lung cancers - bronchial carcinoma Flashcards
what is bronchial carcinoma
the primary malignancy of lung parenchyma
2 types of bronchial carcinoma
small cell and non small cell carcinoma
risk factors for bronchial carcinoma
- smoking
- asbestos
- coal
- ionising radiation
- existing lung disease
what percentage of bronchial carcinomas are small cell
15%
who does small cell carcinoma affect
it is exclusive to smokers
what is small cell carcinoma
Malignancy affecting central respiratory system (bronchi)
appears as small cells with minimal cytoplasm on biopsy.
it is fast growing and early mets
symptoms of small cell carcinoma
- cough w haemoptysis
- SOB
- recurrent chest pain
- Constitutional Sx (same in all ca)
- Compression Sx
- PARANEOPLASTIC SYNDROMES!!!!!
what are paraneoplastic syndromes
- ectopic ACTH –> cushings
- ectopic ADH –> SIADH
- lambert eaton syndrome
investigations for small cell carcinoma
1st line = Imaging (CXR then CT)
GS = Bronchoscopy and biopsy
Staging with TNM
treatment for small cell carcinoma
If very early, may try chemo/radio (usually unsuccessful).
Palliative often
what percentage of bronchial carcinomas are non small cell
85%
4 types of non small cell carcinoma
- squamos
- adenocarcinoma
- carcinoid tumour
- large cell
what is squamos non small cell carcinoma
Bronchial carcinoma arising from lung epithelium histologically resembling squamous epithelium
- affects central lung
- lesions with central necrosis
- may secrete PTHrP –> hypercalcaemia
who does squamos carcinoma affect
mainly smokers
(more than any NSCLC)
symptoms of squamos carcinoma
- Lung Sx
- Constitutional Sx
- Compression Sx,
- PARANEOPLASTIC SYNDROME = PTHrP
when does squamos carcinoma metastasize
Metastasises late, spreads locally in most cases
investigations for squamos carcinoma
1st = Imaging (CXR then CT)
GS = Bronchoscopy + biopsy
TNM staging
how to treat squamos carcinomas
Surgical excision in most cases.
If mets - chemo and/or radiotherapy
what is adenocarcinoma
Bronchial carcinoma arising from mucus secreting glandular epithelium
affects peripheral lung
what is the main risk factor for adenocarcinoma
ASBESTOS EXPOSURE!
what is the most common bronchial carcinoma
adenocarcinoma
40-45%
what symptoms are present in adenocarcinoma
- Lung Sx
- Constitutional Sx
- Compression Sx,
what is adenocarcinoma closely related to
Adenocarcinoma NSCLC is also closely related to HYPERTROPHIC PULMONARY OSTEOARTHROPATHY
→ Triad of clubbing, arthritis and long bone swelling
investigations for adenocarcinoma
1st = Imaging (CXR then CT)
GS = Bronchoscopy + biopsy
TNM staging
how to treat adenocarcinoma
Surgical excision in some cases.
If mets (more likely) - chemo and/or radiotherapy
common mets of adenocarcinoma
bone
brain
adrenals
lymph nodes
liver
what is carcinoid tumour
associated with genetics
MEN1 mutation and neurofibromatosis 1
it is a neuroendocrine tumour
arises in GI tract and sometimes lungs
symptoms only appear when liver mets present
is small cell more aggresive or non small cell
small cell is more aggresive
are secondary lung tumours more common or primary
secondary
because lungs oxygenate 100% blood therefore all blood comes to lungs so higher mets risk
what is pancoast tumour
tumour in lung apex metastasizes to necks sympathetic plexus - causing horners sydnrome
