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2a Resp > Primary Lung cancers > Flashcards

Primary Lung cancers Flashcards

1
Q

What is a cancer of the pleura called?

A

Mesothelioma

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2
Q

What are the different types of cancer of the lung parenchyma?

A

Small cell lung cancer and non-small cell lung cancer

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3
Q

Name some types of non-small cell lung parenchyma cancer

A

Squamous
Adenocarcinoma
Carcinoid
Large cell

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4
Q

What are common sites of metastasis for lung cancer to spread to?

A

Bone
Liver
Adrenals
Brain
Lymph nodes

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5
Q

What causes a mesothelioma?

A

Asbestos
(typically doesn’t present until decades after exposure

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6
Q

Who is most at risk of mesotheliomas?

A

males aged 40-70

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7
Q

What are symptoms of mesothelioma?

A

Weight loss
Tired all the time
Night pain
SOB
Persistent cough
pleuritic chest pain
Hoarse voice
Bone pain if metastasised

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8
Q

Why may a patient with mesothelioma present with a hoarse voice?

A

Tumour may press on nearby structures including the recurrent laryngeal nerve

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9
Q

How do you diagnose mesothelioma?

A

1st line = Chest x-ray and/or CT showing pleural thickening

Cancer antigen 125 raised in many tumours (sensitive but not specific)

Biopsy

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10
Q

Is a CT or a chest x-ray higher resolution and more detailed?

A

CT

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11
Q

How is mesothelioma cancer treated?

A

Very aggressive, so normally palliative care
If found early, surgery and chemo/radiotherapy howevere generally resistant

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12
Q

Is a mesothelioma likely to metastasise distally?

A

No, pleura isn’t found everywhere in the body

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13
Q

What is a primary malignancy of lung parenchyma called?

A

bronchial carcinoma

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14
Q

What percentage of bronchial carcinomas are small cell?

A

15%

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15
Q

What are risk factors for bronchial carcinomas?

A

Smoking
Asbestos
Coal
Ionising radiation
Lung disease already present

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16
Q

Who gets small cell bronchial carcinoma?

A

Exclusively smokers

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17
Q

What does small cell lung cancer cause?

A

Paraneoplastic syndromes

Ectopic ACTH causes Cushing’s
Ectopic ADH causes SIADH
Lambert Eaton Syndrome (disorder of NMJ)

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18
Q

Does small cell lung cancer grow quickly or slowly and metastasis or not?

A

Grows quickly, early metastases

19
Q

What percentage of bronchial carcinomas are non-small cell?

A

85%

(consists of adenocarcinoma, squamous, carcinoid tumour and large cell)

20
Q

What group of people make up the majority of squamous cell lung carcinoma?

A

Smokers

21
Q

Describe what the squamous cell lung carcinoma affects

A

Arises from lung epithelium
Affects central lung
lesions with central necrosis
may secrete PTHrP (related protein) causing hypercalcaemia

22
Q

When do squamous cell lung carcinoma mets appear?

A

Late
Mostly spread locally

23
Q

What condition is heavily associated with non-small cell lung carcinoma, particularly squamous cell carcinoma?

A

Hypertrophic pulmonary osteoarthropathy

24
Q

Hypertrophic pulmonary osteoarthropathy (associated with non-small cell lung carcinomas) consists of what 3 things?

A

Clubbing
Arthritis
Periostosis (swelling of tissue around joints and subperiosteal new bone formation)

25
Q

What is the periosteum?

A

The membrane of nerves and blood vessels that wraps around most bones, key role in growing and repairing bones particularly after a fracture

26
Q

What is an adenocarcinoma?

A

A malignant tumour of glandular structures in epithelial tissue

27
Q

What are common causes of a lung adenocarcinoma?

A

Asbestos and smoking

28
Q

Where does a lung adenocarcinoma form?

A

Affects the peripheral lung and arises from mucous secreting glandular epithelium

29
Q

Where does a lung adenocarcinoma commonly metastasise to?

A

Bone
Brain
Adrenals
Lymph nodes
Liver

30
Q

What does adenocarcinoma in situ mean?

A

Stage 0, tumour has not yet spread

31
Q

What causes a carcinoid tumour?

A

Associated with genetics, MEN1 mutation and Neurofibromatosis 1 (a multisystem disorder)

32
Q

Where do carcinoid tumour commonly arise?

A

in the GIT and sometimes the lungs

33
Q

Carcinoid tumours and n______ tumours that secrete s_____

A

neuroendocrine
serotonin

34
Q

When do symptoms of carcinoid tumour appear?

A

When it metastasises to the liver

35
Q

What are general symptoms of a bronchial carcinoma?

A

Chest pain
Cough
Haemoptysis (coughing up blood)
Weight loss
Night sweats
Feeling tired all the time

Hoarse voice
Pemberton sign

Horner’s syndrome

36
Q

What is Pemberton’s sign?

A

Lift arms up so forearms touch the sides of face. Positive sign shows facial congestion and cyanosis and respiratory distress after 1 minute

37
Q

How do you diagnose a bronchial carcinoma?

A

1st line = imaging with Chest X-ray or CT
Bronchoscopy and biopsy

MRI for staging TNM

38
Q

How do you treat small cell carcinoma of lungs?

A

If early consider chem/radiotherapy but often resistant

If metastasised, then palliative

39
Q

How do you treat non-small cell carcinoma?

A

If early, surgical excision

If metastasised, chemo/radiotherapy

40
Q

What chemotherapy may be used for non-small cell adenomas?

A

mAb therapy cetuximab against epidermal growth factor

41
Q

What is a Pancoast tumour?

A

Tumour in lung apex that metastasis to neck’s sympathetic plexus causing Horner’s syndrome

42
Q

What is the triad of symptoms for Horner’s syndrome?

A

Ptosis
Myosis (excessive pupil constriction)
Anhidrosis

43
Q

True or false: primary lung tumours are much more common than secondary lung tumours

A

False
The lungs oxygenate all the blood so all the blood comes to the lungs therefore there is a higher risk of metasises

44
Q

Which cancers commonly metastasise to the lung?

A

Breast
Kidney
Bowel
Bladder

2a Resp (15 decks)

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