Pulmonary Neoplasms Flashcards
Lung and bronchus cancer is the ____ cause of all new cancer cases in men and women (2017 estimates)?
2nd
Lung and bronchus cancer is the ______ cause of death in men and women (2017 estimates)?
leading
What are the major risk factors for lung cancer?
smoking (bet you knew that one)
2nd hand smoke
certain occupational exposures - asbestos is an important example
radiation
air pollution
Among cigarette smokers what factors determine risk of developing lung cancer?
of cigarettes smoked
years smoked
early age of smoking initiation
unfiltered or high tar cigarettes
What percentage of heavy smokers develop lung cancer?
11%
What are other (besides smoking) epidemiologic risks for lung cancer?
women > men
family history of early lung cancer (<60 2x risk)
HIV
recently, more non-smokers with certain mutations (EFGR, ALK) on the rise
What % of men and women who develop lung cancer are never smokers?
15% men
53% women
What are the WHO classifications of lung cancer?
small cell lung cancer (SCLC)
Non small cell lung cancer (NSCLC)
Unclassified/Undifferentiated
What are the sub-types of NSCLC?
Adenocarcinoma
squamous cell carcinoma
large cell carcinoma
What is the most common sub-type of lung cancer?
adenocarcinoma
What type of lung cancer are you most likely to see in a never smoker?
adenocarcinoma
Which lung cancer has a higher predilection for distant metastasis?
adenocarcinoma
What is a subtype of adenocarcinoma that is more often seen in female non-smokers?
Bronchoaveolar cell carcinoma (BAC)
What are the characteristics of BAC (bronchoalveolar cell carcinoma)?
slow growing with late matastases
may cause bronchorrhea
less likely to be PET +
staged and treated as an adenocarcinoma
What subtype of cancer is the most likely to cause paraneoplastic syndromes?
Squamous cell carcinoma
What is NSCLC has a 3-4% prevalence and is aggressive, with a poor prognosis?
Large cell cancer
(strongly associated with smoking)
What are some characteristics of SCLC (small cell lung cancer)
incidence is declining, largely due to reduced cigarette smoking
early metastatic dissemination with regional nodes
originates in major bronchi
What are the major symptoms of lung cancer?
dry cough
chest pain
dyspnea
infection
fever
hemoptysis
bronchial obstruction with wheezing
If a tumor has intrathoracic extrapulmonary extension, what symptoms might you see?
chest pain
hoarseness
SVC obstruction
dysphagia
cardiac symptoms
what are some systemic symptoms one might see with lung cancer (without metastasis)?
anorexia
weight loss
weakness
paraneoplastic syndromes
What hormone is excreted by large cell carcinoma?
HCG (same as pregnancy)
What are the major radiographic features of lung cancer on chest Xray?
hilar prominence
hilar or peri-hilar mass
localized air trapping
bronchial obstruction with atelectasis or consolidation
chest wall abnormality
mediastinal mass or widening
pleural effusion
elevation of hemidiaphragm
What are the Mayo Clinic’s six independent predictors of a malignant solitary pulmonary nodule (SPN)?
- Patient Age
- Smoking Status
- History of extrathoracic malignancy
- nodule diameter
- nodule spiculation
- location in upper lobe
What size SPN is correlated with a greater risk of malignancy?
6-10 mm (24%)