Lung cancer Flashcards
Name three types of lung cancer
Squamous cell carcinoma
Adenocarcinoma
Small cell lung cancer
Large cell
Name two non SCLC
squamous cell carcinoma SCC
adenocarcinoma
Which lung cancer has the worst prognosis?
small- cell
Which lung cancer is more common in females?
adeno
One histological feature of SCC?
intercellular bridges and keratinisation
One difference between SCC and adenocarcinoma?
SCC- central
adeno- peripheral
One histological feature of adenocarcinoma?
glandular
Three symptoms of lung cancer
Cough and haemoptysis Dyspnoea Chest pain Recurrent or slow resolving pneumonia Anorexia and ↓wt. Hoarseness
Three signs of lung cancer on examination?
consolidation anaemia clubbing supraclavicular + axillay LNs cachexia
Three complications of lung cancer?
recurrentl laryngeal N palsy SVC obstruction Horner's syndrome Cushing's syndrome AF phrenic nerve palsy
Name two palsy’s that can arise as a complication of lung cancer
phrenic nerve and recurrent laryngeal nerve
Name two endocrine disorders that can stem from lung cancer
SIADH
Cushing’s syndrome
Hypercalcaemia
Name one dermatological manifestation of lung cancer
acanthosis nigricans
Three investigations for lung cancer
CXR PET-CT Staging CT Bronchoscopy with endobronchial ultrasound (EBUS) Lung function tests Histological diagnosis- biopsy
Two features of lung cancer on CXR
Hilar enlargement
Pleural effusion
Collapse, consolidation
Peripheral opacity/coin lesion
Two differentials for coin lesion aside from neoplalsia
foreign body
abscess
granuloma
Two treatment options for lung cancer
- Surgical resection + adjunct chemo
- Radiotherapy
- Chemo + radio
Aside from smoking, name two other risk factors for lung cancer?
environmental tobacco smoke, air pollution, asbestos, ionising radiation e.g. radon, HPV, fibrosing conditions of the lung, hereditary
Name two structures close to the lung can be affected by local spread of lung cancer?
pleura, hilar lymph nodes, adjacent lung tissue, pericardium, mediastinum, pancoast tumour
Name two structures of the mediastinum where lung cancer can spread to locally
SVC, recurrent laryngeal nerve, phrenic nerve
What does SVC obstruction due to local cancer result in clinically?
raised JVP and oedema of the face, dilated veins on chest wall
A tumour impinging on the phrenic nerve results in which clinical manifestation?
hemidiaphragm paralysis
What are the features of horner’s syndrome?
ptsosis, miosis, anhydrosis
Two structures can be involved in pancoast tumour?
apex of lung, brachial plexus, cervical sympathetic chain, brachipcephalic vein, subclavian vein
Name two secondary organs can lung cancer spread to?
liver, bone, brain, adrenal glands
What are three non-metastatic endocrine effects of lung cancer?
ACTH secretion- cushing’s, ADH secretion- SIADH, PTHrP secretion- hypercalcaemia
One histological feature of small-cell lung cancer?
nuclear moulding, apoptopic bodies
What is the name for the tumour that arises in the pleura?
mesthelioma
What is the main cause of mesotheliomas?
asbestos exposure
A 64 year old man, who is a lifelong non-smoker, is diagnosed with lung cancer. The tumour biopsy is positive for a mutation in the EGFR gene. Which type of lung cancer?
Lung adenocarcinomas are screened for EGFR mutations. They are also screened for mutations in ALK, PD-L1 and ROS-1
Two contraindiactions to lung cancer surgery?
Contraindications to lung cancer surgery include SVC obstruction, FEV < 1.5, MALIGNANT pleural effusion, and vocal cord paralysis
