trigger - malignant neoplasms Flashcards
what mediastinal compartment contains the esophagus and descending thoracic aorta
posterior
+ lab in thymic tumors
anti-acetylcholine receptor antiboies
+ lab in germ cell tumorss
alpha fetoprotein and beta Hcg
+ lab in seminomas and lymphoma
lactate dehydrogenase
what biopsy to use if a mass is located immediatly adjacent to the airway
endobronchial biospy
what makes up 80% of benign SPN
infectious granulomas
(MC d/t histoplasmosis, coccidioidomycosis, TB or non TB mycobacteria)
CXR shows popcorn calcifications
hamartomas
(benign etiology of SPN)
CT shows area of alternating fat and calcifications
hamartomas
(benign etiology of SPN)
what do we NOT biopsy
AV malformations
centrally presenting primary lung cancers
small cell carcinoma
squamous cell carcinoma
peripherally presenting primary lung cancers
adenocarcinoma
large cell cancer (anywhere but often peripheral)
this location of nodule in the lung is associated with higher rates of malignancy
upper
Lesion described as loblar or spiculated in appearence
benign or malignant?
these are examples of il-defined markings = likely malignant
peripheral halo on lesion on CT
benign or malignant?
likely a malignant lesion
if a patient has an intermediate risk central SPN, what are non-invasive diagnostic options
sputum cytology
not used in peripheral lesions!!
what is used for all SPN biopsies
CT transthoracic FNA or bronchoscopy
please memorize this Billie.
pembertons sign seen when
SVC syndrome in lung cancer as a complication
MC in Small cell lung cancer
CXR showing mediastinal widening or right hilar mass
superior vena cava syndrome in lung cancer
shoulder pain and atrophy of hand muslces
pancoast tumor in llung cancer
(tumor in apex of lungs compressing structures)
also seen:
horners syndrome
bone destruction
horners syndrome
bone destruction
seen when?
pancoast tumor in llung cancer
(tumor in apex of lungs compressing structures)
also seen:
shoulder pain
atrophy f hand muscles
what would be seen in a PET scan of people with:
diabetes
lesions <8mm
slow growing tumors
false negatives
what would cause false positives in PET scans
certain infections and granulomatous disease (TB)
imaging used in lymph node staging
integrated CT/PET
what labs can be seen in paraneoplastic syndrome
- elevated antinuclear antibodies
- Elevated Creatine Kinase
- elevated calcium
- abnormal electrolytes and CBC
what labs can be seen in liver metastases
- elevated alkaline phosphatase
- elevated AST/ALT and total bililrubin
- elevated LFTs
pt with back pain worse at night
bone metastases
more common seen in SCLC
elevated serum alkaline phosphatase
elevated serum calcium
bone metastases from lung cancer
MC in SCLC
pt presents with papilledema, hemiparesis and visual field loss
lung cancer metastasised to brain/spine/nerves
evaluate with MRI w/contrast
also see:
HA, N/V, seizures, cranial/focal nerve deficit
pt presents with headache, vomiting and decreased vision
lung cancer metastasised to brain/spine/nerves
evaluate with MRI w/contrast
also see:
seizures
papilledema
hemiparesis
biopsy used mostly for peripherally located tumors
transthoracic percutaneous FNA
Usually detected as a large hilar mass with bulky mediastinal adenopathy
Small cell carcinoma
MC form of lung cancer in non smokers
adenocarcinoma
centrally located and MC in smokers
squamous cell carcinoma and small cell carcinoma
rapidly growing lung cancer occuring anywhere in lung
large cell carcinoma
more common in periphery but can be anywhere
surgery alone usually curative for these patients
NSCLC stage 0
surgical resection w/lymph node removal if needed and adjuvant chemo. post op radiation if needed
stage 2 and 3 NSCLC
systemic therapy (chemo, ect), pallative radiation/surgery.
treatment for NSCLC stage 4
what is it called when a tumor is limited to the unilateral hemithorax
limited stage SCLC
polyuria, polydipsia, lethargy, constipation and NV are all s/s of what paraneoplastic syndrome
hypercalcemia
irritability, confusion, seizures, coma, restlessness are all s/s of what paraneoplastic syndrome
SIADH (s/s result of hyponatremia)
MC assocaited with SCLC
autoantibody formation resulting in impaired release of acetylecholine
lambert-eaton myasthenic syndrome
muslce weakness, central weight gain, HTN and osetoporosis are s/s of what paraneoplastic syndrome
cushings syndrome
usually presents with hypokalemia and hyperglycemia!!
this tumor presents before age 60 with no relation to smoking or other carcignogens
bronchial carcinoid tumor
pt presents with flushing, diarrhea, wheezing and hypotension
this is carcinoid syndrome (its rare but i have a feeling were gonna be asked)
indicative of bronchial carcinoid tumors!!
biopsy of this tumor results in significant bleeding
bronchial carcinoid tumor
