Lung cancer Flashcards
1) Which subtype of lung cancer - small cell (SCLC) or non-small cell (NSCLC) lung cancer - is most common?
2) What are the 3 most important types of NSCLC?
3) What kind of cells does SCLC arise from?
4) What syndrome does this result in?
1) NSCLC (80%)
2) Squamous cell carcinoma, adenocarcinoma, large cell carcinoma
3) Endocrine cells
4) Paraneoplastic syndromes
Name 2 symptoms of lung cancer
- Shortness of breath/dyspnoea
- Cough
- Haemoptysis
- Chest pain
- Recurrent pneumonia
- Weight loss
- Finger clubbing
- Lethargy
1) What is the first line investigation for lung cancer?
2) Name 1 thing that may appear on this imaging modality to imply lung cancer diagnosis
1) Chest xray
2) Hilar enlargement, peripheral opacity (visible lesion in the lung field), pleural effusion (usually unilateral), lung collapse
Why might a contrast enhanced CT scan be used?
Staging
How can a PET-CT scan be useful in identifying areas the cancer may have spread to?
It shows areas of increased metabolic activity which is suggestive of cancer
What does a bronchoscopy with endobronchial ultrasound allow for?
Biopsy to be taken
Treatment of NSCLC
1) What is the first line treatment for patients that have disease isolated to a single area with intention to cure the cancer?
2) Name another treatment option
1) Surgery
2) Radiotherapy, chemotherapy, immunotherapy i.e. monoclonal antibodies
Treatment of SCLC
1) What is the usual treatment of SCLC and why is it different to the treatment of NSCLC?
2) In a palliative setting, how can bronchial obstruction caused by the tumour be relieved?
1) Chemotherapy and radiation, as prognosis is generally worse
2) Endobronchial treatment with stents or debulking
Extrapulmonary manifestations/complications
1) Name 3 of these
2) What type of tumour causes Horner’s syndrome?
3) What is the triad of Horner’s syndrome?
4) What is limbic encephalitis?
5) What is Lambert-Eaton myasthenic syndrome?
6) What is the main symptom caused by Lambert-Eaton myasthenic syndrome?
1) Phrenic nerve palsy, Recurrent laryngeal nerve palsy, SIADH, SVC obstruction, Cushing’s syndrome, hypercalcemia
2) Pancoast’s tumour
3) Partial ptosis, anhidrosis and miosis
4) Paraneoplastic syndrome where the SCLC causes the immune system to make antibodies (anti-Hu antibodies) against tissues in the limbic system.
5) Antibodies produced by the immune system against SCLC also damage voltage-gated calcium channels on the presynaptic terminals in motor neurones
6) Weakness - particularly in proximal muscles and intraocular muscles
1) Mesothelioma is a tumour of what cells?
2) What cause is this tumour strongly linked to?
3) What is the gold standard for the diagnosis of mesothelioma?
1) Mesothelial cells of the pleura
2) Asbestos exposure
3) Thoracoscopic biopsy
What tumour can metastasise to the lung and presents with “cannon ball metastases” on CXR?
Renal cell carcinoma
Gynaecomastia, hypertrophic pulmonary osteoarthropathy is associated with which lung cancer?
Adenocarcinoma
What is the commonest lung malignancy in non-smokers?
Adenocarcinoma
Does lung cancer most commonly present with raised or reduced platelet count?
Raised
Name 3 contraindications for the surgical management of lung cancer
- SVC obstruction
- Metastases
- Tumour near the hilum
- Vocal cord paralysis
- FEV1 <1.5 L
- Malignant pleural effusion
