Pulmonary Neoplasms Flashcards
What is a Pulmonary Nodule?
- A lesion that is both within and surrounded by pulmonary parenchyma. (also called ‘coin’ lesion)
- Less than 3 cm in size and not associated with atelectasis or lymphadenopathy.
What are the disadvantages of Chest X-Ray-PA/Lateral?
-Can miss small nodules
What is a PET/CT? What is the sensitivity/specificity? Wht is it used for?
- Positron Emission Tomography
- FDG – Fluorodeoxyglucose
- PET-CT scans have a 95% sensitivity, but a lesser specificity of only 81%.
- Can be used for diagnosis, staging, and monitoring treatment of cancers.
What is the significance of size of lesions on Radiograph?
Larger lesions are more likely to be malignant than smaller lesions.
What are the radiographic features of a malignant pulmonary nodule compared to benign nodule?
Malignant lesions will have a more irregular or spiculated border. Benign lesions will have a smooth and discrete border.
What is the expected rate of growth of a malignant pulmonary lesion?
-Lesions that are malignant tend to have an interval increase in size between 4-6 months. Therefore, nodules that grow very rapidly are more likely benign.
What’s the most common Pathology of Lung Cancer?
adenocarcinoma (most common overall)
What is Large Cell Carcinoma?
- Malignant epithelial neoplasm lacking glandular or squamous differentiation.
- Usually a diagnosis of exclusion, to include all poorly differentiated NSCLCa that are not further classifiable.
- Usually presents as large peripheral mass with prominent necrosis.
What type of lung cancer is most common in non-smoker (1) vs smoker (2)
Adenocarcinoma-Most common type of lung cancer, especially in never smokers.
Squamous cell and NSCLC are most common in smokers
What are the Clinical Presentations of lung cancer? (name 3)
- Cough (dry or productive)
- Dyspnea
- Hemoptysis
- Recurrent pneumonias
- Weight loss (unexplained)
- Chest pain
What are the Signs and Symptoms of a more extensive disease of lung cancer? (name 3)
- Bone pain
- Dysphagia
- Hoarseness
- Neurologic abnormalities (HA, syncope, cognitive impairment)
- Horner’s Syndrome (ptosis, anhidrosis, miosis)
- Superior vena cava syndrome
How is lung cancer Diagnosed?
- CT guided needle biopsy
- Bronchoscopy +/- Lavage
- Endobronchial Ultrasound biopsy (EBUS)
- Video-assisted Thoracoscopic Surgery (VATs) biopsy
- Thoracentesis
What is Lung Cancer Staging of TNM?
-Staging is the assessment of the extent of tumor in a particular patient.
Local (T = tumor)
Regional (N = nodes)
Distant (M = Metastasis)
-It allows the grouping of patient with similar disease for prognostic, analytic and therapeutic purposes.
Where does lung cancer commonly metastasize?
-Lung cancers commonly metastasize to these areas: Brain Bone Liver Adrenal glands
What is Carcinoid Tumor?
- Comprise 1-2% of all lung malignancies.
- Characterized by neuroendocrine differentiation and relatively indolent clinical behavior.
- They are made up of peptide and amine producing cells.
- They can arise at a number of sites throughout the body: GI tract, Thymus, lung, and ovaries.
- They are the most common primary lung neoplasm in children.
