Mod 2-4 Bronchogenic Carcinoma

Question 1

What is bronchogenic carcinoma?

Answer 1

Lung cancer

Question 2

What percentage of lung cancer cases are diagnosed while the cancer is confined to the primary site?

Answer 2

16%

Question 3

When the cancer is still confined to the primary site it is in what stage?

Answer 3

Localized stage

Question 4

What percentage of lung cancer cases are diagnosed after the cancer has spread to regional lymph nodes or directly beyond the primary site?

Answer 4

37%

Question 5

What percentage of lung cancer cases are diagnosed after the cancer has already metastasized?

Answer 5

39%

Question 6

What stage of lung cancer is it when the cancer has metastasized?

Answer 6

Distant stage

Question 7

What percentage of lung cancer cases had unknown staging information?

Answer 7

8%

Question 8

___% of lung cancer cases have already spread to other sites when the disease is identified.

Answer 8

76%

Question 9

What is the definition of bronchogenic carcinoma?

Answer 9

Most common primary malignant lung neoplasm; arises from the mucosa of the bronchial tree.

Question 10

What is the etiology of bronchogenic carcinoma?

Answer 10

Cause is unclear, but closely linked to cigarette smoking and inhalation of cancer-causing agents in the environment (air pollution, exhaust gases, industrial funds).

Question 11

Lung cancers most commonly arise from what?

Answer 11

The mucosa of the bronchial tree.

*Often referred to simply as bronchogenic carcinoma, a non-specific term used interchangeable with lung cancer.

Question 12

What percentage of lung tumors are bronchogenic carcinoma?

Answer 12

90%

Question 13

What percentage of patients with lung cancer are cigarette smokers?

Answer 13

85-90%

*Cigarette smoking appears to be the strongest risk factor for developing lung cancer.

Question 14

Other than smoking, what are risk factors for developing lung cancer?

Answer 14

Obstructive lung disease, chronic bronchitis, being male, and African-American male.
*life-style

Question 15

What is the most common cause of cancer death in male and females?

Answer 15

Bronchogenic Carcinoma

Question 16

Bronchogenic carcinoma is seen primarily between what ages?

Answer 16

45-75 years old with the peak incidence at age 70.

Question 17

What are the two major categories of bronchogenic carcinoma?

Answer 17

Small Cell Lung Cancer and Non-small cell lung cancer

Question 18

What are the two types of non-small cell lung cancer?

Answer 18

Squamous cell carcinoma and adenocarcinoma

*Text says squamous cell is more common, but several sites indicate that adenocarcinoma is the most common type.

Question 19

What percentage of lung cancers are small cell lung cancer? Non-small lung cancer?

Answer 19

Small cell lung cancer - 20%

Non-small cell lung cancer - 80%

Question 20

What is the more aggressive type of lung cancer?

Answer 20

Small cell carcinoma

Question 21

What percentage of those treated of small cell carcinoma will be free of the disease 2 years later?

Answer 21

10%

Question 22

Where are most tumors originate in small cell lung cancers?

Answer 22

Centrally located, mid-sized airways and involve the hilar and mediastinal lymph nodes very early.

Question 23

How are the tumors of small cell carcinoma’s characterized?

Answer 23

Rapid growth and early metastasized.

Question 24

Where are the most common metastasized sites of small cell carcinoma?

Answer 24

Bones, liver, adrenal glands, pericardium, brain and spinal cord.

Question 25

What is the most common type of small cell carcinoma?

Answer 25

Oat-cell

Question 26

The book states what type of lung cancer is most common?

Answer 26

Squamous cell or epithelial type non-small cell lung cancer

Question 27

Squamous cell or epithelial type non-small cell carcinoma has been clearly linked to what? And since when?

Answer 27

Linked to smoking since the 1950's

Question 28

Where does Squamous cell (epithelial) type non-small cell carcinoma develop?

Answer 28

In the large airways

Question 29

In what way does most tumors of squamous cell small-cell carcinoma metastasize?

Answer 29

It usually does not go to distant sites but remains localized to the lung.

Question 30

What is the number one type of lung cancer in men?

Answer 30

Squamous cell (epithelial) non-small cell carcinoma

Question 31

What type of non-small cell carcinoma is most common type seen in women?

Answer 31

Adenocarcinoma

Question 32

The incidence of what type of lung cancer has grown significantly over the past 10-15 years?

Answer 32

Adenocarcinoma

Question 33

Bronchiolar carcinoma is considered a subtype of what type of lung cancer?

Answer 33

Adenocarcinoma

Question 34

Where does adenocarcinoma tend to develop?

Answer 34

Deeper in the bronchial tree, in the smaller and more peripherally located airways.

Question 35

Where does adenocarcinoma metastasize?

Answer 35

It prefers distant sites

Question 36

How quickly do bronchogenic carcinomas begin their cellular changes?

Answer 36

Rather slowly and tend to evolve silently.

Question 37

Researchers believe lung cancer develops over a __ to __ year period.

Answer 37

10 to 30

Question 38

What is the most common symptom of lung cancer?

Answer 38

Presence of cough | *Often dismissed as a "smokers cough"

Question 39

Other than cough, what are some other respiratory symptoms of lung cancer?

Answer 39

Constant chest pain, dyspnea (shortness of breath), wheezing, coughing up blood.

Question 40

What are some systemic symptoms of lung cancer?

Answer 40

Fatigue, weight loss, loss of appetite, headache.

Question 41

Radiographic manifestations of bronchogenic carcinoma vary based on what?

Answer 41

Type of cancer and its location within the bronchial tree.

Question 42

What are the three ways a bronchogenic carcinoma tumor may appear radiographically?

Answer 42

Solitary mass, several nodules scattered throughout the chest, or as an irregular mass simulating pneumonia.

Question 43

This type of lung cancer tends to form in the centrally located, major bronchi.

Answer 43

Squamous cell (non-small cell lung cancer)

Question 44

This type of lung cancer generally arises in peripheral locations, developing in the smaller, more deploy located airways.

Answer 44

Adenocarcinoma (non-small cell lung cancer)

Question 45

This type of lung cancer is bulky, centrally located tumors that involve the hilar lymph nodes, often appearing bilaterally.

Answer 45

Small cell or oat cell carcinoma

Question 46

Can a radiologist determine whether a lung mass is malignant or benign based on just the radiograph?

Answer 46

No. The radiologist will only report what is suspected from the radiographic characteristics of the nodule.

Question 47

What percentage of lung mass or nodules end up being malignant?

Answer 47

40-50% | *50-60% are benign

Question 48

Nodules whose borders are shaggy and ill-defined are usually what?

Answer 48

malignant

Question 49

Other than shaggy borders, what are some other signs indicating malignancy?

Answer 49

Atelectasis (collapse of the lung caused by airway blocking by a mass), unilateral hilar enlargement, cavitation (similar to an abscess.

Question 50

What is one of the earliest signs of carcinoma?

Answer 50

Unilateral hilar enlargement

Question 51

What sign would be present in advanced disease?

Answer 51

Cavitation, a process similar to an abscess.

Question 52

Describe a malignant lung mass.

Answer 52

Shaggy borders, lines of extension from the mass, grows in size.

Question 53

What are some characteristics of benign lung lesions?

Answer 53

Smooth, round borders and rate of growth.

Question 54

A pulmonary mass that does not change size in two years or more is usually considered ________.

Answer 54

benign

Question 55

What does the "popcorn" appearance of small calcifications indicate?

Answer 55

The mass was once a site of inflammation or infection such as TB and the area has healed.

Question 56

What affect does malignancy and atelectasis have on radiographic technique?

Answer 56

They will both attenuate the beam more than the surrounding normal tissue.

Question 57

What are two radiographic considerations when bronchogenic carcinoma is the diagnosis?

Answer 57

Position to include all of the ribs and have previous images available for comparison.