Lung Cancer Flashcards
Most lung cancers are what type of tumour?
Adenocarcinomas (non small cell)
How is lung cancer divided up into different classes?
- Small cell
- Non-small cell (Adenocarcinoma, squamous, large/giant cell)
Non small cell accounts for 75% of lung cancer with adenocarcinoma being the most common
Lung cancer investigations?
1) CXR
2) contrast CT of neck, thorax and upper abdo to stage
3) If medial lesion then you can sample it with bronchoscopy
If peripheral lesion then you need to do a needle biopsy
Features of adenocarcinoma?
- Most common type of lung cancer.
- Also the most common type seen in non smokers.
- Gland forming and mucous producing.
- Most commonly grow in the peripheries of the lung.
- Express TTF 1 mutations (Thyroid transcription factor)
- Adenocarcinoma has the best survival rate
Squamous cell cancer features?
- Second most common type of tumour.
- Keratinising tumour
- Usually found centrally and frequently cavitates.
SECRETES PTH - GIVES HYPERCALCAEMIA
- Expresses nuclear antigen p63 and high molecular weight cytokeratins.
Small cell lung cancer features?
Worst prognosis of all lung cancers.
- High grade neuroendocrine tumours.
- Secrete ACTH and ADH due to their high neuroendocrine nature.
- Lamber Eaton myasthenia syndrome
- Cushing’s syndrome
- SIADH
Which cancer is chemo and which cancer is radiosensitive?
Small cell = chemosensitive
Non small cells = No chemo, radiosensitive.
Hoarseness + Shortness of breath:
Probably lung cancer with compression of recurrent laryngeal nerve.
Exposure to asbestos + Recurrent pleural effusion?
Mesothelioma
How does malignant mesothelioma appear on imaging?
- CXR = pleural effusions
- CT = pleural thickenings (can do a pleural tap/biopsy)
Management of malignant mesothelioma?
Give sclerosing TALC to prevent effusions.
Surgery +/- chemo +/- radiotherapy
