Transcript Lung cancer

Thorax / Lung
Basic Science Conference
12/21/2005
J.R. Nitzkorski
Sponsored by Joe
1. The most common cause of cancer death (US)
in men is:
1.
2.
3.
4.
5.
Prostate cancer
Lung cancer
Colorectal cancer
Mesothelioma
Leukemia
1. The most common cause of cancer death (US)
in men is:
1. Prostate cancer
2. Lung cancer
Lung cancer death rate vastly surpasses that of
other cancers in men, however reached a peak
in 1990 and is trending downward
3. Colorectal cancer
4. Mesothelioma
5. Leukemia
2. The most common cause of cancer death (US)
in women is:
1.
2.
3.
4.
5.
Breast cancer
Lung cancer
Colorectal cancer
Mesothelioma
Leukemia
2. The most common cause of cancer death (US)
in women is:
1. Breast cancer
2. Lung cancer
More women die from lung cancer than
breast cancer, although breast cancer is more
common than lung cancer. Heart disease
remains the number one overall cause of
death.
3. Colorectal cancer
4. Mesothelioma
5. Leukemia
3. Lung cancer develops in what percentage of
smokers
1.
2.
3.
4.
20%
40%
60%
80%
3. Lung cancer develops in what percentage of
smokers
1. 20%
It also develops in some people with no exposure
to cigarettes/occupational exposure, suggesting
a genetic predisposition (especially in those less
than 50)
2. 40%
3. 60%
4. 80%
4. The correct distribution of small cell lung cancer
(SCLC) to non-small cell lung cancer (NSCLC) is
1.
2.
3.
4.
5.
80 SCLC : 20 NSCLC
50 SCLC : 50 NSCLC
20 SCLC : 80 NSCLC
10 SCLC : 90 NSCLC
2 SCLC : 98 NSCLC
4. The correct distribution of small cell lung cancer
(SCLC) and non-small cell lung cancer (NSCLC) is
1. 80 SCLC : 20 NSCLC
2. 50 SCLC : 50 NSCLC
3. 20 SCLC : 80 NSCLC
Although these represent two different histologic
and clinical entities, some tumors have admixtures
of cell types, suggesting a possible common origin
for all lung cancers
4. 10 SCLC : 90 NSCLC
5. 2 SCLC : 98 NSCLC
5. Name the subdivisions of non-small cell lung
cancer (NSCLC):
1. _______________
2. _______________
3. _______________
5. Name the subdivisions of non-small cell lung
cancer (NSCLC):
1. Squamous cell
2. Adenocarcinoma
3. Large cell
6. Match the histologic cell type with the correct
frequency (%)
1.
2.
3.
4.
Large cell
Adenocarcinoma
Squamous cell
Small cell
1.
2.
3.
4.
31
29
18
9
6. Match the histologic cell type with the correct
frequency (%)
1.
2.
3.
4.
Large cell
Adenocarcinoma
Squamous cell
Small cell
1.
2.
3.
4.
31
29
18
9
7. Patient with a centrally located lung tumor is
most likely to have a:
1.
2.
3.
4.
Adenocarcinoma
Squamous cell
Carcinoid
Large cell carcinoma
7. Patient with a centrally located lung tumor is
most likely to have a:
1. Adenocarcinoma
2. Squamous cell
Squamous cell carcinomas usually arise from the
main, lobar, or segmental bronchi, however 1/3 can
occur in the small bronchi of lung tissue.
Symptoms = hemoptysis, atelectasis, postobstructive pneumonia
Diagnosis = bronchoscopy
3. Carcinoid
4. Large cell carcinoma
8. Patient with a peripherally located lung tumor is
most likely to have a:
1.
2.
3.
4.
Adenocarcinoma
Squamous cell
Carcinoid
Large cell carcinoma
8. Patient with a peripherally located lung tumor is
most likely to have a:
1. Adenocarcinoma
Adenocarcinomas usually arise peripherally within
the pulmonary parenchyma.
Symptoms = pain related to invasion of chest wall,
spine, brachial plexus.
Diagnosis = percutaneous
2. Squamous cell
3. Carcinoid
4. Large cell carcinoma
9. Regarding NSCLC, the percentage of patients
who present with disseminated disease is _____%
Of those without disseminated disease, the
percentage of patients who present with locally
advanced / unresectable cancer is _____%
9. Regarding NSCLC, the percentage of patients
who present with disseminated disease is 50%
Of those without disseminated disease, the
percentage of patients who present with locally
advanced / unresectable cancer is 20%
10. Surgery is generally the accepted treatment
for NSCLC with the following stages (more than 1)
1.
2.
3.
4.
5.
6.
Stage Ia and b
Stage IIa
Stage IIb
Stage IIIa
Stage IIIb
Stage IV
10. Surgery is generally the accepted treatment
for NSCLC with the following stages (more than 1)
1.
2.
3.
4.
Stage Ia and b - surgery
Stage IIa - surgery
Stage IIb - surgery
Stage IIIa – surgery, usually after
chemo/xrt
5. Stage IIIb – chemo/xrt, poss surgery
after chemo/xrt
6. Stage IV - chemo
• For
reference:
11. On CT, a lymph node _____ cm or less is
usually considered to be benign, whereas a lymph
node greater than _____ cm is usually considered
to be malignant
11. On CT, a lymph node 1.0 cm or less is usually
considered to be benign, whereas a lymph node
greater than 1.5 cm is usually considered to be
malignant**
**Co-morbid pulmonary disease and/or postobsructive pneumonia may cause significant
lymphadenopathy without metastasis
12. False-positive lymph node detection on FDGPET scanning commonly results from:
1. ________________________
2. ________________________
12. False-positive lymph node detection on FDGPET scanning commonly results from:
1. Granulomatous disease
2. Histoplasmosis
13. The modality of choice to confirm FDG-PET
positive mediastinal lymphadenopathy with a
tissue diagnosis:
1. ________________________
13. The modality of choice to confirm FDG-PET
positive mediastinal lymphadenopathy with a
tissue diagnosis:
1. Mediastinoscopy