Lung Cancer Flashcards
What are the RFs of Lung cancer?
Genetic (KRAS)
Smoking mc
Radon 2nd mc
Occupational Nickle and asbestosis
Pollution
COPD
Unilateral lesion
Stage 1
Unilateral lesion with affection of peribronchial LN
Stage w
Unilateral lesion with affection of hilar LN on the same side
3a
Unilateral lesion with affection of hilar LN on the other side
3b
Bilateral lesion with affection of hilar LN on the both sides
Grade 4
Histopathological types of lung cancer
Small oat cell
Non small
-Large
-Adenocarninoma
-Squamous Carcinoma
Lymphoma sarcoma carcinoid
Mc type of cancer
And a very important note
Adeno
Even in non smoker females
Site of adenocarcinoma and conclusion
Peripheral
Confirmation through thoracotomy
Leads to
• chest pain
• plural effusion
• Massive hemorrhage non responding
• pulling of mediastinum
• presence of seeds
Site of squamous and conclusions
Usually central
Confirmation through bronchoscopy
Mediastinal syndrome (dyspnea, dysphagia and hoarseness)
Causes of solitary lung nodules
TB
Abcess
Hemartoma
Primary lung cancer
Single metasis
Hydatid cyst
Rhoid nodule
Bilateral lung nodule
Wegner granulomatosis
Bronchopneumonia
Hillary TB
ILD
Pulmonary edema
What is very characteristic to Squamous carcinoma other than mediastinal syndrome ?
Hypercalcemia 2ndry to ptrp
Other than peripheral and central what is the last site ?
Apical or pancoast
Describe the C/P of pancoast tumor
Usually old age
Thoracic inlet syndrome
-unilateral paresthia
-unilateral limb ischemia
-Horner syndrome (ptosis miosis anhydrosis)?
Describe small cell carcinoma
Rapidly dividing
Early metasis
Ccc by paramalignant syndrome (siadh and Cushing)
Sensitive to chemotherapy
Describe paraneplastic syndrome of lung cancer
Specific:
Ca
Cushing siadh
Non specific
Acanthosis Nigricans
Lambert eaton sydrome
Clubbing
Hypertrophic pulmonary osteoarthopathy
What is general C/P of lung cancer
Specific to each cancer
TOP male old smoker
General:
Metastasis: other lung, brain, bone and liver
Persistent cough plus or minus hemoptisis
Mc benign solitary nodule
TB
Describe the TTT of bronchogenic carcinoma
- CXR if larger than 1 cm
- CT for TNM (diagnostic)
- Biopsy (confirmatory)
- PETCT for metasis
How do we benefit from neoadjuvant
Decrease size
Decrease metastasis
What is an adjuvant ?
Chemotherapy to eliminate remains and becomes main in stage 3 and 4
What are the treatments of stages and 1 and 2
- Resection
- Segmentectomy, lobectomy or pneumoectomy
What are the treatment of stages 3 and 4?
- Surgery, radiation and chemo
- Surgery, chemo,targeted and immunotherapy
Treatment of small cell carcinoma
- Surgery, chemo,targeted and immunotherapy
