Lung cancer

Question 1

SCLC or NSCLC; which is more common?

Answer 1

NSCLC

Question 2

Which cancer is known to cause hypercalcaemia?

Answer 2

Squamous cell

PTH secretion -> hypercalcaemia

Question 3

Which lung cancer subtypes are usually central?

Answer 3

Squamous cell and SCLC

Question 4

Which lung cancer is commonly seen in non-smokers?

Answer 4

Adenocarcinoma

Question 5

Which lung cancer subtypes are usually peripheral?

Answer 5

Adenocarcinoma and Large cell

Question 6

Hypertrophic osteoathritis is commonly seen with..

Answer 6

Adenocarcinoma

Inflammation of bones and joints. Commonly also causes clubbing

Question 7

Small cell (SCLC) almost always occurs in..

Answer 7

Smokers

Question 8

Which is the most common lung cancer to cause paraneoplastic syndrome

Answer 8

SCLC

Question 9

Which is most likely to cause SVC obstruction

Answer 9

SCLC

Question 10

Which subtype is known to be fast-growing and early metastasising?

Answer 10

SCLC

but note: also highly responsive to chemo/radiotherapy

Question 11

Which subtypes are known to cause pancoast tumours

Answer 11

Squamous cell and adenocarcinomas

Question 12

Pancoast tumour=

Answer 12

Tumor of the pulmonary apex which often compresses nerves (brachial plexus) and blood vessels of the arm

Weakness of the hands
Pain in the shoulder and shoulder blade
Horner’s syndrome (cervical sympathetic ganglion) = miosis (constriction), ptosis (drooping) and anhidrosis (absence of sweating of the face)

Question 13

Carcinoid syndrome

Answer 13

Type of paraneoplastic syndrome
Release of serotonin

Increased peristalsis and dioarrhoea
Bronchoconstriction

Question 14

SVC obstruction

Answer 14

Facial swelling/oedema and SOB

Question 15

Cannonball lung lesions are indicative of..

Answer 15

Lung mets

Most commonly caused by renal cell cancer or secondary to choriocarcinoma and prostate cancer

Question 16

Neuroendocrine activity of

Squamous cell and Small cell carcinoma

Answer 16

Squamous = increased PTH and hypercalcaemia (‘Squalcium’ or Squamous squishes your bones)

Small cell = Increased ACTH + ADH and Lambert Eaton syndrome (SmAAll cELS= ACTH, ADH, Eaton-Lambert Syndrome)

Question 17

Carcinoid tumours symptoms

Answer 17

Flushing, wheezing and diarrhoea

Question 18

Pancoast tumours =

Answer 18

Lung cancer at the pulmonary apex
Can affect the sympathetic chain and cause Horner's syndrome:
Ptosis
Meiosis
Anhydrosis.

Question 19

Carcinoid tumours are..

Answer 19

Low-grade neuroendocrine malignancies
Typicall affect the lung and GI tract

Release Serotonin, ACTH and GHRH

Question 20

Which Lung Ca is associated with PTH hormone release?

Answer 20

Squamous cell

Question 21

Voice hoarseness is commonly seen with..

Answer 21

Pancoast tumours (suppression of recurrent laryngeal nerve) -> usually squamous and adenocarcinoma

Question 22

Pancoast tumours are _____ cancers and are found in the ____________ and commonly cause compression of ________ (5 structures) and the _______ ganglion

Answer 22

NSCLC

Apex of lungs

Brachiocephalic vein, subclavian artery, phrenic nerve, recurrent laryngeal nerve, vagus nerve

Sympathetic ganglion

Leads to miosis, ptosis, anhydrosis