Neoplastic lung

Question 1

What is the prevalence of lung carcinoma in the UK?

Answer 1

2nd most common cancer in the UK.
More likely to occur in males than females
Aged 40-70

Question 2

What are the risk factors surrounding lung carcinomas?

Answer 2

Smoking
Family history
Immunodeficiency
Industrial hazards (radiation, uranium, asbestos, radon, silica and air pollution).

Question 3

What are the physical symptoms of lung carcinoma?

Answer 3

Cough
Weight loss
Chest pain
Dyspnoea

Question 4

Explain paraneoplastic syndromes.

Answer 4

Ectopic hormone secretion by tumour.
Release of ADH- hyponatraemia
ACTH- causing cushing syndrome
Parathyroid hormone- causing hypercalcaemia
Calcitonin- causing hypocalcaemia
Gondatrophin- causing gynaecomstia
Serotonin and Bradykinin- carcinoid syndrome.

Question 5

What are the cut of sizes for T1, T2, T3 tumours?

Answer 5

Less than 2cm- T1a
Less than 3cm- T1b
Less than 5cm- T2a
Less than 7cm- T2b
Greater than 7cm- T3.

Question 6

What are small cell carcinomas?

Answer 6

20% of lung cancers.
Strong link to smokers
Occur in major bronchi
Do not respond to surgery- must use chemo.
Finely granular nuclear chromatin- look like salt and pepper.

Question 7

Explain squamous cell carcinoma

Answer 7

Most commonly affects men.
Strong link to smoking.
Arises close to hilum centrally from bronchi- and area of squamous metaplasia.
Characterised by keratin formation and intercellular bridges.

Question 8

Explain adenocarcinoma of the lung

Answer 8

Most common type of neoplastic lung cancer found in women and non-smokers.
Peripherally located.
Grow more slowly than squamous cell carcinoma but metastasise early and widely.
Associated with scaring- healed TB.

Question 9

Explain large cell carcinoma.

Answer 9

Undifferentiated malignant epithelial tumour with no discernible features by light microscopy.

Question 10

Explain lung metastases.

Answer 10

Most common site of metatastic neoplasms.
Arrive by blood or lymphatics.
Common primary sites- bowl, prostate, breast, kidney.

Question 11

Explain plural tumours.

Answer 11

Secondary metatastic involment- more common than a primary tumour in the lung.
Serous effusion is often present.

Question 12

Explain malignant mesothelioma

Answer 12

Primary pleural tumour.
Caused by exposure to asbestos
No increased link with smoking
Latent period of 25-45 years.

Question 13

What are the side effects of mesothelioma?

Answer 13

Chest pain
Dyspnoea
Pleural effusions.