Lung Cancer General Features

Question 1

2 types of bronchogenic cancer?

Answer 1

Non-small cell lung carcinoma

Small cell lung carcinoma

Question 2

NSCLC types?

Answer 2

1. Squamous cell carcinoma
2. Adenocarcinoma
3. Bronchioloalveolar carcinoma
4. Large cell anaplastic carcinoma

Question 3

SCLC types?

Answer 3

Small cell carcinoma (oat cell carcinoma)

Question 4

NSCLC qualities?

Answer 4

Less frequently metastatic, less responsive to chemotherapy

Question 5

SCLC qualities?

Answer 5

Almost always metastatic, high initial response to chemotherapy

Question 6

All lung carcinomas Routes of spread and metastasis?

Answer 6

1. Local spread to adjacent lung parenchyma
2. Lymphatic spread to regional lymph nodes
3. Transcoelomic spread to pleural space, pericardium
4. Haematogenous spread to distant organs (brain, bone, liver, adrenal glands etc)

Question 7

All lung carcinomas local effects? (7)

Answer 7

1. Tumour ulceration (hemoptysis)
2. Tumour obstruction of airway (dyspnea, pneumonia, lung
   abscess, lobar collapse)
3. Tumour obstruction with accumulation of cellular lipid in foamy macrophages (lipid pneumonia)
4. Tumour spread into pleura (pleural effusion)
5. Recurrent laryngeal nerve invasion (hoarseness)
6. Sympathetic ganglia invasion, especially by Pancoast tumours (Horner’s syndrome)
   leading to ptosis, miosis, anhidrosis
7. Tumor compression of SVC- Superior vena cava syndrome

Question 8

All lung carcinomas prognosis?

Answer 8

􀂃 Poor prognosis (especially small cell carcinoma & late stages of the other carcinomas)

􀂃 Overall 5-year survival rate = 5-15%

Question 9

All lung carcinomas etiology?

Answer 9

Cigarette smoking (especially linked with squamous cell and small cell carcinoma); air pollution;
ionizing radiation;
asbestos; nickel; chromium exposure

Question 10

Lung carcinomas metastasize to?

Answer 10

Adrenals, brain, liver, bone

Question 11

Is primary lung cancer more common or metastasis from other locations more common?

How do they spread?

Answer 11

Metastases of other cancers to the lung are more common than primary lung cancer and may spread to lung hematogenously, via lymphatics or through contiguous growth.

Question 12

What other neoplasm can occur in the lung?

Answer 12

Carcinoid tumor

Question 13

Lung carcinomas Imaging fx?

Answer 13

CXR= demonstrates pneumonic coin lesion