Lung neoplasms and malignancy Flashcards
what are the major risk factors for lung cancer?
smoking occupational ionizing radiation p450 polymorphisms - CYP1A1 chromosome fragility
what % of newly diagnosed lung cancer occur in those who never smoked?
60%
what are the major presenting signs and symptoms of lung cancer?
weight loss chest pain bone pain fever SVCO wheezing and stridor
what tests are ordered for a likely cancer diagnosis?
PET
biopsy
resection
what are the most common cancers that metastasize to the lung?
breast colorectal prostate cervical endometrial renal head / neck
what are the non small cell lung cancers?
squamous cell CA
adenocarcinoma
large cell CA
lung cancer arises from what tissue?
respiratory epithelium (alveoli, bronchioles, bronchi)
which NSCLC cancer type has a classic association with smoking?
squamous cell
what are the features of squamous cell CA?
centrally located mass
nests of cells, often have keratin pearls
can cavitate
what is the current #1 lung cancer in non-smokers?
adenocarcinoma
what are the features of adenocarcinoma?
bronchoalveolar
peripherally located
multiple subtypes / variants
wide metastases
what are the features of large cell CA?
usually peripheral
sheets of cells, often with necrosis
poor differentiation
what are some lung cancer-associated syndromes?
horner syndrome
pancoast’s syndrome
SVC syndrome
all types of paraneoplastic syndromes can cause what condition?
dermatomyositis
what is/are the paraneoplastic syndromes associated with squamous cell CA?
hypercalcemia - PTHrP
what is/are the paraneoplastic syndromes associated with small cell CA? why?
cushing’s syndrome - ACTH, cortisol
SIADH - ADH
eaton-lambert syndrome - calcium channel antibody
it is a neuroendocrine tumor
what is/are the paraneoplastic syndromes associated with adenocarcinoma?
DIC
thrombophlebitis
microangiopathic hemolytic anemia
what is/are the paraneoplastic syndromes associated with large cell CA?
gynecomastia
what are the most likely metastasis sites for lung cancer (where does it go)?
liver
brain
bone
adrenal
what is the definitive diagnostic test for lung cancer?
biopsy
what are the indications for low dose CT?
age 55-74
over 30 pack year smoking history
current smoker or have quit within the last 15 years
in relatively good health
treatment: NSCLC stages I and II
resection possible
chemo / radiation
treatment: NSCLC stage III
chemo
treatment: NSCLC stage IV
chemo
palliative
treatment: SCLC - solitary nodule, no regional nodes, no distant mets
surgery (rare)
treatment: SCLC - advanced
chemo
radiation
what are the biologic agents for lung cancer? what is the MOA?
nivolumab
pembrolizumab
monoclonal IgG4 Ab
half of benign lung neoplasms are what type of growth?
hamartoma
