Lung Tumours
*Note: asbestos is the odd one out — lower lobes, and the only one strongly linked to mesothelioma (a pleural tumour, not a lung tumour).
LUNG TUMOURS
- Lung cancers account for 90–95% of lung tumours. Lung cancer is the leading cause of cancer death worldwide.
- Risk factors: Smoking (80% of cases), asbestos exposure, radiation, radon gas, industrial carcinogens.
Read this in Endocrine & Renal Pathology — Must Know Notes — Notes
LUNG TUMOURS
- Lung cancer = 1 cause of cancer death worldwide. 90–95% carcinomas. Risk factors: smoking ( 1, 80%), asbestos, radon, ionising radiation.
Read this in Endocrine & Renal Pathology — Notes
What our notes say
- *Note: asbestos is the odd one out — lower lobes, and the only one strongly linked to mesothelioma (a pleural tumour, not a lung tumour). (Essential Cardiovascular Pathology: Atherosclerosis to Endoc — Notes)
- Lung Tumours: Adenocarcinoma, squamous cell carcinoma, and small cell carcinoma are the main types, strongly associated with smoking. (Endocrine & Renal Pathology — Notes)
- Figure 9.7.\nBiopsy and histopathology: Central lung tumours can be biopsied (Davidson's Essentials of Medicine - 2nd)
- lung tumours, it carries a good prognosis (95% 5-yr survival with (Davidson's Essentials of Medicine - 2nd)
- Discuss the aetiopathogenesis, classification and pathology of lung tumours. (Systemic Pathology Essay Bank — Advanced Archive)
- Classify lung tumours and discuss bronchogenic carcinoma. (Systemic Pathology Essay Bank — Advanced Archive)
Study material on Lung Tumours
- Endocrine & Renal Pathology — Must Know Notes — Notes
- Davidson's Essentials of Medicine - 2nd
- Systemic Pathology Essay Bank — Advanced Archive
- Endocrine & Renal Pathology — Notes
- Lung Tumours and Thoracic Oncology — Essay Questions
- Lung Tumours — Essay Questions
- MCQ: Respiratory System Pathology
Practice questions on Lung Tumours
Adenocarcinoma is the most common lung tumour. Which population is most characteristically associated?
- Male heavy smokers
- Uranium miners
- Asbestos-exposed workers
- Non-smokers and women
Answer: D. Adenocarcinoma is the most common primary lung cancer in non-smokers and women, and is often located peripherally.
Adenocarcinoma has become the most common primary lung tumour. Which population is most characteristically affected?
- Elderly males with occupational asbestos exposure history
- Women, non-smokers, and individuals under 45 years
- Middle-aged males with greater than 40 pack-year smoking history
- Immunocompromised patients with recurrent pulmonary infections
Answer: B. Adenocarcinoma is now the most common lung cancer overall, particularly in women, non-smokers, and those under 45 — a demographic shift from squamous cell carcinoma.
The neuroendocrine spectrum of lung tumours ordered from lowest to highest malignant potential is
- Typical carcinoid → atypical carcinoid → large cell neuroendocrine carcinoma → SCLC
- Atypical carcinoid → typical carcinoid → SCLC → large cell neuroendocrine carcinoma
- Large cell neuroendocrine carcinoma → atypical carcinoid → typical carcinoid → SCLC
- SCLC → large cell neuroendocrine carcinoma → atypical carcinoid → typical carcinoid
Answer: A. The correct spectrum of increasing aggressiveness is: typical carcinoid → atypical carcinoid → large cell neuroendocrine carcinoma → SCLC.
Ectopic ACTH syndrome from a lung tumour characteristically shows
- Very high cortisol + very high ACTH + hypokalaemic alkalosis, NOT suppressed by high-dose DST
- Low cortisol, low ACTH, hyperkalaemia
- Cortisol suppressed by high-dose dexamethasone
- Low cortisol, high ACTH, hypernatraemia
Answer: A. Ectopic ACTH: very high ACTH → bilateral adrenal hyperplasia → very high cortisol, hypokalaemia (mineralocorticoid effect), metabolic alkalosis. Does NOT suppress with high-dose dexamethasone — distinguishing it from pituitary Cushing's disease.