Pulmonary Diseases Quiz
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Questions and Answers

Which immunohistochemical marker is most likely needed to confirm a diagnosis of squamous cell carcinoma in a poorly differentiated carcinoma showing strong CK5/6 staining and absence of TTF-1?

  • p40 (correct)
  • Chromogranin
  • Napsin A
  • CDX2
  • What histologic appearance is characterized by increased mitochondrial density and is associated with squamous cell carcinoma?

  • Papillary growth pattern
  • Signet-ring cell morphology
  • Oncocytoid appearance (correct)
  • Microcystic structure
  • In which biological process do mutations in KEAP1 and NFE2L2 primarily affect cellular function?

  • Apoptosis pathways
  • DNA repair mechanisms
  • Oxidative stress response (correct)
  • Cell cycle regulation
  • What distinguishes basaloid squamous cell carcinoma from other types of squamous cell carcinoma?

    <p>Focal staining for neuroendocrine markers</p> Signup and view all the answers

    Which of the following markers would be inappropriate to diagnose squamous cell carcinoma?

    <p>TTF-1</p> Signup and view all the answers

    What type of lung cancer is characterized by poorly differentiated carcinoma showing positive staining for CK5/6?

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

    Which marker presence helps to solidify a diagnosis of squamous cell carcinoma if CK5/6 is already positive?

    <p>p40</p> Signup and view all the answers

    What is the significance of the absence of TTF-1 in a lung biopsy of a 59-year-old male with a lung mass?

    <p>Indicates a diagnosis of squamous cell carcinoma</p> Signup and view all the answers

    Which condition is primarily characterized by shoulder pain that radiates down the arm in conjunction with a mass in the superior pulmonary sulcus?

    <p>Pancoast syndrome</p> Signup and view all the answers

    In the context of lung adenocarcinoma in a non-smoker woman, which factor is most significant in her cancer development?

    <p>Genetic predisposition</p> Signup and view all the answers

    What is the defining characteristic of Pancoast syndrome?

    <p>Shoulder pain radiating down the arm</p> Signup and view all the answers

    Which symptom is least expected to be a consequence of a Pancoast tumor?

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

    Among the risk factors for adenocarcinoma in non-smokers, which is considered a less significant contributor?

    <p>Chronic dust exposure</p> Signup and view all the answers

    Which of the following is a common misconception regarding lung cancer in non-smokers?

    <p>Lung cancer cannot occur in non-smokers</p> Signup and view all the answers

    What is commonly associated with Horner syndrome in patients with a lung mass?

    <p>Pancoast tumor leading to sympathetic chain involvement</p> Signup and view all the answers

    Which risk factor is often attributed to lung adenocarcinoma development in Asian women?

    <p>Genetic predisposition</p> Signup and view all the answers

    What histological characteristics suggest the presence of adenosquamous carcinoma in a lung tumor?

    <p>Both squamous and glandular components are above 10%</p> Signup and view all the answers

    In what situation would a lung tumor be classified as adenocarcinoma rather than adenosquamous carcinoma?

    <p>When the squamous component comprises less than 10%</p> Signup and view all the answers

    What is the most significant associated feature of adenosquamous carcinoma based on its growth location?

    <p>Association with lung scarring</p> Signup and view all the answers

    What key diagnostic feature would point towards squamous cell carcinoma in a lung biopsy?

    <p>Presence of spindle-shaped cells</p> Signup and view all the answers

    Which tumor type is characterized by an even distribution of both squamous and glandular components without significant necrosis?

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

    If a lung tumor shows a predominance of glandular features with minimal squamous differentiation, which classification is most appropriate?

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

    What immunohistochemical marker would most likely be positive in a diagnosis of squamous cell carcinoma?

    <p>p63</p> Signup and view all the answers

    In which lung cancer subtype is necrosis most commonly associated?

    <p>Large cell carcinoma</p> Signup and view all the answers

    What histological feature is primarily used to differentiate large cell neuroendocrine carcinoma from small cell carcinoma?

    <p>Presence of prominent nucleoli</p> Signup and view all the answers

    Which immunohistochemical marker is commonly positive in small cell carcinoma despite negative chromogranin expression?

    <p>CD56</p> Signup and view all the answers

    In the context of lung tumors, which feature is most indicative of small cell carcinoma?

    <p>Extensive nuclear molding of small cells</p> Signup and view all the answers

    What is the significance of a high Ki-67 index in a tumor biopsy of a lung mass?

    <p>Reflects high cellular proliferation</p> Signup and view all the answers

    Which of the following is NOT a characteristic feature of large cell neuroendocrine carcinoma?

    <p>Small round cells</p> Signup and view all the answers

    What kind of tumor typically exhibits positivity for TTF-1 along with small cells?

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

    Which tumor is most likely associated with a smoking history in patients?

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

    In the diagonsis of lung masses, which combination of features is most suggestive of an atypical carcinoid tumor?

    <p>Positive chromogranin and moderate mitotic activity</p> Signup and view all the answers

    Which lung segment is typically affected in congenital cystic adenomatoid malformation (CCAM)?

    <p>One of the upper lobes or the right middle lobe</p> Signup and view all the answers

    Which feature is a key characteristic of a large cystic congenital cystic adenomatoid malformation (CCAM)?

    <p>Multilocular cystic spaces</p> Signup and view all the answers

    How is placental transmogrification visually characterized in emphysematous bullae?

    <p>Cystic spaces resembling the structure of chorionic villi</p> Signup and view all the answers

    Which congenital cystic lung condition has a strong association with later development of mucinous adenocarcinoma?

    <p>Congenital cystic adenomatoid malformation (CCAM)</p> Signup and view all the answers

    What distinguishes pulmonary sequestration from other congenital lung abnormalities?

    <p>Abnormal lung tissue with its own blood supply disconnected from the bronchial tree</p> Signup and view all the answers

    In which scenario is ciliated respiratory epithelium most likely found?

    <p>Bronchogenic cyst</p> Signup and view all the answers

    Which is the least likely feature seen in a large cystic congenital cystic adenomatoid malformation (CCAM)?

    <p>Destruction of alveolar walls</p> Signup and view all the answers

    What is a common histological finding in pulmonary sequestration?

    <p>Cystic spaces lined by ciliated epithelium</p> Signup and view all the answers

    Study Notes

    Lung Tumors and Carcinomas

    • A 70-year-old male with smoking history and asbestos exposure presenting with weight loss, chronic cough, and hemoptysis likely indicates a Pancoast tumor; associated with Pancoast syndrome featuring shoulder pain radiating to the arm.
    • A 45-year-old non-smoking woman diagnosed with adenocarcinoma may have developed cancer due to genetic predisposition, especially prevalent in women and Asian populations.
    • Basaloid squamous cell carcinoma is a poorly differentiated variant that shows focal neuroendocrine marker staining but remains predominantly p63 positive, supporting its diagnosis.
    • A 59-year-old male with a lung mass showing strong CK5/6 and negative TTF-1 staining suggests squamous cell carcinoma; confirmation is achieved with p40 positivity.
    • Oncocytoid appearance in tumors, marked by increased mitochondrial density, is often associated with squamous cell carcinoma, supported by CK5/6 and p63 positivity.
    • Genetic mutations in KEAP1 and NFE2L2 in a squamous cell carcinoma patient affect the oxidative stress response, indicating a potential mechanism for tumor development.
    • Biopsy showing high mitotic activity, necrosis, and positivity for synaptophysin and CD56 (without chromogranin) is indicative of small cell carcinoma.
    • Small cell carcinoma is identified by small, round cells exhibiting nuclear molding, strong TTF-1 positivity, and necrotic features.
    • A peripheral lung mass biopsy revealing prominent nucleoli, abundant cytoplasm, and neuroendocrine growth pattern alongside high Ki-67 index confirms neuroendocrine carcinoma diagnosis.
    • Adenosquamous carcinoma is characterized by simultaneous squamous and glandular components each accounting for at least 10% of the tumor; location and histological presentation guide classification.
    • Classification based on histological components dictates that a tumor with less than 10% squamous differentiation is classified as adenocarcinoma.
    • Adenosquamous carcinoma, especially when peripheral, is frequently associated with lung scarring.
    • In a patient with a large necrotic lung mass and spindle-shaped cells alongside giant cells, pankeratin and p63 positivity leads to a diagnosis of squamous cell carcinoma.

    Congenital Cystic Lung Diseases

    • Large cystic congenital cystic adenomatoid malformation (CCAM) is least likely to involve destruction of alveolar walls compared to other characteristics like multilocular cystic spaces.
    • Placental transmogrification, seen in emphysematous bullae, is characterized by cystic spaces resembling chorionic villi structure.
    • Congenital cystic adenomatoid malformation (CCAM) is notably linked to the later development of mucinous adenocarcinoma.
    • Pulmonary sequestration features abnormal lung tissue with its own blood supply, independent from the bronchial tree, distinguishing it from typical lung tissue pathology.

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    Description

    This quiz focuses on the presentation and associated findings of pulmonary diseases, particularly in older males with a history of smoking and asbestos exposure. Evaluate your understanding of conditions like Horner syndrome and Pancoast syndrome related to chest masses.

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