Pathology of lung cancer Flashcards
What are the local signs of bronchial obstruction?
Collapse of lobe/segement
Mucociliary escalator damaged so secretions pool in the lung
Bronchiectasis distal to tumour
Endogenous lipid pneumonia
What are the local signs of pleural malignancy?
Inflammation
Malignancy in pleura
Where can lung cancer directly invade?
Chest wall
Nerves
Mediastinum
Lymph nodes
What happens when lung cancer invades the phrenic nerve?
Diaphragmatic paralysis
What happens when lung cancer invades the L recurrent laryngeal nerve?
Hoarse bovine cough
What happens when lung cancer invades the brachial plexus?
Pancoast T1 damage
- Neurological symptoms in the hand/arm
What happens when lung cancer invades the cervical sympathetic chain?
Horner’s syndrome
- Sympathetic neurological paralysis unilaterally
What is the effect of lymph node metastasis?
Mass effect
Lymphangitis carcinomatosis
Where can lung cancer effect extra thoracically?
Skeletal
Endocrine
Neurological
Cutaneous
Haematologic
Cardiovascular
Renal
What are the signs in the skeleton?
Finger clubbing
Hypertrophic pulmonary osteoarthropathy (HPOA)
What are the endocrine signs?
ACTH
siADH
PTH
Carcinoid syndrome
Gynecomastia
What are the neurological sings of lung cancer?
Polyneuropathy
Encephalopathy
Cerebellar degeneration
Myasthenia (Eaton-Lambert)
What are the cutaneous signs of lung cancer?
Acanthosis nigricans
Dermatomyositis
What are the haematologic signs of lung cancer?
Granulocytosis
Eosinophilia
DIC
What are the cardiovascular signs of lung cancer?
Thrombophlebitis migraines
What are the renal signs of lung cancer?
Nephrotic syndrome
What are the characteristics of lung cancer?
Presents LATE in natural history.
Symptomatic lung cancer generally equals fatal lung cancer.
May have few signs/symptoms until disease is advanced.
SYMPTOMATIC LUNG CANCER = FATAL
What are the 4 types of lung cancer?
Squamous cell
Adenocarcinoma
Large cell carcinoma
Small cell carcinoma
What are complications of tumour invasion of the chest?
Recurrent chest infections
What are complications of tumour invasion of the oesophagus?
Progressive dysphagia
What are complications of tumour invasion of the pericardium?
Pericardial effusion
Malignant arrythmias
What are complications of tumour invasion of the venous system?
Superior vena cava obstruction
What are the effect of tumour compression of the phrenic nerve?
Ipsilateral diaphragmatic paralysis
What are the effect of tumour compression of the L. recurrent laryngeal nerve?
Hoarse, bovine cough
What are the effect of tumour compression of the cervical sympathetic chain?
Horner’s syndrome
(ptosis, miosis, anhydrosis)
