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

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Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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Page 1: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

Thorax / Lung

Basic Science Conference

12/21/2005

J.R. Nitzkorski

Page 2: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

Sponsored by Joe

Page 3: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 4: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 5: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 6: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 7: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

3. Lung cancer develops in what percentage of smokers

1. 20%

2. 40%

3. 60%

4. 80%

Page 8: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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%

Page 9: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 10: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 11: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

5. Name the subdivisions of non-small cell lung cancer (NSCLC):

1. _______________

2. _______________

3. _______________

Page 12: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

5. Name the subdivisions of non-small cell lung cancer (NSCLC):

1. Squamous cell

2. Adenocarcinoma

3. Large cell

Page 13: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 14: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 15: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 16: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 17: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 18: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 19: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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 _____%

Page 20: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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%

Page 21: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 22: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 23: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

• For reference:

Page 24: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski
Page 25: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 26: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

Page 27: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

1. ________________________

2. ________________________

Page 28: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

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

1. Granulomatous disease

2. Histoplasmosis

Page 29: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

13. The modality of choice to confirm FDG-PET positive mediastinal lymphadenopathy with a tissue diagnosis:

1. ________________________

Page 30: Thorax / Lung Basic Science Conference 12/21/2005 J.R. Nitzkorski

13. The modality of choice to confirm FDG-PET positive mediastinal lymphadenopathy with a tissue diagnosis:

1. Mediastinoscopy