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Clinical Impression: BRONCHOGENIC CARCINOMA

Bronchogenic carcinoma, primarily lung cancer, is categorized into small cell and non-small cell types. Non-small cell lung carcinoma accounts for 75% of cases, progressing slower than small cell carcinoma and encompassing various subtypes like adenocarcinoma and squamous carcinoma. Key factors influencing its pathogenesis include cigarette smoking, occupational exposures, and genetic predispositions. Activation of oncogenes and inactivation of tumor-suppressor genes are critical in tumor development, emphasizing the role of cancer stem cells for effective treatment strategies.

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Clinical Impression: BRONCHOGENIC CARCINOMA

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  1. Clinical Impression: BRONCHOGENIC CARCINOMA

  2. Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain.

  3. Non-small cell lung carcinoma • 75% of lung cancer • Grows and spreads more slowly than small cell Ca • Includes adenocarcinoma, squamous, large cell carcinoma, bronchioloalveolar carcinoma, and mixed version. • RB mutation 20%, p16 changes 50%, KRAS mutation 30%, and EGFR 10% Bronchiolo-alveolar carcinoma of the lung with mucin production. Hematoxylin and eosin stain

  4. Pathogenesis of Bronchogenic Cancer

  5. Etiology & Pathogenesis • Cigarette smoking/ Tobacco exposure (~90%) • Occupational associations: asbestos, uranium( in miners), arsenical fumes, nickel,radon gas. • Genetic factors • Chronic lung disease: TB & COPD • Other factors include air pollutions , ionizing radiation .

  6. Etiology & Pathogenesis Initiated by activation of dominant oncogenesand inactivation of tumor-suppressor gene or recessive oncogenes A small subpopulation of cells with a tumor are responsible for the full malignant behavior of the tumor which are called cancer stem cell this will be important to identify since successful treatment of the tumor will require the eradication of this stem cell component.

  7. Activation of Dominant Oncogene

  8. Inactivation of tumor-Suppressor gene • genes involved in lung cancer pathogenesis: p53, RB, RASSF1A, SEMA3B, SEMA3F, FUS1, p16, LKB1, RAR, and FHIT.

  9. Autocrine Growth Factors Inherited Predisposition to Lung Cancer • People with inherited mutation on RB and p53 gene may develop lung cancer. • First degree relative of lung cancer probands have a two to threefold excess risk of lung cancer or other cancer, many of which are not smoking-related. expresses nicotinic acetylcholine receptor nicotine activates signaling pathway in tumor and normal cell that blocks apoptosis  involvement of nicotine directly in lung cancer pathogenesis both as a mutagen and tumor promoter

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