Lung cancer Flashcards
What are the two main types of lung cancer? And which is more common?
Small cell and non-small cell. Non-small cell more common
Where are small cell lung cancers found?
Centrally, near mediastinum, often as solitary nodule
Define paraneoplastic syndrome
Set of clinical features caused by altered immune response due to systemic metastasis or substances released by tumours
What are the paraneoplastic syndromes caused by small cell lung cancer?
SIADH, Lambert-Eaton syndrome, Cushing syndrome
What are the sub-sets of non-small cell lung cancer?
Adenocarcinoma, Squamous cell carcinoma, Large cell carcinoma, Bronchial carcinoid, Mesothelioma
Where are adenocarcinomas found?
Peripherally (in lung), solitary nodule
What genetic mutations are involved in adenocarcinoma?
KRAS, EGFR, ALK
What are the characteristics of hypertrophic osteoarthopathy and what form of lung cancer causes it?
Clubbing, periostitis, distal expansion of long bones. Adenocarcinoma
What is the histological feature of adenocarcinoma?
Glandular (tall, columnar), positive mucin
Where are squamous carcinomas found?
Centrally, hilar mass near bronchus, associated with smoking
What are the paraneoplastic syndromes caused by squamous cell cancer?
Hypercalcemia, low PTH,
What is the histological feature of squamous cell carcinoma?
Keratin pearls, intracellular bridges
Where are large cell carcinomas found?
Peripheral nodule, undifferentiated, poor prognosis, unresponsive to chemo/surgery preferred
What are the paraneoplastic syndromes caused by small cell lung cancer?
Increase beta-hCG
Where are bronchial carcinoid found?
Originates from intestine. Good prognosis and rarely metastasises
What are the paraneoplastic syndromes caused by bronchial carcinoid?
Increased serotonin, flushing, right sided valvular defect, diarrhoea, bronchospasms
Where are mesotheliomas found?
Malignancy of lung pleura, caused by asbestos,
What is the histological feature of mesotheliomas?
Calcium deposits, positive cytokeratin + calretinin (positive in mesotheliomas but negative in most other cancers)
What are some of the causes of lung cancer?
Smoking, exposure (e.g. asbestos, radon, arsenic, uranium), idiopathic (especially adenocarcinoma)
What are the clinical features of lung cancer?
Cough, haemoptysis, progressive dyspnea, chest pain
What are some extra pulmonary symptoms of lung cancer?
Superior vena cava syndrome, swelling of arms and face, compression of recurrent laryngeal nerve, Horner’s, pleural effusion
How are lung cancers staged?
TNM staging. NSCLC staged via TNM. SCLC based on whether there is spread to other hemithorax
How are lung cancers diagnosed?
Chest X-ray (nodule, hilar enlargement, consolidation, lung collapse, pleural effusion), cytology of sputum and pleural fluid, fine needle aspiration/biopsy, CT staging
What are the treatments of lung cancer?
NSCLC: Lobectomy (small tumours), radical radiotherapy, radiotherapy with chemotherapy(e.g. cetuximab) (advanced)
SCLC: Surgery, chemo/radiotherapy
