignant Mesothelioma: Strongly linked to asbestos exposure; typically originates in the pleura, peritoneum, or pericardium.

    Paraneoplastic Syndromes

    • Occur in about 10% of lung cancer patients; hormonal disturbances due to tumor cell secretions may manifest as hypercalcemia.
    • Median Survival Rates: Lung cancer treatment leads to a median survival of 1 year, with only 5% of patients surviving beyond 10 years.

    Smoking and Lung Cancer

    • Smokers have increased risk of developing lung cancer, including invasive fungal infections like mucormycosis and aspergillosis.
    • Passive smoking also heightens risk due to proximity to cigarette smoke.

    Treatment and Management Considerations

    • Treatment typically requires supportive care and management of symptoms associated with fungal infections and malignancies.
    • Development of targeted therapies and advanced treatments is crucial due to rapid recurrence in cancer cases.

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