Lung cancer Flashcards
Etiology of Lung Cancer?
– Tobacco smoke • Direct relationship between amount of exposure and risk • Filter decreases risk • Stop smoking greater than 6 years reduces risk
– Asbestos exposure • Mesothelioma
– Atmospheric pollution • Higher lung CA in urban vs. rural
– Involvement with radioactive ores
– Metals • Nickel, silver, chromium, cadmium, beryllium, cobalt, selenium
– Chemical products • Chloromethyl ethers
Signs and symptoms of lung cancer?
Signs and Symptoms
– Secondary to central or endobronchial growth or primary tumor • Cough • Hemoptysis • Wheeze and stridor • Dyspnea from obstruction • Pneumonitis from obstruction (fever, cough)
– Secondary to peripheral growth • Pain from pleural or chest wall • Cough • Lung abscess from tumor cavitation
Paraneoplastic syndromes of lung cancer?
Lesions that cause a mass on chest radiography?
What is the diagnostic assessment of mass lesions?
Histological types of lung cancer?
Squamos cell carcinoma?
– Squamous Cell Carcinoma
- Bronchial epithelium
- Centrally located – commonly cavitates
- Locally invasive (less distant metastasis)
- Responsible for 50% of pancoast tumors
- More common in males
- Associated with smoking
- Usually surgically resectable
- Produces PTH
Explain adenocarcinoma?
– Adenocarcinoma
- Bronchoalveolar epithelium
- Peripheral, small, confined to one lobe
- Prior lung injury may predispose
- More common in females
- Not associated with smoking
- Invade pleura and lymph nodes
Explain large cell carcinoma?
– Large cell carcinoma
– Bulky, peripheral or central
– Invade pleura, adjacent lung
– Anaplastic type metastases
– Can cavitate
explain bronchoalveolar carcinoma?
– Bronchoalveolar carcinoma
- Multinodular presentation
- Hard to distinguish from metastasis
- Associated with prior lung disease
- No smoking history
What are the staging procedures for lung cancer (not small cell)
– History, physical exam including ENT exam
– Chest x-ray
– CT scan if x-ray suspicious
– Complete blood counts, blood chemistries
– Complete pulmonary function studies (surgery)
– Scans of brain, liver, bone, if appropriate
– Biopsy of suspicious lesions
– Mediastinoscopy (surgery)
– Skin test for tuberculosis
Explain small cell lung carcinoma?
– Small Cell Carcinoma
- Appear submucosal
- Kulchitsky-type cells of neuroectodermal origin
- Central location – star burst picture
- Most rapidly growing lung cancer
- Early widespread metastasis (liver, bone, CNS, adrenal glands)
- Ectopic hormone production (ACTH, calcitonin, ADH)
- Associated with smoking
- Therapy is chemotherapy for all atages
Staging procedures for small cell carcinoma?
– History, physical exam
– Chest x-ray
– Blood count, blood chemistry
– Scans of liver, brain, and bone
– Bone marrow biopsy
– Liver biopsy if suspicious on exam or lab
– CSF evaluation if lab or exam suspicious
explain the standard treatment of lung cancer? small cell and others?
contraindications for surgery in lung cancer?
