Lug cancer Flashcards
What are some examples of benign tumors in the lungs?
Hamartoma
Arteriovenous malformations (AVMs)
Granuloma
What are the two main categories of tumors in the lungs?
Benign tumors
Malignant tumors
What are some examples of malignant tumors in the lungs?
Primary lung cancer
Carcinoid tumor
Secondary tumors (metastases) from breast, colon, kidney, ovaries, prostate, thyroid
What is the most common type of malignant primary tumor of the lung?
Bronchogenic carcinoma
What are the two main subtypes of bronchogenic carcinoma?
Non-small cell lung cancer (arises from epithelial and glandular cells)
Small cell lung cancer (arises from neuroendocrine cells)
What is the previous name for adenocarcinoma in situ?
Bronchoalveolar cell carcinoma
What is the primary site of origin for mesothelioma?
Pleura (lining of the lungs)
What is a known risk factor associated with mesothelioma?
Asbestos exposure
What is the epidemiology of lung cancer?
Lung cancer is the most common fatal malignancy.
Approximately 34,000 deaths are attributed to lung cancer.
It is more common in females.
Lung cancer is usually diagnosed between the ages of 40-70 years.
It is more prevalent in the north of England.
Lung cancer is more common in lower socioeconomic groups.
What is the main risk factor for developing lung cancer?
Cigarette smoking
How does cigarette smoking contribute to the development of lung cancer?
Cigarette smoke contains carcinogens that can cause genetic mutations, increasing the risk of developing lung cancer.
What is the latent period between asbestos exposure and the development of bronchogenic lung cancer?
The latent period is approximately 30-40 years.
How does the combination of asbestos exposure and cigarette smoking affect the risk of developing lung cancer?
Asbestos and cigarette smoking act synergistically, increasing the risk of lung cancer by approximately 100 times.
Apart from lung cancer, with which type of cancer is asbestos exposure primarily associated?
Asbestos exposure is primarily associated with mesothelioma.
What are some sites of local invasion by lung cancer?
Parenchyma (ipsilateral or contralateral sides)
Pleura
Pericardium
Ribs
Muscle
Nerves (recurrent laryngeal nerve, phrenic nerve, sympathetic chain, brachial plexus)
Lymph nodes in thorax (hilar, mediastinal, subcarinal)
How does lung cancer spread to lymph nodes outside the thorax?
Lung cancer can spread to lymph nodes outside the thorax, mainly in the supraclavicular and cervical regions, through the lymphatic system.
What are some sites of distant spread for lung cancer through hematogenous spread?
Liver
Adrenals
Bones
Brain
Skin
What are some common symptoms of lung cancer?
Persistent cough (80%)
Breathlessness (60%)
Chest pain (50%)
Hemoptysis (30%)
Monophonic wheeze
Shoulder pain (Pancoast’s tumor causes invasion of brachial plexus)
Hoarse voice (vocal cord palsy secondary to left recurrent laryngeal nerve palsy)
Superior vena cava (SVC) obstruction (20%)
Enlarged lymph nodes
Skin nodules
What are some systemic symptoms associated with lung cancer?
Weight loss (cachexia)
Lethargy
Bone pain
Neurological symptoms (headache, limb weakness, peripheral neuropathy)
Spinal cord compression
Paraneoplastic symptoms caused by secretion of hormones or cytokines by small cell lung cancer (SCLC)
What are some signs that may be observed in patients with lung cancer?
Cachexia (extreme weight loss)
Clubbing (in 20% of cases with non-small cell lung cancer)
Hypertrophic pulmonary osteoarthropathy (HPOA) with adenocarcinoma: painful tender swelling of wrists and ankles
Hoarse voice
Horner’s syndrome (meiosis, ptosis, enophthalmos, and anhidrosis)
Cervical and supraclavicular lymphadenopathy
Tracheal deviation (upper lobe collapse, pleural effusion)
Superior vena cava obstruction (SVCO)
Clinical signs of pleural effusion (decreased chest expansion, decreased breath sounds, dullness on percussion, decreased tactile vocal fremitus, and decreased vocal resonance)
What are some concerning findings on a chest X-ray in relation to lung cancer?
Mass
Cavitating lesion
Unilateral pleural effusion
Non-resolving consolidation
Solitary pulmonary nodule
What imaging modality is essential for the initial staging of lung cancer?
CT (computed tomography) of the thorax and abdomen with contrast.
What are the contraindications for using iodine-based contrast in CT scans for lung cancer staging?
Renal failure
Allergy to iodine or previous contrast
How does a PET (positron emission tomography) scan contribute to lung cancer diagnosis and staging?
PET scans use FDG (fluorodeoxyglucose) to detect rapidly metabolizing cells, including cancer cells.
It can detect areas of high FDG uptake, which are indicative of cancer.
Dual PET/CT scans can correlate FDG-avid areas with anatomical structures.
PET scans are useful for detecting distant metastases, except for brain metastases.
The sensitivity of PET for lung cancer is 80%, and the specificity is 97%.