Neoplasia Flashcards
What are the causes of lung cancer?
Smoking (85%)
Asbestos
Environmental radon
Air pollution
Pulmonary fibrosis
What are the types of tumours of the lungs?
Carcinomas
Lymphoma
Sarcoma
Metastases
What are the 2 types of lung carcinomas?
Small cell lung cancer 15%
Non-small cell lung cancer 85%
What is the distribution of SCLC?
Central
What are the types of NSCLC?
Squamous cell (central)
Adenocarcinoma (peripheral)
Large cell carcinoma (peripheral)
Mutations in what genes can cause adenocarcinomas?
EGFR
KRAS
HER2
BRAF
What are the local symptoms of lung cancer?
Cough
SoB
Pneumonia
Chest infections
What are the constitutional symptoms of lung cancer?
Fever
Weight loss
Fatigue
Malaise
What are the local invasion symptoms of lung cancer?
Hoarse voice (recurrent laryngeal nerve)
Difficulty breathing (phrenic nerve)
Shooting arm pain (brachial plexus)
Horner’s syndrome (cervical sympathetic chain)
Facial swelling (blood vessels)
What are the metastatic symptoms of lung cancer?
Brain- headaches, dizziness, vomiting
Bone- pain, fractures
Liver- abdominal pain
Adrenal gland- asymptomatic
What are the paraneoplastic syndromes of lung cancer?
Caused by the tumour releasing hormones
What are the skeletal signs of lung cancer?
Clubbing
Hypertrophic pulmonary osteoarthropathy (HPOA)
What are the endocrine signs of lung cancer?
Carcinoid syndrome
SiADH- excessive ADH release
PTH- parathyroid hormone
Cushing’s- high levels of cortisol
What are the neurological signs of lung cancer?
Polyneuropathy
Cerebellar degeneration
What are the cutaneous signs of lung cancer?
Dermatomyositis
What are the haematological signs of lung cancer?
Eosinophilia
Disseminated intravascular coagulation (DIC)
What are the cardiovascular signs of lung cancer?
Thrombophlebitis migraines
What are the renal signs of lung cancer?
Nephrotic syndrome
What are the immune signs of lung cancer?
Lambert Eaton Myasthenia syndrome
What are the general signs of lung cancer?
Clubbing
Lymphadenopathy
Horner’s syndrome
Pancoast tumour
Hepatomegaly
Skin nodules
Chest signs
Svc obstruction
What does lung cancer look like on CXR?
Lobar collapse
Consolidation
Hilary lymphadenopathy
Mediastinal widening
Pleural effusion
Mass or nodule
What does lung cancer look like on CT?
Non calcified nodule
What other investigations are done?
FBC
Renal and liver function
Calcium
Clotting screen
Spirometry
What are the types of tissue biopsy?
Bronchoscopy
EBUS
Image guided biopsy
Fine needle aspiration of neck node
Bone biopsy
Mediastinoscopy
Surgical excision biopsy
What are the treatment options for lung cancer?
Surgical
TKI inhibitors
Chemotherapy
Radiotherapy
Immunotherapy
Palliative management
What are the types of surgical resection?
Lobectomy (FEV1>1)
Pneumonectomy (FEV1>2)
Wedge resection (FEV1>2)
What is an example of an immunotherapy treatment?
Nivolumab blocks binding of PD1 and PDL1
This allows the immune system to attack the tumour
