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Pulmonary Neoplasms Flashcards

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1
Q

Solitary pulmonary nodule definition

A
  1. Well-circumscribed
  2. Isolated
  3. Round opacity
  4. Completely surrounded by normal lung
  5. Not associated with infiltrate, atelectasis or adenopathy
  6. ≤ 3 cm
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2
Q

Most common SPN etiology

A
  1. Bronchogenic carcinoma
  2. Metastatic lesion
  3. Infectious granuloma
    - Histoplasmosis
    - Coccidioidomycosis
    - Tuberculosis
    - Other fungal
  4. Calcification
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3
Q

Solitary pulmonary nodule clinical presentation

A
  1. Usually asymptomatic

2. Found incidentally on CXR

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4
Q

What increases the risk of a SPN being cancerous?

A

Increasing age

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5
Q

What does cavitation with thick walls (>16 mm) findings on a CXR indicate?

A

Higher change of malignancy

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6
Q

What does dense calcification indicate on a CXR? Less calcification?

A 
Benign = dense calcification -(central or laminated pattern)
Malignant = less calcification (stippled or eccentric pattern)
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7
Q

CT concerning features for malignancy

A
  1. Spiculated margins
  2. Peripheral halo
  3. Density on CT scan
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8
Q

Harmartoma

A

“popcorn calcification” on CXR= Benign

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9
Q

What is low risk assessment of SPN?

A
  1. Age < 30
  2. Stable lesion x ≥ 2 years
  3. Characteristic benign calcification pattern
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10
Q

Management of low risk SPN

A
  • Watchful waiting

- Serial imaging (CXR or CT)

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11
Q

Management of intermediate risk SPN

A
  1. Diagnostic biopsy (transthoracic needle aspiration or bronchoscopy)
  2. PET
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12
Q

Management of high risk SPN

A

Resection

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13
Q

Lung cancer definition

A

Malignant neoplasm of the lung arising from respiratory epithelium:

  • Bronchi
  • Bronchioles
  • Alveoli
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14
Q

What are the two main groupings of lung cancer

A
  1. Non–small cell lung cancer (NSCLC) = most common (80-85%)

2. Small cell lung cancer (SCLC)

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15
Q

What are the two most common types of lung cancer?

A
  1. Adenocarcinoma

2. Squamous cell carcinoma

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16
Q

what is the greatest risk factor for lung cancer? how many lung cancers does the compose of?

A

Tobacco smoke
=about 80% of lung cancers
Duration and quantity increase risk

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17
Q

What cancer is least associated with lung cancer

A

Adenocarcinoma

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18
Q

Location of adenocarcinomas

A

Peripheral nodules or masses

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19
Q

Squamous cell carcinoma location

A

Arise from the bronchial epithelium–>centrally located, large airways

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20
Q

What cancer tends to metastasize later?

A

Squamous cell carcinoma

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21
Q

Large cell carcinoma characteristic

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A

Usually a large, peripheral mass with prominent necrosis

22
Q

Small cell carcinoma location

23
Q

Small cell carcinoma survival

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A

6-18 weeks

Regional or distant metastasis @ time of dx

24
Q

Bronchial carcinoid tumors

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A

Pedunculated or sessile growths in central bronchi

25
What cells are Bronchial carcinoid tumors derived from?
neuroendocrine cells
26
Bronchial carcinoid tumors clinical presentation
1. Hemoptysis 2. Cough 3. Focal wheezing 4. Recurrent pneumonia 5. Peripherally located: asymptomatic SPNs
27
Carcinoid syndrome
1. Flushing 2. Diarrhea 3. Wheezing 4. Hypotension * rare
28
What are the most common signs/sx's of lung cancer?
1. Cough 2. Hemoptysis 3. Dyspnea 4. Pain
29
Superior vena cava syndrome sx's
1. Bulky upper lobe tumor 2. Sensation of fullness in the head 3. Dyspnea
30
Superior vena cava syndrome PEx's
Dilated neck veins Facial edema Plethoric appearance
31
Superior vena cava syndrome CXR findings
Widening of mediastinum | R hilar mass
32
What lung cancer is Superior vena cava syndrome most common in?
Small cell carcinoma
33
Pancoast syndrome
Shoulder pain | Horner’s syndrome: Ptosis, Miotic (constricted pupil)
34
What cancer is Pancoast syndrome most common in?
non-small cell carcinoma
35
What are the 4 most common extrathoracic metastases
1. Liver 2. Bone-Use. vertebral bodies 3. Adrenal-usu. asymptomatic 4. Brain
36
Paraneoplastic syndromes / Extrathoracic effects definition
- Effects of tumor that are not related to direct invasion, obstruction, or metastasis - Common in small cell carcinoma and squamous cell
37
Lung cancer diagnosis
Tissue biopsy
38
Define limited small cell carcinoma staging
Disease limited to the unilateral hemithorax
39
Define extensive small cell carcinoma staging
Tumor extends beyond the hemothorax
40
limited small cell carcinoma treatment
chemo & radiation
41
extensive small cell carcinoma treatment
chemo alone as initial treatment
42
How often should pt's receive a chest CT post-treatment?
every 6 months x 2 years, and then annually
43
Chemotherapy sequelae
1. Neuropathy 2. Hearing loss 3. Neurocognitive changes
44
Radiation sequelae
1. Skin changes 2. Radiation pneumonitis 3. Esophagitis 4. Cardiovascular disease
45
Mesothelioma definition
Primary tumor arising from the surface lining of the pleura=80% of cases
46
What is Mesothelioma linked to?
asbestos exposure!!
47
How long is the latent period of Mesothelioma
20-40 years
48
Mesothelioma treatment
Chemotherapy
49
What is the 5-yr survival rate of mesothelioma?
10% | Poor prognosis
50
What is the gold standard for mediastinal staging?
Mediastinoscopy
51
For advanced stages of lung cancer, what imaging do you want to use?
Bone scan and brain imaging
52
What is the most common site of non-small cell lung cancer mets?
Brain

Foundations-Pulmonary (9 decks)

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