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Foundations-Pulmonary > Pulmonary Neoplasms > Flashcards

Pulmonary Neoplasms Flashcards

1
Q

Solitary pulmonary nodule definition

A
  1. Well-circumscribed
  2. Isolated
  3. Round opacity
  4. Completely surrounded by normal lung
  5. Not associated with infiltrate, atelectasis or adenopathy
  6. ≤ 3 cm
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2
Q

Most common SPN etiology

A
  1. Bronchogenic carcinoma
  2. Metastatic lesion
  3. Infectious granuloma
    - Histoplasmosis
    - Coccidioidomycosis
    - Tuberculosis
    - Other fungal
  4. Calcification
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3
Q

Solitary pulmonary nodule clinical presentation

A
  1. Usually asymptomatic

2. Found incidentally on CXR

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4
Q

What increases the risk of a SPN being cancerous?

A

Increasing age

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5
Q

What does cavitation with thick walls (>16 mm) findings on a CXR indicate?

A

Higher change of malignancy

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6
Q

What does dense calcification indicate on a CXR? Less calcification?

A 
Benign = dense calcification -(central or laminated pattern)
Malignant = less calcification (stippled or eccentric pattern)
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7
Q

CT concerning features for malignancy

A
  1. Spiculated margins
  2. Peripheral halo
  3. Density on CT scan
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8
Q

Harmartoma

A

“popcorn calcification” on CXR= Benign

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9
Q

What is low risk assessment of SPN?

A
  1. Age < 30
  2. Stable lesion x ≥ 2 years
  3. Characteristic benign calcification pattern
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10
Q

Management of low risk SPN

A
  • Watchful waiting

- Serial imaging (CXR or CT)

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11
Q

Management of intermediate risk SPN

A
  1. Diagnostic biopsy (transthoracic needle aspiration or bronchoscopy)
  2. PET
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12
Q

Management of high risk SPN

A

Resection

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13
Q

Lung cancer definition

A

Malignant neoplasm of the lung arising from respiratory epithelium:

  • Bronchi
  • Bronchioles
  • Alveoli
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14
Q

What are the two main groupings of lung cancer

A
  1. Non–small cell lung cancer (NSCLC) = most common (80-85%)

2. Small cell lung cancer (SCLC)

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15
Q

What are the two most common types of lung cancer?

A
  1. Adenocarcinoma

2. Squamous cell carcinoma

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16
Q

what is the greatest risk factor for lung cancer? how many lung cancers does the compose of?

A

Tobacco smoke
=about 80% of lung cancers
Duration and quantity increase risk

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17
Q

What cancer is least associated with lung cancer

A

Adenocarcinoma

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18
Q

Location of adenocarcinomas

A

Peripheral nodules or masses

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19
Q

Squamous cell carcinoma location

A

Arise from the bronchial epithelium–>centrally located, large airways

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20
Q

What cancer tends to metastasize later?

A

Squamous cell carcinoma

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21
Q

Large cell carcinoma characteristic

A

Usually a large, peripheral mass with prominent necrosis

22
Q

Small cell carcinoma location

A

Centrally

23
Q

Small cell carcinoma survival

A

6-18 weeks

Regional or distant metastasis @ time of dx

24
Q

Bronchial carcinoid tumors

A

Pedunculated or sessile growths in central bronchi

25
Q

What cells are Bronchial carcinoid tumors derived from?

A

neuroendocrine cells

26
Q

Bronchial carcinoid tumors clinical presentation

A
  1. Hemoptysis
  2. Cough
  3. Focal wheezing
  4. Recurrent pneumonia
  5. Peripherally located: asymptomatic SPNs
27
Q

Carcinoid syndrome

A
  1. Flushing
  2. Diarrhea
  3. Wheezing
  4. Hypotension
    * rare
28
Q

What are the most common signs/sx’s of lung cancer?

A
  1. Cough
  2. Hemoptysis
  3. Dyspnea
  4. Pain
29
Q

Superior vena cava syndrome sx’s

A
  1. Bulky upper lobe tumor
  2. Sensation of fullness in the head
  3. Dyspnea
30
Q

Superior vena cava syndrome PEx’s

A

Dilated neck veins
Facial edema
Plethoric appearance

31
Q

Superior vena cava syndrome CXR findings

A

Widening of mediastinum

R hilar mass

32
Q

What lung cancer is Superior vena cava syndrome most common in?

A

Small cell carcinoma

33
Q

Pancoast syndrome

A

Shoulder pain

Horner’s syndrome: Ptosis, Miotic (constricted pupil)

34
Q

What cancer is Pancoast syndrome most common in?

A

non-small cell carcinoma

35
Q

What are the 4 most common extrathoracic metastases

A
  1. Liver
  2. Bone-Use. vertebral bodies
  3. Adrenal-usu. asymptomatic
  4. Brain
36
Q

Paraneoplastic syndromes / Extrathoracic effects definition

A
  • Effects of tumor that are not related to direct invasion, obstruction, or metastasis
  • Common in small cell carcinoma and squamous cell
37
Q

Lung cancer diagnosis

A

Tissue biopsy

38
Q

Define limited small cell carcinoma staging

A

Disease limited to the unilateral hemithorax

39
Q

Define extensive small cell carcinoma staging

A

Tumor extends beyond the hemothorax

40
Q

limited small cell carcinoma treatment

A

chemo & radiation

41
Q

extensive small cell carcinoma treatment

A

chemo alone as initial treatment

42
Q

How often should pt’s receive a chest CT post-treatment?

A

every 6 months x 2 years, and then annually

43
Q

Chemotherapy sequelae

A
  1. Neuropathy
  2. Hearing loss
  3. Neurocognitive changes
44
Q

Radiation sequelae

A
  1. Skin changes
  2. Radiation pneumonitis
  3. Esophagitis
  4. Cardiovascular disease
45
Q

Mesothelioma definition

A

Primary tumor arising from the surface lining of the pleura=80% of cases

46
Q

What is Mesothelioma linked to?

A

asbestos exposure!!

47
Q

How long is the latent period of Mesothelioma

A

20-40 years

48
Q

Mesothelioma treatment

A

Chemotherapy

49
Q

What is the 5-yr survival rate of mesothelioma?

A

10%

Poor prognosis

50
Q

What is the gold standard for mediastinal staging?

A

Mediastinoscopy

51
Q

For advanced stages of lung cancer, what imaging do you want to use?

A

Bone scan and brain imaging

52
Q

What is the most common site of non-small cell lung cancer mets?

A

Brain

Foundations-Pulmonary (9 decks)

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