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Lung Cancer
Pulmonology
| Question | Answer |
|---|---|
| What is the leading cancer killer of women and men? | Lung |
| Most aggressive type of lung cancer. Not surgically treated. Highest rate of mets. Usually systemic disease = | Small cell lung ca (16% of lung cancers) |
| Most common type of lung cancer | non-small cell (85%) |
| Most common types of non-small cell lung cancer | Squamous cell (30-35%), adenocarcinoma (30-35%), large cell (3-5%) |
| Squamous cell lung cancer usually originates where in the lung? | central |
| Adenocarcinoma lung cancer usually originates where in the lung? | peripheral |
| What is the presentation of stage 1 lung cancer? | Predominately asymptomatic (while more advanced is symptomatic) |
| What fraction of patients present to PCP with stage 3-4 lung cancer? | 2/3 |
| Most frequent symptoms associated with advanced lung cancer | Cough, wt loss, dyspnea, chest pain, hemoptosis, bone pain, lymphadenopathy, hepatomegaly, clubbing, horseness, SVC syndrome |
| In which population is there an increasing incidence in lung cancer? | Young, white, non-smoking females |
| What is the most common cause of death in lung cancer? | distant metastases |
| Which stages of lung cancer are resectable? | stages I-IIIa |
| Initial imaging modality for suspicion of lung cancer | chest x-ray |
| A __ lesion on chest x-ray is considered malignant until proven otherwise | non-calcified |
| RFs for lung cancer include: | smoking, air pollution, ionizing radiation, asbestosis, heavy metals,industrial carcinogens |
| Most common etiologic factor in lung cancer: | smoking (85% of cases overall M>F) |
| Imaging used to evaluate for mets: | PET, brain CT, MRI |
| Imaging modality considered the standard of care in proper staging of lung tumors | Bronchoscopy |
| Gold standard for lymph node evaluation with lung cancer = | cervical mediastinoscopy |
| Lung cancer type more easily detected early: | SCLC (in sputum) - bc it often originates in central bronchi |
| Tends to be glandular & mucus-producing; associated with pleural effusions = | adenocarcinoma |
| In lung cancer, local mets may cause symptoms associated with what anatomic area? | Mediastinal structures (phrenic nerve, SVC, recurrent laryngeal nerve) |
| Common distant mets sites in lung cancer: | bone, brain, adrenals, kidney, liver |
| Lung cancer is often associated with paraneoplastic syndromes grouped as: | endocrine, systemic, neuro, cutaneous, hematologic, renal |
| Lung ca workup | CXR, CT, CBC, LFTs, lytes, Ca. Bronchoscopy; sputum cyto & pleural fluid; LN bx |
| 5 year survival rate for SCLC & NSCLC = | NSCLC = 15%. Limited-stage SCLC = 7%; extensive-stage dz = 1% |
| What % of mediastinal masses, originating in mediastinum, are benign? | 75% |
| Most common anterior mediastinal mass = | thymoma |
| Anterior mediastinal mass DDx | Thymoma, lymphoma, thyroid/PT, teratoma (germ cell tumor) |
| Middle mediastinal mass DDx | Hiatal hernia & mets cancer most common; also sarcoid, AAA, pericardial cyst (most common mediastinal cyst), bronchogenic cyst, LAD |
| Posterior mediastinal mass DDx | Neurogenic tumor (20% of all primary mediastinal tumors) |
| 50% of patients with thymoma initially present with: | myasthenia gravis |
| Complications of lung cancer (SPHERE) | SVC syndrome, Pancoast tumor, Horner syndrome, Endocrine (carcinoid), Recurrent laryngeal nerve (hoarseness), Effusions |
| Common endocrine syndrome/effect of SCLC | Cushing/SIADH |
| Common endocrine syndrome/effect of SCC | Hypercalcemia/PTH dz |
| Common endocrine syndrome/effect of large cell lung cancer | Gynecomastia |
| Common endocrine syndrome/effect of adenocarcinoma | thrombophlebitis |
Created by:
Abarnard
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