lung cancer Flashcards
cough hemoptysis chest pain weight loss, night sweats pneumonia pleural effusion airway obstruction paraneoplastic syndrome hoarseness: recurrent laryngeal nerve Horner syndrome: pancoast tumor dysphagia: esophageal invasion superior vena cava syndrome
lung cancer presentation
most common cause of death in men and women
lung cancer
4 types of lung cancer (based on histological type)
1) small cell lung carcinoma
2) non-small cell carcinoma: adenocarcinoma, squamous cell carcinoma, large cell carcinoma
most common type of primary lung cancer OVERALL
adenocarcinoma
PERIPHERAL location
most common lung cancer in NON-SMOKERS + FEMALES, also found in SMOKERS
adenocarcinoma
activating mutations associated with this lung cancer: EGFR, ALK, ROS, RET, KRAS genes
adenocarcinoma
2nd most common type of primary lung cancer
squamous cell carcinoma
CENTRAL location hilar mass arising from bronchus cavitated lesion on xray or CT associated with SMOKING ↑Ca
squamous cell carcinoma
keratin pearls
squamous cell carcinoma (characteristic of many squamous cell cancers)
squamous cell cancer characteristics
keratin pearls
secrete PTRrP →↑ Ca
PERIPHERAL location associated with SMOKING anaplastic, undifferentiated cells giant cells poor prognosis (poor response to chemo)
large cell carcinoma
high nucleus: cytoplasm ratio
CENTRAL location
associated with SMOKING
cushing syndrome or
SIADH (hyponatremia) or Lambert-Eaton syndrome (muscle weakness that IMPROVES with use)
undifferentiated, aggressive - poor prognosis
small cell carcinoma
Central
Smokers
Secreting
squamous cell carcinoma (PTHrP)
small cell carcinoma (ACTH, ADH, or Abs against Ca channel)
all S sounds
paraneoplastic syndrome associated with squamous cell carcinoma lung cancer
secretes PTHrP → hypercalcemia
3 paraneoplastic syndromes associated with small cell carcinoma
lung cancer secretes:
1) ACTH → cushing syndrome
2) ADH → SIADH (hyponatremia)
3) Abs against presynaptic Ca channels → Lambert-Eaton syndrome (muscle weakness that IMPROVES with use)
mutations in TP53, Rb, amplification MYC
small cell carcinoma
low-grade malignant epithelial tumor
bronchospasm + wheezing, flushing, diarrhea, right-sided heart lesions
carcinoid tumor
paraneoplastic syndrome associated with carcinoid
5HT secretion → carcinoid syndrome: BFDR Bronchospasm and wheezing Flushing Diarrhea Right-sided heart lesions (murmur)
most common location for carcinoid tumors
lung
GI tract (most common tumor of appendix)
only get ↑5HT if tumor in lung or mets from GI to liver b/c 5HT goes directly in systemic circulation instead of GI → portal vein → liver for metabolism)
defined by where it is found: APEX of lung → compress cervical sympathetic system → horner syndrome (ipsilateral PAM), SVC syndrome, hoarseness)
most are non-small cell lung carcinomas
pancoast tumor
obstruction of superior vena cava → impaired drainage from head “facial plethora”, neck (jugular venous distention), upper extremitity (edema)
commonly caused by malignancy or indwelling cathether
superior vena cava syndrome
EMERGENCY
located in PLEURA (outer lining of lung)
associated with asbestos exposure
poor prognosis
NOT ASSOCIATED WITH SMOKING
mesothelioma
lung cancer mets goes to
brain
bone
liver
adrenal glands
lung receives mets from
breast
colon
prostate
bladder
risk factors for lung cancer
smoking
silica: coal mines
radon: heavy gas that settles in basements or coal mines
asbestos (mesothelioma)
lung cancers not associated with smoking
carcinoid tumor
mesothelioma
