All Sample Questions

Lung Carcinoma 1

Question

Vignette: A 48-year-old man presents to his primary care physician with complaints of fatigue, weight loss, and night sweats for the past 2 months. He also reports a persistent cough with occasional blood-tinged sputum. He has a 30 pack-year smoking history. His physical examination reveals decreased breath sounds and dullness to percussion in the right upper lung. A chest x-ray shows a mass in the right upper lobe of the lung. A biopsy of the mass is performed and reveals cells with large nuclei, prominent nucleoli, and abundant pink, glassy cytoplasm.

Question: The biopsy findings in this patient are most consistent with which of the following types of lung carcinoma?

Choices

A. Adenocarcinoma

B. Small cell carcinoma

C. Squamous cell carcinoma

D. Large cell carcinoma

E. Carcinoid tumor

Answer

D. Large cell carcinoma

Explanation

This patient's history of smoking, symptoms of fatigue, weight loss, night sweats, and hemoptysis, along with the imaging findings of a lung mass, strongly suggest lung cancer. The biopsy findings of cells with large nuclei, prominent nucleoli, and abundant pink, glassy cytoplasm are consistent with large cell carcinoma, a type of non-small cell lung cancer. Large cell carcinoma is characterized by large cells with abundant cytoplasm, large nuclei, and conspicuous nucleoli. With regards to location, large cell carcinoma can occur anywhere in the lung. This type of lung cancer tends to grow and spread quickly, which may account for this patient's rapid onset of symptoms.