Respirology - Lung Cancer

Question 1

What are the major subtypes of Non-small Cell Carcinoma?

Answer 1

1.) Adenocarcinoma (40%)
i.) associated with glands & mucin
2.) Squamous cell carcinoma (30%)
i.) associated with keratin pearls & intercellular bridges
3.) Large Cell Carcinoma
i.) associated with the lack of keratin pearls, glands, mucin, or intercellular bridges

Question 2

This colourless, odourless gas accumulates in basements from the breakdown or uranium. This agent also increases the risk of lung cancer

Answer 2

Radon

Question 3

Name the condition:

Poorly differentiated neuroendocrine cells found centrally in the lung. These cells may produce ADH or ACTH (Cushing’s) and may cause Eaton-Lambert Syndrome

Answer 3

Small Cell Carcinoma

Eaton-Lambert Syndrome (antibodies against presynaptic calcium channels resulting in muscle weakness)

Question 4

What are the signs and symptoms of mesothelioma?

Answer 4

1. ) Chest Pain
2. ) Pleural Effusion
3. ) Dyspnea

Question 5

What two conditions do you consider with hemoptysis?

Answer 5

1. ) Tuberculosis

2. ) Lung Cancer

Question 6

Describe a Pancoast Tumour

Answer 6

A tumour located in the apex of the lung that results in compression of the sympathetic chain causing:
i.) Ptosis
ii.) Pinpoint Pupils
iii.) Anhidrosis

Question 7

What two lung cancers are associated with smoking, present centrally in the lung, and are associated with paraneoplastic syndrome?

Answer 7

Small Cell Carcinoma & Squamous Cell Carcinoma

Mnemonic = if the lung cancer starts with an S then it happens Sentrally (central) in Smokers and causes paraneoplastic Syndrome

Question 8

Where does a mesothelioma neoplasm occur?

Answer 8

In mesothelial cells located between the parietal and visceral pleura.

Mesothelia cells are responsible for the production of a lubricating fluid that allows frictionless movement of the lung in relation to the chest wall

Question 9

What is the next step after discovering a solitary nodule in the lungs of a patient with nonspecific symptoms?

Answer 9

To go back and compare the XRay with a previous XRay.

If the coin lesion (solitary nodule) has been present over a long time and remains unchanged then it is most likely benign.

If the coin lesion is new or growing, then biopsy is required to diagnose lung cancer

Question 10

Name the condition:

Keratin pearls or intercellular bridges present on histology in this centrally occurring lung tumour

Answer 10

Squamous cell carcinoma

Question 11

Name the condition:

Lung Neoplasm highly associated with occupational exposure to asbestos

Answer 11

Mesothelioma

Question 12

Why is it important to distinguish small cell carcinoma from non-small cell carcinoma?

Answer 12

Small cell carcinoma is treated with chemotherapy while non-small cell carcinoma is treated with surgery

Question 13

Name the condition:

The most common lung cancer occurring in non-smokers and in female smokers. This classically occurs in peripherally in the lung

Answer 13

Adenocarcinoma