SM 183 Lung Cancer Flashcards
Which type of lung cancer involves keratin pearls?
Squamous cell carcinoma
How does early stage Lung Cancer present and how is it detected?
Early stage Lung Cancer is often asymptomatic and detected incidentally or via Lung Cancer screening
What are the traits of Adenocarcinoma, with respect to cellular origin, location, and relationship to smoking?
Derived from gland cells, may be found centrally or peripherally, and seen in both smokers and non-smokers
Which type of lung cancer involves densely packed blue cells?
Small Cell Carcinoma
What are the traits of Small Cell Lung Cancer, with respect to cellular origin, location, and relationship to smoking?
Aggressive neuroendocrine tumors, found centrally and occur in smokers, associated with most paraneoplastic syndromes
What is a Pancoast tumor?
An apical tumor that causes nerve impingement, with symptoms varying by site of involvement
What is extensive Small Cell Lung Cancer?
Extensive Small Cell lung cancer extends beyond a single hemithorax and anything outside of the chest, cannot be cured
What is Mesothelioma?
A pleural cancer that occurs due to Asbestos exposure
What are the two large categories of Lung Cancer?
Small cell lung cancer and non-small cell lung cancer
Which tumors are central?
Small cell and Squamous Cell (smoking related)
Can biopsies prove stage of disease?
Yes
What questions should be asked when treating a patient for Lung Cancer?
What stage is the patient? Is the disease curable or not curable? What can the patient tolerate?
Which tumors are peripheral?
Adenocarcinoma (smokers and non-smokers) as well as Large Cell
What type of Lung Cancer are paraneoplastic syndromes associated with?
Small cell lung cancer, except for PTHrp, which is associated with Squamous cell lung cancer
What causes horseness in Lung Cancer?
Compression of the recurrent Laryngeal nerve by a Lung Cancer
Where can Lung Cancer metastasize to?
Lung Cancer can spread to the pleura, bone, brain/spine, and liver
What should be done if metastatic disease is suspected?
A biopsy of a distant site should be done if metastatic disease is suspected to confirm diagnosis and stage
What is Miosis?
Constricted pupils due to a mass effect from an apical Lung Cancer on a stellate ganglion, seen in Horner’s Syndrome
What is HOA?
A paraneoplastic syndrome associated with Lung Cancer that presents as a triad of distal clubbing, arthralgias, and large finger nails
What type of lesion does Lung Cancer produce?
A “coin lesion”, but it can look like anything
What information is obtained from a lung cancer biopsy?
Histology (cell of origin), Molecular Analysis (what is driving the tumor), and PDL1 Analysis (tumor interaction with the immune system)
What type of Lung Cancer is this and why?
Adenocarcinoma, due to lots of gland cells
What is required to diagnose Lung Cancer?
Tissue sampling is required to diagnose Lung Cancer
How do paraneoplastic syndrome’s manifest in Lung Cancer?
Paraneoplastic syndromes in lung cancer involve the ectopic production of hormones, such as ADH, ACT, and PHTrp
At what stage will most patients present with Lung Cancer?
Most patients with lung cancer present with advanced disease
What is the leading cause of cancer related mortality in the US?
Lung cancer, the second most commonly diagnosed cancer in men and women
What type of Lung Cancer is this and why?
Squamous Cell Carcinoma, due to Keratin Pearl
What is limited Small Cell Lung Cancer?
Limited Small Cell lung cancer is confined to a single hemithorax
What is Small Cell Lung Cancer associated with?
Smokers, rapid/aggressive growth, paraneoplastic syndromes (except PTHrp), staged as Limited or Extensive
What can paraneoplastic syndromes in Lung Cancer result in?
Ectopic production of Hormones and Development of Antibodies
What is SVC Syndrome?
Occurs when a Lung Cancer obstructs the SVC, leading to facial redness and dilated collateral veins along the chest
What paraneoplastic syndrome is Squamous Cell Carcinoma associated with?
PTHrp = Parathyroid Hormone related protein, which causes hypercalcemia and hypophosphatasia
What are the main risk factors for Lung Cancer?
Tobacco, though environmental factors like asbestos and radiation therapy also plays a role
How do we prevent lung cancer?
Smoking cessation
What is Horner’s Syndrome?
Horner’s Syndrome occurs when a Lung Cancer compresses a Stellate Ganglion, leading to constricted pupils, drooping of the upper eyelid, and absence of sweating
Where is Adenocarcinoma found?
Both centrally and peripherally
What are the signs and symptoms of late stage Lung Cancer?
Cough, Weight Loss, Dyspnea, Chest Pain, Hemoptysis
What type of lung cancer is this and why?
Small cell lung cancer, due to small densely packed blue cells
What is Anhidrosis?
Absence of sweating in the face, due to a mass effect from an apical Lung Cancer on a stellate ganglion, as seen in Horner’s Syndrome
What is a Paraneoplastic syndrome?
A paraneoplastic syndrome is a syndrome mediated by humoral factors secreted by a tumor itself, or the immune response against a tumor
What are the traits of Squamous Cell Carcinoma, with respect to cellular origin, location, and relationship to smoking?
Occurs in squamous cells, found centrally near hilum, and occurs primarily in smokers
What are the subtypes of non-small cell lung cancer?
Adenocarcinoma, squamous cell carcinoma, and large cell carcinoma
What are Carcinoid tumors?
Neuroendocrine tumors that can overproduce Serotonin
How does Lung Cancer cause Lambert Eaton?
Lung Cancer causes the production of antibodies against presynaptic Cav channels in the synapse, which prevent the release of ACh, as a result of a paraneoplastic syndrome
Do all patients with Lung Cancer smoke?
Nope, you can get Lung Cancer without ever smoking
Is Adenocarcinoma found in smokers or non-smokers?
Adenocarcinoma is found in both smokers and non-smokers
What paraneoplastic syndromes are found in Small Cell Lung Cancer?
All of them, except for PTHrp, which occurs in Squamous Cell Carcinoma
What is Ptosis?
Ptosis is drooping of the upper eyelid due to a mass effect from an apical Lung Cancer on a stellate ganglion, as seen in Horner’s Syndrome
What symptoms can a Pancoast tumor cause, and what determines the symptoms?
Pancoast tumors can cause shoulder pain, brachial plexus, and Horner’s syndrome
