Lung Lumps Flashcards
Small cell
Often called oat-cell lung cancer –> Small, primitive undifferentiated cells –> from APUD neuroendocrine cells
20-25% of lung cancers –> strongly linked to smoking
Rapidly spreads; treat with chemo and palliation
These cancers often secrete ectopic hormones
Ca of the bronchus may be
Small cell 18% Large cell 10% Squamous 35% Adenomatous 27% Alveolar <1%
Hormone secretion by small cell cancers
ACTH
ADH (syndrome of inappropriate ADH)
Lambert-eaton syndrome
Squamous cell carcinomas (SCLC)
strongest link to smoking, affects men more, 20% of LC
Starts in the large bronchi near the centre of the lung and often metastases to locoregional lymph nodes–> spreads outside the lung later than other types
Can cause PTHrP or hypertrophic pulmonary osteo-arthropathy
PTHrP
This is parathyroid hormone related protein
It can be secreted by squamous cell lung cancers
This can cause a para-neoplastic humoral hypercalcaemia
Hypertrophic pulmonary osteo-arthropathy
Also known as Bambger-Marie syndrome
A syndrome of increased bone deposition in long bones presenting with clubbing and painful joints
This can occur as a para-neoplastic syndrome in non-small cell lung carcinomas.
Lambeth eaton myasathenic syndrome
A rare autoimmune syndrome characterised by muscle weakness In the limbs due to antibodies against presynaptic voltage gated Ca channels
It occurs as a para-neoplastic syndrome secondary to small cell lung cancer in 60%
Large cell lung cancer (LCLC)
A heterogenous group of undifferentiated cancers originating from transformed epithelial cells 5-10% of lung cancers
not as strongly associated with smoking
May be curatively excised
Adenocarcinoma of the lung
27% of lung cancers with the weakest link to smoking
distinct adenomatous features: gland or duct formation +- mucus production
starts at the outside of the lung
often seen in women
May be curatively excised
Local complications of lung cancer
Recurrent laryngeal nerve palsy Phrenic nerve palsy SVC obstruction Horner's Rib erosion Pericarditis AF
Common mets for lung ca
Brain
Bone
Liver
Adrenals (addison’s)
Prognosis of lung cancer
non-small cell: 50% 2yr w/out spread, 10% w/spread
Small cell: 3mo w/out treatment, 1-1 1/2 yrs w/treatment
Commonly affected patients in sarcoidosis
High in Northern Europe, more frequently in African-caribbeans, more frequently in women.
Associated with HLA-DRB1 and DQB1
CXR in sarcoidosis
Bilateral hilar lymphadenopathy +/- pulmonary infiltrates/fibrosis
Blood tests in sarcoidosis
^ESR ^LFT ^ACE ^Ca2+ ^Ig
