Lung cancer Flashcards
How might a patient with lung cancer present?
Chest pain Haemoptysis Chronic chest infection Weight loss Fatigue Breathlessness
What is the most common type of lung cancer?
Adenocarcinoma
Where might a tumour spread to?
Pericardium Pleura Brachial plexus Recurrent laryngeal nerve Oesophagus Superior vena cava
What might invasion of the recurrent laryngeal nerve cause?
Hoarse voice
What is a pancoast tumour?
A tumour of the apex
What nerves might a pancoast tumour invade and how might a patient with the resulting pathology present?
Brachial plexus
Arm paralysis
What are some common sites for lung tumour metastases?
Liver
Brain
Bone
What biochemical abnormalities may indicate a lung cancer?
Hypercalcaemia
Hyponatraemia
What is Lambert-Eaton syndrome?
Muscle weakness in the limbs, most commonly caused by underlying malignancy - in lung cancer this is usually small cell
What changes in the hands could indicate underlying malignancy?
Finger clubbing
What investigations must be done if a diagnosis of lung cancer is suspected?
FBC Ca, Na, K, Alk phos Spirometry Coagulation screen CXR Bronchoscopy CT scan & CT guided biopsy Lymph node aspirate Aspiration of pleural effusion
Why is small cell carcinoma rarely suitable for surgery?
Metastasises early
Which cancer shows the best initial reaction to chemotherapy?
Small cell lung cancer
Which cancer is the most rapidly progressive?
Small cell
Which area does small cell lung cancer typically affect?
Hilum, may compress bronchial lumen externally
Which area do squamous cell carcinomas typically affect?
They are central, usually affecting main or segmental bronchi
Which area do adenocarcinomas typically affect?
Peripheries
Where do central adenocarcinomas arise from?
Bronchial mucous glands
Which other anatomical structures might adenocarcinomas rapidly invade?
Lymphatics
Blood vessels
Pleura
How might you distinguish a lung primary adenocarcinoma from a secondary carcinoma e.g. of lung or pancreas?
Primary adenocarcinoma express thyroid transcription factor
