Lung cancer Flashcards
which cx is associated with smokers, central, SIADH, ACTH, Lambert-Eaton Myasthenic Syndrome (LEMS)
o Small cell lung cancer (SCLC)
details on adenocarcinoma of lung?
non-smokers, peripheral, early metastasis,
gynaecomastia, HPOA - hypertrophic pulmonary osteoarthropathy (HPOA)
details on squamous cell cx of lung?
smokers, central, spread locally, late metastasis,
- PTHrp -> “stones, bones, abdominal groans, psychiatric overtones”
- Ectopic TSH -> hyperthyroid
- Clubbing
which cx is associated with peripheral location, poor prognosis, b-hCG
Large cell carcinoma
presentation of small cell LC?
aggressive malignancy. Approximately two-thirds of patients have evidence of distant metastasis at presentation
cough, chest pain, haemoptysis, dyspnoea, and weight loss.
- SIADH hyponatraemia
- ACTH Cushing’s syndrome
- LEMS MG-like syndrome (but improves with activity)
what do small cells look like on histology
oat cell carcinoma,
The tumour cells are small and densely packed, with scant cytoplasm, finely granular nuclear chromatin, and absence of nucleoli
ivx of lung cancer?
Baseline bloods
CXRAY
- small cell - hilar invovlement
PET-CT chest, liver, adrenals - mets
Sputum cytology - malignant cells in sputum
Bronchoscopy + biopsy
Mx NSC LC?
Suitable for surgery - surgery
IF not - radiotherapy then chemo
CIs to surgery in NSC LC?
Poor health,
mets,
FEV1 <1.5,
malignant effusion,
hilar tumour, vocal cord paralysis, SVCO
mx for SC LC?
Chemo + radiotherapy
+- surgery
ivx of mesothelioma?
- chest x-ray - showing either a pleural effusion or pleural thickening
- Pleural CT
2b. if a pleural effusion is present fluid should be sent for MC&S, biochemistry and cytology - -> Diagnosis of a mesothelioma is made on histology, following a thoracoscopy
