Lung Cancer Flashcards by S C

most common cancer worldwide

bronchogenic carcinoma

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bronchogenic carcinoma

malignancies that originate in airways or pulmonary parenchyma

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Solitary Pulmonary Nodule (SPN)

coin lesion, <3cm, isolated, rounded opacity not a/w infiltrate, atelectasis or adenopathy , mostly benign

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benign SPN

smooth, well-defined edeges, dense central calcification

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watchful waiting for SPN

only if low risk, otherwise biopsy

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> 3cm SPN

mass, usually malignant , CA until proven otherwise (mass or nodules)

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Benign SPN

infectious granulomas (TB, cocci), hamartoma, pulm abscess, vasculitic lesion, pulm dirofilariasis

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Malignant SPN

bronchogenic CA, bronchoalveolar CA, carcinoid tumor, Mets

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PE findings of SPN

wt loss, lymphadenopathy (supraclavicular/scalene nodes), fixed/localized wheeze, joint tenderness

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fixed or localized wheeze a/w

endobronchial tumor

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Lab findings of SPN

no specific findings

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abnl labs w/

paraneoplastic syndrome

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why review of old films

malignant nodules double in 20-400 days -minimal growth= benign

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no calcification=

elevated risk of CA

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poorly defined irregular spiculated shape=

elevated risk of CA

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the larger the lesion=

greater risk of malignancy >5cm

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indication for referral SPN

lesion is unstable, noncalcified, not rounded, >3cm 2. new or enlarging 3. indeterminate lesion with at risk pt

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lung malignancy cell types

small cell carcinoma 2. non-small cell types : a.adenocarcinoma b.squamous cell carcinoma c. large cell carcinoma

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most common type of lung malignancy

adenocarcinoma

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occurs centrally - bronchial origin

small cell carcinoma

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small cell carcinoma

narrows bronchi by extrinsic compression, metastasizes aggressively, not amenable to surgery, micrometastases are present at time of dx

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most prevalent lucg CA in both sexes

adenocarcinoma

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adenocarcinoma arises from

mucous glands

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occurs in lung periphery

adenocarcinoma

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present as nodules or masses and metas. to distant organs

adenocarcinoma

occurs centrally

squamous cell carcinoma

squamous cell carcinoma arises from

bronchial epithelium

seen as an intraluminal growth in the bronchi

squamous cell carcinoma

may be able to detect by sputum cytology

squamous cell carcinoma

more likely to cause hemoptysis

squamous cell carcinoma

likely to metastasize to regional lymph nodes

squamous cell carcinoma

can cavitate

squamous cell carcinoma

large cell carcinoma occurs in

lung periphery and metas. to distant organs

lung CA symptoms result from

1. primary lesion 2. intrathoracic spread : a.pleural effusion, pericardial effusion, hoarseness b. SVC syndrome c. pancoast syndrome 3. paraneoplastic syndromes 4. mets w/no lung complaints

most common symptom

cough

primary lesion symptoms

cough, sputum, dyspnea, hemoptysis, chest pain, unilateral localized wheezing, wt loss

most common cause of hemoptysis

bronchitis

unilateral localized wheezing a/w

suspect bronchogenic CA causing obstruction of major airway

pleural effusion due to

1. direct pleural extension 2. mediastinal node involvement & lymphatic obstruction

pericardial effusion due to

direct extension of tumor into pericardium

hoarseness due to

compression of recurrent layngeal nerve

hoarseness more common with

Left side tumors

SVC (superior vena cava) syndrome due to

compression or direct invasion

SVC syndrome most commonly a/w

small cell carcinoma

SVC syndrome symptoms

ha, dyspnea, facial/ UE edema, plethora, dilated neck veins, prominent venous pattern on chest

pancoast syndrome

tumor involving superior sulcus of lung compresses brachial plexus and cervical sympathetic nerves

Horner's syndrome

part of pancoast -injury to sns of face, signs of ipsilateral side of tumor

symptoms of Horner's syndrome

miosis, anhidrosis, ptosis, sinking of eyeball

symptoms of pancoast syndrome

ipsilateral: rib destruction, atrophy of hand muscles, pain C8,T1,T2 nerve roots

paraneoplastic syndrome

disorders arises from tumor secretions (hormones, peptides, cytokines)

constellation of paraneoplastic syndrome

anorexia, st loss, cachexia, fever, suppressed immunity

hematologic symptoms of paraneoplastic syndrome

1. carcinogenic thrombophlebitis (trousseau's syndrome) 2. malignancies often a/w hypercoaguability

carcinogenic thrombophlebitis (trousseau's syndrome) is most commonly a/w

adenocarcinoma

endocrine symptoms of paraneoplastic syndrome

PTH like substance, Xs HCG production, SIADH, Cushing's (ectopic ACTH)

PTH like substance is a/w

NSCLC squamous

Xs HCG is a/w

large cell

SIADH is a/w

Small cell

Cushings a/w

small cell

neurologic symptoms of paraneoplastic syndrome

eaton-lambert syndrome, peripheral neuropathy

eaton-lambert a/w

small cell

most common sites of distant met.

liver, bone, brain, adrenal gland

primary site for majority of cancers that present as symptomatic brain mets

lung

lung CA tissue dx

1. sputum culture 2. bronchoscopy w/biopsies 3. thoracentesis 4. fine needle aspiration/CT guided needle biopsy 5. transbronchial aspiration (VATS)

best tissue dx for central lesions

sputum culture

stages of SCLC

1. limited dz 2. extensive dz (80%)

SCLC extensive dz

beyond hemithorax, includes pleural effusions

tx of non small cell lung CA

surgical resection in localized dz

tx of small cell lung CA

regardless of stage : chemo, prophylactic WBRT (brain)

management of malignant effusions

thoracentesis, pleurodesis, pleurx catheters

screening for lung CA

not recommended

zyban

for smoking cessation- SE: seizure

Lung Cancer Flashcards

(71 cards)