thorax / lung basic science conference 12/21/2005 j.r. nitzkorski

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. Prostate cancer

2. Lung cancer

3. Colorectal cancer

4. Mesothelioma

5. Leukemia

1. The most common cause of cancer death (US) in men is:

1. Prostate cancer

2. Lung cancerLung 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. Breast cancer

2. Lung cancer

3. Colorectal cancer

4. Mesothelioma

5. Leukemia

2. The most common cause of cancer death (US) in women is:

1. Breast cancer

2. Lung cancerMore 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. 20%

2. 40%

3. 60%

4. 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. 80 SCLC : 20 NSCLC

2. 50 SCLC : 50 NSCLC

3. 20 SCLC : 80 NSCLC

4. 10 SCLC : 90 NSCLC

5. 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 NSCLCAlthough 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. Large cell

2. Adenocarcinoma

3. Squamous cell

4. Small cell

1. 31

2. 29

3. 18

4. 9

6. Match the histologic cell type with the correct frequency (%)

1. Large cell

2. Adenocarcinoma

3. Squamous cell

4. Small cell

1. 31

2. 29

3. 18

4. 9

7. Patient with a centrally located lung tumor is most likely to have a:

1. Adenocarcinoma

2. Squamous cell

3. Carcinoid

4. Large cell carcinoma

7. Patient with a centrally located lung tumor is most likely to have a:

1. Adenocarcinoma

2. Squamous cellSquamous 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, post-obstructive pneumonia

Diagnosis = bronchoscopy

3. Carcinoid

4. Large cell carcinoma

8. Patient with a peripherally located lung tumor is most likely to have a:

1. Adenocarcinoma

2. Squamous cell

3. Carcinoid

4. Large cell carcinoma

8. Patient with a peripherally located lung tumor is most likely to have a:

1. AdenocarcinomaAdenocarcinomas 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. Stage Ia and b

2. Stage IIa

3. Stage IIb

4. Stage IIIa

5. Stage IIIb

6. Stage IV

10. Surgery is generally the accepted treatment for NSCLC with the following stages (more than 1)

1. Stage Ia and b - surgery

2. Stage IIa - surgery

3. Stage IIb - surgery

4. 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 post-obsructive pneumonia may cause significant lymphadenopathy without metastasis

12. False-positive lymph node detection on FDG-PET scanning commonly results from:

1. ________________________

2. ________________________

12. False-positive lymph node detection on FDG-PET 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