path: lung and pleural neoplasms

where are the 4 common locations lung carcinomas metastasize to?

adrenals, liver, brain, and bone

what tumor?

usually peripheral location

lung adenocarcinoma

what tumor?

KRAS mutation and EGFR mutation

lung adenocarcinoma

what tumor?

positive TTF-1 stain

lung adenocarcinoma

what tumor?

histology: irregular gland formations; finger-like tufted projections of micropapillary pattern

lung adenocarcinoma

What tumor?

small (<5 mm) precursor lesion; dysplastic pneumocytes lining mildly fibrotic alveolar walls

atypical adenomatous hyperplasia

what tumor?

also a precursor; composed entirely of dysplastic cells growing along preexisting alveolar septae

adenocarcinoma-in-situ

what tumor?

most common in men, close correlation with smoking

squamous cell carcinoma of the lung

what tumor?

usually found centrally in the lung obstructing the right main bronchus

squamous cell carcinoma of the lung

what tumor?

histology: keratinization an intracellular bridges, esp if well-differentiated (squamous pearls)

squamous cell carcinoma of the lung

what tumor?

most have p53 mutations

squamous cell carcinoma of the lung

What tumor?

associated with hypercalcemia due to elaboration of PTH-related peptide

squamous cell carcinoma of the lung

what tumor?

Cushing (hirsutism and moon facies), hilar mass, neuroendocrine granules

small cell carcinoma 

what tumor?

azzopardi effect: basophilic staining of vascular walls due to encrustation by DNA from necrotic tumor cells

small cell carcinoma 

What tumor?

very aggressive, highly malignant, and often metastasize 

small cell carcinoma 

What tumor?

neuroendocrine; dense-core neurosecretory granules can secrete hormones ectopically

small cell carcinoma 

what tumor?

positive chromogranin and synaptophysin staining 

small cell carcinoma 

what tumor?

p53 and RB1 tumor suppressor genes frequently mutated

small cell carcinoma 

what tumor?

histology: small blue cells with scant cytoplasm, absent or inconspicuous nucleoli, and finely granular nuclear chromatin

small cell carcinoma 

what tumor?

Cushing syndrome and SIADH (hyponatremia)

small cell carcinoma 

what are two syndromes of lung cancer? what are the most common symptoms of lung cancer?

cough, hemoptysis, chest pain, weight loss

SVC syndrome or Horner syndrome

what tumor?

low grade malignant neoplasm of neuroendocrine cells

hist: organoid, trabecular, palisading, or ribbon arrangement of cells separated by delicate fibrovascular stroma

can have diarrhea

“carcinoid” tumor of the lung

what tumor?

benign; “coin lesion”, usually peripheral and well-circumscribed

hamartoma

what tumor?

cannonball lesions

metastatic nodules

what is the most common site for metastatic neoplasms?

the lungs

pleural plaques are a common manifestation of ___

asbestos exposure

circumscribed plaques of dense collagen, often calcified leads you to think

asbestos exposure

ferruginous bodies are associated with ___

asbestos exposure

what tumor?

pleural effusion and pleural mass encasing the lung

malignant mesothelioma

a risk factor for malignant mesothelioma is

asbestos exposure

what tumor?

diffuse lesion which spreads over pleural surface and ensheaths the lung with thick tumor

malignant mesothelioma

What tumor?

can have epithelioid cuboidal, columnar or flattened cells forming tubular or papillary structures, sarcomatoid, or biphasic

malignant mesothelioma

what tumor?

deletion of chromosome 9p and CDKN2A

malignant mesothelioma

what tumor?

histology: high degree of glandular differentiation with the presence of mucin

adenocarcinoma