Bronchial Carcinoma Flashcards
define bronchial carcinoma
malignant neoplasm of the lung
risk factors for bronchial carcinoma
- smoking
- asbestos
- radiation
- pre-existing lung disease
- pulmonary fibrosis
types
- small cell carcinoma
- non-small cell
- adenocarcinoma
- large cell carcinoma
where does small cell carcinoma arise?
from neuroendocrine cells and often secrete polypeptide hormones (GH, SIADH)
does small cell carcinoma metastasise
yes, very early
where is small cell carcinoma usually located?
centrally
where does non-small cell arise?
squamous epithelium and is associated with production of keratin (cavities with central necrosis)
timing of metastasises
local spread common
metastasises late
where are adenocarcinomas located?
peripheral lesion
what is the most common type in non-smokers
adenocarcinoma
where does adenocarcinoma originate from
mucus secreting glandular cells
which type of bronchial carcinoma can present with gynaecomastia
adenocarcinoma
metastasises in adenocarcinoma
pleura, lymph nodes, brain and bones
describe large cell carcinoma
poorly differentiated and metastasises early
clinical features
- cough
- breathlessness
- haemoptysis
- chest pain
- wheeze
- hoarse voice (recurrent laryngeal nerve palsy)
- hand muscle wastage (pancoast tumour, brachial plexus invasion) and Horner’s syndrome
- recurrent infection (due to partial obstruction of airway)
describe Horner’s syndrome
name for a group of symptoms including flushing on one side of the face and that side doesn’t sweat. The eye on the same side has a constricted pupil with a drooping eyelid
metastatic spread
- mediastinum, cervical and axillary lymph nodes
- liver
- bone
- adrenal glands
- brain
list of investigations into bronchial carcinoma
- CXR
- CT
- PET
- biopsies
CXR for bronchial carcinoma
- mass lesion
- pleural effusion
- mediastinal widening
- collapse
- reticular shadowing
- normal
CT for bronchial carcinoma
indicates extent of disease, should include liver and adrenal glands
PET for bronchial carcinoma
characters extent of mediastinal nodal involvement and distal metastases
how is a biopsy taken in peripheral lesions?
percutaneous FNA
biopsy for mediastinal lymph node staging
endoscopic bronchial US biopsy
methods for biopsies
Bronchoscopy CT guided biopsy Lymph node aspirate Aspiration of pleural fluid Endobronchial Ultrasound Thoracoscopy
prognosis in lung cancer
BAD
When is surgery performed for bronchial carcinoma
early stage non-small cell lung cancer
when is radiotherapy used?
non-small cell lung carcinoma with curative intent
small cell treatement
- chemotherapy and radiotherapy for symptoms
- palliative care
