BRONCHIAL CARCINOMA Flashcards
What is bronchial carcinoma?
a malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole.
Is it rare or common?
common
What are the risk factors? (10)
- cigarettes
- asbestos
- chromium
- arsenic
- iron oxide
- radiation
- age
- copd
- previous history of cancer
- epidermal growth factor receptors (egfr)
What are the symptoms? (7)
- cough
- haemoptysis
- dyspnoea
- chest pain
- recurrent or slow resolving pneumonia
- lethargy
- anorexia/weight loss
What are the signs? (7)
- cachexia
- anaemia
- clubbing
- Hypertrophic pulmonary osteoarthropathy (HPQA)
- supraclavicular/axillary nodes
- chest signs
- metastatic signs
What chest signs may a patient with bronchial carcinoma have? (1,3)
- none
or
- consolidation
- pleural effusion
- collapse
What metastatic signs may a patient with bronchial carcinoma have? (7)
- bone tenderness
- hepatomegaly
- confusion fits
- focal CNS signs
- cerebellar syndrome
- proximal myopathy
- peripheral neuropathy
differential diagnosis (10)
- Secondary malignancy.
- Arteriovenous malformation.
- Pulmonary hamartoma
- Bronchial adenoma.
- Abscesses.
- Granuloma - eg, tuberculosis.
- Encysted effusion (fluid, blood, pus).
- Cyst.
- Foreign body.
- Skin tumour (eg, seborrhoeic wart).
Investigations (8)
- sputum
- pleural fluid
- CXR
- biopsy/fine needle aspiration
- bronchoscopy
- radionuclide bone scan
- lung function tests
What would be investigated for cytology? (2)
- sputum
2. pleural fluid
What would be sign on CXR? (6)
- peripheral nodule
- hilar enlargement
- consolidation
- lung collapse
- pleural effusion
- bony secondaries
What would you take a biopsy of? (2)
- peripheral lesions
2. superficial lymph nodes
Why would you do a CT? (2)
- to stage the tumour - PET scan
2. to guide bronchoscopy
Why would you do a bronchoscopy? (3)
- histology
- assess operability
- biospy
What is a radionuclide bone scan used to assess? (1)
metastases
What is the reasoning behind doing lung function tests? (1)
to assess suitability for a lobectomy
What is the treatment for non-small cell tumours? (4)
- excision
- curative radiotherapy
- chemotherapy - with/without radiotherapy
- monoclonal antibodies
Which one out of small cell tumours and non-small cell tumours are likely to metastasise?
Small cell tumours
What is the treatment for small cell tumours?
- chemotherapy +/- cisplatin, +/- radiotherapy
What is the palliative treatment? (3)
- radiotherapy
- endobronchial therapy
- pleural drainage
What drug treatment is used? (6)
- analgesia
- steroids
- antiemetics
- cough linctus (codeine)
- broncodilators
- anti-depressants
