Deck 25: Thoracic Neoplasms

Question 1

Which pattern of nodule calcification is not generally accepted as a benign pattern?

A) Stippled nodule calcification
B) Peripheral nodule calcification
C) Laminated nodule calcification
D) Central nodule calcification

Answer 1

Peripheral nodule calcification

Question 2

Which of the following is not a common differential for presenting solitary pulmonary nodule?

A) Granuloma
B) Lung cancer
C) Hamartoma
D) Aspiration pneumonia

Answer 2

Aspiration pneumonia

Question 3

Which of the following is not associated with a Pancoast tumor?

A) Radiodense mass in the superior sulcus
B) Dilated pupil
C) Radiating arm pain
D) Vertebral body destruction

Answer 3

Dilated pupil

Question 4

Asbestos exposure in combination with cigarette smoking has a(n) __________ effect, __________ lung cancer rates.

A) inhibitory, decreasing
B) inhibitory, not altering
C) synergistic, increasing
D) synergistic, decreasing

Question 5

Which of the following is not a subtype of bronchogenic carcinoma?

A) Pneumocarcinoma
B) Small cell
C) Adenocarcinoma
D) Oat cell carcinoma

Question 6

Which of the following is the most important risk factor for developing lung cancer?

A) Urbanization
B) Industrialization
C) Asbestos exposure
D) Cigarette smoking

Question 7

Which of the following best characterizes a teratoma?

A) Tumor of embryological tissue
B) Common to the chest wall
C) Typically lack calcification
D) Usually malignant

Question 8

Which radiographic feature is not typical of pulmonary metastasis?

A) Bilateral hilar enlargement
B) Multiple pulmonary masses and nodules
C) Calcification of the hilar lymph nodes
D) Pleural effusion

Question 9

Which of the following tumors is not a parenchymal lung neoplasm?

A) Bronchogenic carcinoma
B) Leiomyoma
C) Fibroma
D) Chondroma

Question 10

Which of the following lung tumors is associated with endocrine-related symptoms, mimicking those of Cushing syndrome?

A) Hamartoma
B) Squamous cell carcinoma
C) Bronchial carcinoid
D) Large cell bronchogenic carcinoma

Question 11

The most common location for a bronchial carcinoid tumor is in the __________.

A) lobar bronchi
B) mainstem bronchi
C) lung periphery
D) lung parenchyma

Question 12

Which of the following does not correlate positively with increased rates of lung cancer?

A) Living in a rural area
B) Cigarette smoking
C) History of asbestos inhalation
D) Having a father who developed lung cancer

Question 13

What percentage of bronchial carcinoid tumors are well differentiated?

A) 10%
B) 30%
C) 60%
D) 90%

Question 14

Which finding suggests a benign etiology in the differential diagnosis of a solitary pulmonary nodule?

A) The nodule is 3 cm in diameter on the current films.
B) The patient is 43 years of age.
C) The nodule is completely calcified on the current films.
D) The nodule is noted on films taken 2 months ago.

Question 15

Bronchoalveolar carcinoma is a subtype of which of the following types of bronchogenic carcinoma?

A) Alveolar cell
B) Small cell
C) Squamous cell
D) Adenocarcinoma

Question 16

Which radiological division of the mediastinum most commonly features a teratoma?

A) Anterior
B) Middle
C) Posterior
D) Superior

Question 17

Lung lesions must measure greater than or equal to __________ cm to be classified as a mass.

A) 2
B) 3
C) 4
D) 5

Question 18

Which of the following is not an anterior mediastinal lesion?

A) Neurofibroma
B) Teratoma
C) Substernal thyroid
D) Lymphoma

Question 19

Which of the following is the most common primary lung tumor in patients under age 16?

A) Hamartoma
B) Bronchial carcinoid
C) Bronchogenic carcinoma
D) Metastasis

Question 20

Which radiographic feature is not typical of lymphoma?

A) Pneumothorax
B) Bilateral hilar enlargement
C) Involvement of the anterior mediastinum
D) Atelectasis

Question 21

What percentage range of cancer patients have pulmonary metastasis at autopsy?

A) 1%-29%
B) 30%-50%
C) 51%-74%
D) 75%-90%

Question 22

On average, bronchogenic tumors double in size every __________ months.

A) 1-18
B) 19-24
C) 25-30
D) 31-36

Question 23

Cavitation has been described most commonly in masses relating to which of the following types of bronchogenic carcinoma?

A) Squamous cell
B) Adenocarcinoma
C) Small cell
D) Large cell

Question 24

Which of the following statements is true concerning Hodgkin disease versus non-Hodgkin lymphoma?

A) Isolated parenchymal involvement is common with Hodgkin disease.
B) Hodgkin disease is more likely to involve the mediastinum.
C) Hilar lymphadenopathy is rare in non-Hodgkin lymphoma.
D) Non-Hodgkin lymphoma has a bimodal distribution.

Question 25

What cell type would most likely be discovered on biopsy of an apical lung mass in a patient with chronic smoking history and destruction of the adjacent first and second ribs?

A) Squamous cell carcinoma
B) Adenocarcinoma
C) Small cell carcinoma
D) Large cell carcinoma

Question 26

Which of the following is the most common primary tumor of the pleura?

A) Bronchogenic carcinoma
B) Mesothelioma
C) Non-Hodgkin lymphoma
D) Pleural plaquing

Question 27

Which of the following best describes the calcification pattern characteristic of a hamartoma?

A) Popcorn
B) Central
C) Laminated
D) Amorphous

Question 28

Hamartomas result from faulty tissue differentiation at the __________ level.

A) cellular
B) tissue
C) organ
D) organ system

Question 29

Circumferential, strand-like radiopacities radiating from the outer border of a lung tumor, described in relation to bronchogenic carcinoma, are known as __________.

A) brush borders
B) corona radiate
C) hair-on-end appearance
D) sunburst appearance

Question 30

Lung consolidation in a patient that does not resolve after 4 weeks of conservative treatment requires further evaluation to exclude which of the following?

A) Bacterial pneumonia
B) Postobstructive pneumonitis
C) Cavitated lung abscess
D) Pulmonary contusion

Question 31

Which route of dissemination in bronchogenic carcinoma would result in the presence of Kerley lines on chest radiographs?

A) Hematogenous
B) Lymphangitic
C) Direct extension
D) Contiguous spread

Question 32

Tissue biopsy of a mediastinal mass in a 30-year-old patient reveals the presence of Reed-Sternberg cells. This cell type is diagnostic for __________.

A) Hodgkin lymphoma
B) non-Hodgkin lymphoma
C) leukemia
D) bronchogenic carcinoma

Question 33

What percentage of increase in the diameter of a lung tumor is needed to indicate the lesion has doubled in size?

A) 25%
B) 50%
C) 75%
D) 100%

Question 34

Which of the following is the most common cell type for bronchogenic carcinoma?

A) Squamous cell
B) Adenocarcinoma
C) Oat cell
D) Large cell

Question 35

Which of the following types of bronchogenic carcinoma would present with the pattern of diffuse or localized air-space disease?

A) Squamous cell
B) Adenocarcinoma
C) Bronchoalveolar cell
D) Small cell

Question 36

Which of the fine diagnostic modalities is the most sensitive imaging method to detect pulmonary metastasis?

A) Computed tomography
B) Conventional tomography
C) PA and lateral chest radiographs
D) Radionuclide scintigraphy

Question 37

Which of the following is the most common type of benign lung tumor?

A) Granuloma
B) Hamartoma
C) Bronchial carcinoid
D) Lymphoma

Question 38

What percentage of patients with thymomas will also have myasthenia gravis?

A) 15%
B) 25%
C) 35%
D) 50%

Question 39

PA and chest radiographs of a 70-year-old retired male construction worker show multiple areas of pleural thickening, encasing, and constricting the right lung. This history and radiographic presentation is most consistent with remote exposure to __________.

A) silica
B) talc
C) asbestos
D) polyvinylchloride

Question 40

Which of the following roots of metastasis to the lungs results in multiple well-defined peripheral nodules?

A) Lymphangitic
B) Pleural seeding
C) Direct extension
D) Hematogenous