Lung Cancer Overview and Preop Eval Short Flashcards
Characteristics of lung adenocarcinoma
- MC histologic type in non-smokers
- Peripheral distribution
- Cytokeritin 7 and thyroid transcription factor-1 (TTF-1)
What is bronchoalveolar ca
indolant, non-invasive, variant of adenocarcinoma
Characteristics of lung SCC
- Usually arise in major bronchi
- Discrete smoking dose-response relationship
- Assoc with necrosis and cavitary lesions
- Cytokeratin pearls on histology
Characteristics of large cell lung ca
- 10-15% of lung ca
- Large, peripheral mass on CXR
Characteristics of SCLC
- 15-20% of lung ca
- Usually metastatic at time of dx
- Poor prognosis
- Neuroendocrine type of lung ca
2 neuroendocrine tumor associated lung cancers
- SCLC
- Carcinoid
Most common presenting symptoms of lung ca
Weight loss
Fatigue
Cough
Dyspnea
Hemoptysis
Paraneoplastic syndroms MC with what lung cancer types
SCLC (SIADH)
SCC (hypercalcemia, PTHRP)
SVC synrome MC with what lung cancer type
SCLC (bulky upper lobe tumor)
MC metastatic symproms
Neurologic (headache)
Bone pain
General approach to cancer management
Name
Stage
Treat
Approach to diagnosis (Name) of lung ca
Histologic confirmation (Name) mandatory:
- Sputum cytology
- Bronch with bx
- EBUS with bx
- FNA
- CT guided FNA
- Surgical bx
Lung cancer staging based on
TNM classification
Lung ca (T-stage)
T1: < 3 cm (T1a: < 2cm, T1b 2-3 cm)
- surrounded by visceral pleura
- involvment of lobar (not main) bronchus
T2: 3-7cm (T2a: 3-5 cm, T2b: 5-7 cm)
- involvement of main bronchus (> 2cm from carina)
- invasion of visceral pleura
- atelectaiss or obstructive pneumonitis (< entire lung)
T3: > 7 cm
- invasion of CW, diaphragm, phrenic n, mediastinal pleura, parietal pleura
- involvement of main bronchus (< 2cm from carina, not involving carina itself)
- atelectasis or obstructive pneumonitis (entire lung)
- separate tumor nodules in same lobe
T4:
- invasion of mediastinum, heart, great vessels, trachea, RLN, esophagus, vertebral body
- involvement of carina
- separate tumor nodules in different, ipsilateral lobes
Lung ca (N-stage)
N1: Ipsilateral peribronchial, hilar, intrapulmonary LN
N2: Ipsilateral mediastinal/subcarinal LN
N3:
- Contralateral mediastinal/hilar LN
- Ipsilateral/contraleral scalene or supraclavicluar LN
Lung ca (M-stage)
M1: Distant mets
M1a:
- Separate tumor nodule in contralateral lobe
- Tumor with pleural nodules
- Malignant pleural or pericardial effusion
M1b: distant mets (liver, bone, brain, adrenal)