Neoplastic (heads up these kinda suck) Flashcards
What are 4 examples of pulmonary nodules?
- granulomatous infections
- inflammation
- mediastinal tumors
- tumors in general
What types of things are granulomatous?
TB, histoplasmosis, coccidiomycosis
What diseases cause inflammatory nodules of the lungs?
RA, sarcoidosis, Wegener’s granulomatosis
What would cause a mediastinal tumor?
thymoma
(aren’t you glad we learned all this? nahhht)
What are characteristics of a benign nodule?
round, smooth, < 3cm
slow growth
calcifications present
cavitary present
What are characteristics of a malignant tumor?
irregular, spiculated
rapid growth (may double in 4 mos)
cavitary with thick walls
What is a bronchogenic carcinoma?
a benign or malignant neoplasm
In whom do you find malignant bronchogenic carcinomas?
What causes them?
50-60y MC
cigarette smokers or 2ndhand exposure MC cause (asbestosis 2nd MC)
Where is the greatest tendency for bronchogenic carcinoma to METS?
brain, bone, liver, lymph nodes, adrenals
What are examples of non small cell carcinoma (NSCLC)?
adenocarcinoma
squamous cell carc
large cell (anaplastic) carc
bronchoalveolar carc
Who gets adenocarcinoma and where is it in the lungs?
MC in both smokers and non, women
peripheral
Where is squamous cell carcinoma found?
What is it assoc with on dx tests?
Found centrally
common in smokers
assoc with cavitary lesions, hypercalcemia, and Pancoast syndrome
Where is large cell (anaplastic) carcinoma found?
What is this type of cancer like?
found peripherally
very aggressive
How common is bronchoalveolar carcinoma?
How do patients respond to tx?
Rare.
Very good prognosis!!!
What is the treatment for all these non small cell carcinomas?
usually local spread, so surgery is 1st line
What are the characteristics of small cell (oat cell) carcinoma (SCLC)?
metastasizes early, so METS usually found
assoc. with smoking
central and aggressive
What are treatment options for small cell carcinoma?
not surgery, because of METS
chemo w/ or w/o radiotherapy
What are clinical manifestations of bronchogenic carcinoma?
asymptomatic
cough, hemoptysis, dyspnea, anorexia, wt loss
Trousseau’s syndrome (inc blood clotting d/o)
Other syndromes that will show up on the next cards: SVC, Cushing’s, Pancoast
What is SVC syndrome?
dilated neck veins, facial plethora, prominent chest veins
assoc. with bronchogenic carc
What is Cushing’s syndrome?
ectopic ACTH production, Eaton-Lambert syndrome (neuromuscular d/o)
assoc. with bronchogenic carc
What is Pancoast syndrome?
esp with NSCLC
causes shoulder pain and Horner’s syndrome (miosis, ptosis, anhydrosis)
atrophy of hand/arm muscles
assoc. with bronchogenic carc
What will your ABG labs show you with bronchogenic carcinoma?
Hypercalcemia
SIADH/hyponatremia
Which findings are more common in small cell carcinoma?
SIADH/hyponatremia
Eaton-lambert syndrome
SVC syndrome
Which finding is more common with squamous cell carcinoma?
Pancoast syndrome
What are bronchial carcinoid tumors?
rare neuro-endocrine tumors characterized by slow growth and low METS
What can bronchial carcinoid tumors secrete?
serotonin, ACTH, ADH, and MSH
What are the clinical manifestations of a bronchial carcinoid tumor?
many asymptomatic, but show Cushing’s syndrome, obstruction, and hemoptysis
if not asymptomatic, will show “carcinoid syndrome”
What is carcinoid syndrome?
diarrhea due to high serotonin, flushing, tachycardia, bronchoconstriction, hemodynamic instability
How do you dx bronchial carcinoid tumors?
“pink to purple well-vascularized central tumor”
How do you treat a bronchial carcinoid tumor?
tumor excision (surgery)
Aaaand what do we need to know about metastatic tumors?
Like really.. just that it’s cancer from another part of the body that metastasized to the lung?
Sounds good to me
