15 Lung Cancer

Epidemiology

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• breast: most common for women

• prostate: most common for men

• lung: second most common for both men/women

Risk

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• cigarettes contain PAH

• radiation to chest

• radon: naturally occurring substance get to homes through ground

Symptoms and Diagnosis

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• 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

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• 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

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• small cell rare but much worse

Small Cell

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• Kulchitsky cells: sea of undifferentiated small cells

• neuroendocrine: associated paraneoplastic symptoms

• neuroendocrine: NSE, NCAM, CD56, chromogranin, synaptophysin

• occur centrally in lung

Non Small Cell

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Squamous

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• near center of chest right when primary bronchi branches

Adenocarcinoma

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• tumor in nonsmoker and peripheral: think adeno

Bronchioloalveolar Carcinoma

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Large Cell Carcinoma

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• doesn't fit in other types

• very poor prognosis

Carcinoid

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

Complications

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• steroids shrink tumor

• different from SVC, just arm edema, no facial edema

• irritating nerves: shoulder pain radiating

Metastasis

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• adrenal: asymptomatic