SM_183a: Lung Cancer Flashcards
Lung cancer is the _____ cause of cancer related deaths
Lung cancer is the leading cause of cancer related deaths
(not the most common cancer)
Most lung cancer patients present with ______ disease
Most lung cancer patients present with advanced disease
The greatest risk factor for lung cancer is _______
The greatest risk factor for lung cancer is tobacco
(mostly smoking, but also second hand smoke)
Patients with early stage lung cancer are often ______
Patients with early stage lung cancer are often asymptomatic
(often found incidentally or through lung cancer screening)
(may have a cough, hemoptysis, or dyspnea)
_______ is the classic radiographic finding of lung cancer
Coil lesion is the classic radiographic finding of lung cancer
(but lung cancer can look like anything)
Describe the presenting signs and symptoms of lung cancer
- Often asymptomatic
- Cough
- Weight loss
- Dyspnea
- Chest pain
- Hemoptysis
Lung tumors can cause _____, _____, or _____ in advanced disease
Lung tumors can cause superior vena cava syndrome, nerve impingement, or hoarseness in advanced disease
Superior vena cava syndrome occurs when ______
Superior vena cava syndrome occurs when SVC is obstructed, leading to vessel obstruction
Symptoms of superior vena cava syndrome include ______, ______, ______, and ______
Symptoms of superior vena cava syndrome include facial plethora, dilated collateral veins along chest, extremity edema, and headaches
Pancoast tumor is a(n) _____ tumor causing _____, with symptoms of ______, ______, or ______
Pancoast tumor is an apical tumor causing nerve impingement, with symptoms of shoulder pain, brachial plexus, and Horner’s syndrome
Horner’s syndrome is caused by a ______ tumor and involves symptoms of ______, ______, and ______
Horner’s syndrome is caused by a pancoast tumor and involves symptoms of constricted pupil (miosis), drooping of upper eyelid (ptosis), and absence of sweating of the face (anhidrosis)
(sympathetic nerve constricted)
Pancoast tumor can cause hoarseness if _____ is compressed
Pancoast tumor can cause hoarseness if laryngeal nerve is compressed
What are the most common sites of lung cancer metastases?
Pleura, brain, bone, adrenal, and liver
______ is redness of the face after lifting arms and is associated with _____ secondary to lung tumor
Pemberton’s sign is is redness of the face after lifting arms and is associated with superior vena cava syndrome secondary to lung tumor
_____ is required to make a diagnosis of lung cancer
Tissue sampling is required to make a diagnosis of lung cancer
(if metastatic disease is suspected, a biopsy of a distant site is preferred because it confirms both the diagnosis and the stage)
- Histology: cell type
- Molecular analysis: what is driving cell to grow
- PDL1 analysis: interaction between tumor and immune system
Lung cancer is categorized as _____ or _____
Lung cancer is categorized as non-small cell lung cancer (most lung cancers) or small cell lung cancer
Non-small cell lung cancer is divded into _____, _____, or _____
Non-small cell lung cancer is divded into adenocarcinoma, squamous cell carcinoma, or large cell carcinoma
Describe adenocarcinoma
Adenocarcinoma
- Most frequent histology in non-small cell lung cancer
- Derived from gland cells
- Biopsy: glandular structures
- Central or peripheral tumors
- Seen in non-smokers and smokers
Describe squamous cell carcinoma
Squamous cell carcinoma
- 2nd most common type of non-small cell lung cancer
- Occurs in smokers
- Central tumors, near hilum, cavitary lesions
- Paraneoplastic syndrome: PTHrp -> hypercalcemia
- Biopsy: keratin pearls
Describe small cell lung cancer
Small cell lung cancer
- Aggressive tumors (poor prognosis)
- Neuroendocrine tumor
- Occurs in smokers
- Central tumors
- Biopsy: small, densely packed blue cells
- Associated with paraneoplastic syndromes
Which type of lung cancer is this?
Adenocarcinoma
Which type of lung cancer is this?
Squamous cell carcinoma
Which type of lung cancer is this?
Small cell lung cancer
What is the biopsy finding of this type of lung cancer?
Glandular structure (adenocarcinoma)
What is the biopsy finding of this type of lung cancer?
Keratin pearls (squamous cell carcinoma)
What is the biopsy finding of this type of lung cancer?
Small, densely packed blue cells (small cell lung cancer)
______ and ______ are lung cancers that occur in smokers
Squamous cell carcinoma and small cell carcinoma are lung cancers that occur in smokers
_____ is a type of lung cancer that is seen in non-smokers in addition to smokers
Adenocarcinoma is a type of lung cancer that is seen in non-smokers in addition to smokers
Central tumors include ______ and _______
Central tumors include squamous cell and small cell
Peripheral tumors include ______ and ______
Peripheral tumors include adenocarcinoma and large cell
_____ is the most aggressive form of lung cancer
Small cell lung cancer is the most aggressive form of lung cancer
(almost exclusively in smokers, rapid growth and aggressive disease, associated with paraneoplastic syndromes)
Describe limited stage and extensive stage of small cell lung cancer
Small cell lung cancer
- Limited stage: confined to a single hemithorax (one side of chest) and requires all disease be encompassed in a single radiation port
- Extensive stage: extends beyond a single hemithorax (anything outside of the chest as well) - chest cannot fit into one radiation field so cannot be cured
______ tumor is a ______ tumor occurring in the chest
Carcinoid tumor is a neuroendocrine tumor occurring in the chest
- typical carcinoid: well differentiated
- atypical carcinoid: intermediate grade tumor
- can overproduce serotonin -> carcinoid syndrome (flushing, diarrhea)
A patient with a tumor in the chest along with flushing and diarrhea has _______ due to _______
A patient with a tumor in the chest along with flushing and diarrhea has carcinoid syndrome due to overproduction of serotonin
_____ is a pleural tumor due to ______ exposure
Mesothelioma is a pleural tumor due to asbestos exposure
