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* nbme 4 section 1 q31
 #642148  
  vera - 12/22/11 20:34
 
  A 67-year-old man comes to the physician for a follow-up examination. Three years ago, he underwent radical resection of a T3 N0 M0 epidermoid carcinoma of the floor of his mouth and supraomohyoid dissection of his neck. He currently takes no medications. He smoked three packs of cigarettes daily for 40 years but stopped 3 years ago. Vital signs are within normal limits. Examination shows well-healed surgical scars. There are no signs of local recurrence. An x-ray of the chest shows a 3-cm mass in the medial upper lobe of the right lung. Which of the following is the most likely cause of these findings?

A
) Bronchioalveolar carcinoma of the lung

B
) Metastatic carcinoma

C
) Obstructive pneumonia

D
) Primary squamous cell carcinoma of the lung

E
) Sarcoidosis
 
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* Re:nbme 4 section 1 q31
#2549665
  md12 - 12/22/11 20:40
 
  dd  
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* Re:nbme 4 section 1 q31
#2549666
  mzk - 12/22/11 20:41
 
  Pr. squamous cell carcinoma considering his long term smoking history  
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* Re:nbme 4 section 1 q31
#2549696
  vera - 12/22/11 21:39
 
  thank you guys  
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* Re:nbme 4 section 1 q31
#2549704
  danayu69 - 12/22/11 21:59
 
  r u sure guys? can we tell the histology from the history alone, small cell and large cell ca are also ass. with smoking. and this epidermoid is also sq cell ca.

any body got right on this one? the only thing i can say is it not B, it is not E
 
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* Re:nbme 4 section 1 q31
#2549752
  danayu69 - 12/22/11 22:43
 
  sorry, i mean , not C not E  
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* Re:nbme 4 section 1 q31
#2549787
  sonia29 - 12/22/11 23:30
 
  why is not a,pr squamous cell cancer is located mor centraly  
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* Re:nbme 4 section 1 q31
#2549790
  sonia29 - 12/22/11 23:32
 
  didnt read wll not possible becaus bac is not associated with smoking  
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* Re:nbme 4 section 1 q31
#2549793
  raheem - 12/22/11 23:42
 
  you can exclude ....BB......by this histopath. principle...epith. primary metastesize to epith.
tissue,
glandular primary metastesize to glandular tissue(score95step1)
 
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* Re:nbme 4 section 1 q31
#2550356
  drguirand - 12/23/11 22:39
 
  Bronchioalveolar carcinoma of the lung: peripheric, more common in non smoker
Metastatic carcinoma: no history of lymphadenopathy.
Obstructive pneumonia: Clinical history doesn't correspond, no mention of fever.
Sarcoidosis: no hiliar adenopathy


Primary squamous cell carcinoma of the lung: only 2 CA of the lung are medially placed, squamous cell and small cell and both are mainly due to smoking...The logic, I use to remember it is that the smoke enters the lung parenchyma medially thus this part of the lung will receive higher dose of smoke so has higher risk to develop those 2 cancers...I don't know if it will help you?...but for me it works...lol

 
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* Re:nbme 4 section 1 q31
#3166707
  harpa62 - 12/07/14 10:44
 
  thanks  
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