Lung Cancer

Question 1

SLCC

Answer 1

Centrally located, widely metastasizes to brain (use prophylactic brain rad tx), mets usually present at dx, chemo has a fast response rate but relapse is common. Hilar and mediastinal lymphadenopathy. Paraneoplastics: SIADH, Cushings, Eaton Lambert syndrome; SVC syndrome

Question 2

What cancer is Eaton Lambert associated with? What is it?

Answer 2

SLCC, antibodies at NMJ with defective release of ACh, presents with muscle weakness

Question 3

SPN

Answer 3

less than 3 cm, rounded, most are benign, smooth well defined lesion with dense central calcification.
If you find one, do serial CT scans up to 24 months

Question 4

Dx approach to SPN

Answer 4

Unexplained wt loss, lymphadenopathy, fixed or localized wheeze, joint tenderness

Question 5

NSLCC adenocarcinoma (most common)

Answer 5

arise peripherally, a/w thrombophleb and clubbing. If you’re a non-smoker, this is the one you get most often, carcinogenic thrombophlebitis

Question 6

NSLCC Squamous Cell Carcinoma

Answer 6

Central bronchi, hemoptysis, slower growing, mets later, could cavitate, hypercalcemia due to secretion of PTH-like substance

Question 7

NSLCC Large Cell

Answer 7

Distant mets, primarily dx of exclusion, excess HCG