Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Peter Illei, M.D. and prepared by Kara Judson, M.D.
Case 6: This 53-year-old female patient with a 35 years history of smoking presented with chronic productive cough, shortness of breath and hypoxemia.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 263: Case 6
This 53-year-old female patient with a 35 years history of smoking presented with chronic productive cough, shortness of breath and hypoxemia. CT scan showed a left lower lobe lung nodule and other tiny nodules in the rest of her lung. This left lower lobe nodule was PET negative. The patient underwent a fiberoptic bronchoscopy and left lower lobe lobectomy.images/4406 case 5 1.jpg
images/4406 case 5 2.jpg
images/4406 case 5 a.jpg
images/4406 case 5 b.jpg
images/4406 case 5 c.jpgCorrect
Answer: Squamous cell carcinoma and carcinoid tumorlets
Histology: none provided
Discussion: The main tumor measures 1.5 cm and histologically is a moderately to poorly differentiated squamous cell carcinoma. The tumor cells are strongly and diffusely positive for p63. The small nodules in the surrounding lung are centered on broncho-vascular sheaths and are composed of nests of uniform small cells with round to oval nuclei, fine powdery chromatin and no nucleoli. Immunostains demonstrate that these small nests and small aggregates of similar cells seen in the respiratory epithelium in the bronchioles are synaptophysin and chromogranin positive consistent with carcinoid tumorlets and associated neuroendocrine cell hyperplasia of the bronchial/bronchiolar mucosa. Mucicarmine stain is also negative. Pulmonary neuroendocrine hyperplasia may present as small nodules or as nodular aggregates of neuroendocrine cells within respiratory epithelium. They always occur within or around bronchovascular sheaths with or without associated lung disease. The nodular form or carcinoid tumorlets are benign neuroendocrine cellular proliferations that morphologically resemble typical carcinoid tumors but are by definition less than 4.0 mm in diameter. The smaller intraepithelial aggregates are sometimes referred to as neuroepithelial bodies.
Minute menigothelioid nodules are small benign pulmonary lesions that were originally described as paragangliomas (also called chemodectomas) and are currently considered to represent a reactive process. Morphologically, they are small proliferations of uniform cells that resemble arachnoidal cells and the cells of meningioma. Ultrastructurally and immunohistochemically, they lack neuroendocrine differentiation and are cytokeratin negative, but are EMA, CEA, vimentin and progesterone receptor positive similar to menigothelial cells.
Atypical adenomatous hyperplasia of type 2 pneumocytes by definition are small (less than 5.0 mm) proliferations of cytologically atypical type 2 pneumocytes that exhibit lepidic spread and resemble bronchioloalveolar carcinoma. Immunohistochemicallly they lack neuroendocrine differentiation and are cytokeratin and TTF-1 positive.Incorrect
Answer: Squamous cell carcinoma and carcinoid tumorlets
Histology: none provided
Discussion: The main tumor measures 1.5 cm and histologically is a moderately to poorly differentiated squamous cell carcinoma. The tumor cells are strongly and diffusely positive for p63. The small nodules in the surrounding lung are centered on broncho-vascular sheaths and are composed of nests of uniform small cells with round to oval nuclei, fine powdery chromatin and no nucleoli. Immunostains demonstrate that these small nests and small aggregates of similar cells seen in the respiratory epithelium in the bronchioles are synaptophysin and chromogranin positive consistent with carcinoid tumorlets and associated neuroendocrine cell hyperplasia of the bronchial/bronchiolar mucosa. Mucicarmine stain is also negative. Pulmonary neuroendocrine hyperplasia may present as small nodules or as nodular aggregates of neuroendocrine cells within respiratory epithelium. They always occur within or around bronchovascular sheaths with or without associated lung disease. The nodular form or carcinoid tumorlets are benign neuroendocrine cellular proliferations that morphologically resemble typical carcinoid tumors but are by definition less than 4.0 mm in diameter. The smaller intraepithelial aggregates are sometimes referred to as neuroepithelial bodies.
Minute menigothelioid nodules are small benign pulmonary lesions that were originally described as paragangliomas (also called chemodectomas) and are currently considered to represent a reactive process. Morphologically, they are small proliferations of uniform cells that resemble arachnoidal cells and the cells of meningioma. Ultrastructurally and immunohistochemically, they lack neuroendocrine differentiation and are cytokeratin negative, but are EMA, CEA, vimentin and progesterone receptor positive similar to menigothelial cells.
Atypical adenomatous hyperplasia of type 2 pneumocytes by definition are small (less than 5.0 mm) proliferations of cytologically atypical type 2 pneumocytes that exhibit lepidic spread and resemble bronchioloalveolar carcinoma. Immunohistochemicallly they lack neuroendocrine differentiation and are cytokeratin and TTF-1 positive.
