15 Lung Cancer - Boards and Beyond

  • breast: most common for women
  • prostate: most common for men
  • lung: second most common for both men/women

Risk

  • cigarettes contain PAH
  • radiation to chest
  • radon: naturally occurring substance get to homes through ground

Symptoms and Diagnosis

  • may grow into blood vessels and cause bleeding

  • benign if same prior
  • see coin lesions, first thing to do is to compare with prior Xray

Benign Lung Nodules

  • granulomas: people previously with TB, sarcoidosis
  • hamartomas: lesion made of normal tissues but disorganized

  • fungal: can be very mild/asymptomatic
  • also prior mycobacteria

Primary Lung Cancer

  • small cell rare but much worse

Small Cell

  • Kulchitsky cells: sea of undifferentiated small cells
  • neuroendocrine: associated paraneoplastic symptoms
  • neuroendocrine: NSE, NCAM, CD56, chromogranin, synaptophysin
  • occur centrally in lung

Non Small Cell

Squamous

  • near center of chest right when primary bronchi branches

Adenocarcinoma

  • tumor in nonsmoker and peripheral: think adeno

Bronchioloalveolar Carcinoma

Large Cell Carcinoma

  • doesn't fit in other types
  • very poor prognosis

Carcinoid

  • even though has name, rarely causes carcinoid syndrome, more common with GI tumors met to liver

Complications

  • steroids shrink tumor

  • different from SVC, just arm edema, no facial edema
  • irritating nerves: shoulder pain radiating

Metastasis

  • adrenal: asymptomatic