Lung CA Flashcards
Solitary Pulmonary Nodule (SPN) is?
“coin lesion” (U) benign
<3cm
defined edges
dense, central calcification
SPN risks for malignancy, epidemiology?
> 60yo
lifestyle
co-existing lung dz
infection risk/exposure
SPN risks for malignancy, physical findings?
weight loss
LAD
fixed/local wheeze
joint tenderness
SPN imaging findings?
Review old films for stability (growth)
↑ risk of malig if:
Φ calcification
poor definition
> 3 cm
Small Cell CA characteristics?
Bronchial origin (central)
Compresses bronchi
Micrometastases
Poor prog (Φ surgery)
Non-small Cell CA (NSC):
Adenocarcinoma characteristics?
Most common,
Mucous gland origin (peripheral),
Met to distant organs,
Nodules or masses
NSC Squamous Cell CA characteristics?
Bronchi epith origin (central),
Hemoptysis common,
Met to regional lymph nodes,
(P) cavitation
NSC Large Cell CA characteristics?
Lung periphery,
Met to distant organs,
Undifferentiated,
Rapid/aggressive
Lung CA presentation:
Primary Lesion sxs?
Cough Sputum Dyspnea Hemoptysis Chest pain Unilat/Local wheeze
Lung CA presentation:
Intrathoracic Spread sxs?
Pleural effusion
Pericardial effusion
Hoarseness (compressed laryn n, U L side tumors)
Superior Vena Cava Synd is?
compression/invasion of SVC
(U) a/w small cell
SVC Synd sxs?
HA Dyspnea Facial/extrem swelling Plethora Venous pattern on chest
Pancoast Synd is?
compression of brachial plexus/cervical sympathetic nn
Pancoast Synd sxs?
Horner's: Ipsilateral of tumor miosis anhidrosis ptosis sunken eyeball
Rib destruction
Hand atrophy
Pain C8 - T2
Lung CA presentation:
Paraneoplastic Syndromes
anorexia weight loss wasting fever ↓ immunity
Paraneoplastic Syndromes are?
disorders from tumor secretions
hormones, peptides, cytokines
Paraneoplastic Syndrome presentation: Hematologic?
thrombophlebitis (e.g. Trousseau’s)
hypercoaguability
Paraneoplastic Syndrome presentation: Endocrine?
PTH-like: hyperCa2+
HCG (gonad): gynecomastia
SIADH: hypoN+
Cushing’s: ACTH
Paraneoplastic Syndrome presentation: Neurologic?
Eaton-Lambert: NMJ antibodies -> mm weakness
peripheral neuropathy
Most common metastasis sites?
Liver
Bone
Adrenal gland
Brain
Lung CA workup?
Tissue dx
Staging
Performance status
Staging of SCLC?
Limited: in ipsil hemithorax
Extensive: beyond hemi, includes effusion
Staging of NSC?
TNM system
T - primary tumor
N - nodal involvement
M - distant mets
Stage 1?
localized
Stage 2?
in lymph nodes at top of lung
Stage 3?
into chest wall
Stage 4?
met elsewhere
Performance status: post-op complication predictor is?
FEV < 60%
Positive Emission Tomo (PET) used for?
staging
Lung CA management: small cell
chemo always
(P) whole brain prophy radiation
Lung CA management: non-small cell
surgery
Stage IIIa-IV: radiation/chemo
