Pulm Neoplasms Flashcards Preview

PANRE PULM > Pulm Neoplasms > Flashcards

Flashcards in Pulm Neoplasms Deck (26)
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1
Q

Coin lesions
< 3 cm
Surrounded by nml lung tissue

A

Solitary pulm nodule (SPN)

2
Q

Etiology (SPN)

A

1) Benign
Infx granulomas (80%); TB, fungi - histoplas
Hamartoma (15%); slow growing, mult tissue (cartilage, fat, muscle, bone, etc), popcorn calc

2) Malignant (5%)
Bronchogenic carcinoma, bronchial carcinoid, mets tumors (multiple SPNs)

3
Q

RFs (SPNs)

A

AGE (malignancy inc proportionately)
SMOKING
Environment/Work exposure (asbestos)
H/o cancer
Other lung dz
Travel (endemic fungal areas)

4
Q

Dx (SPNs)

A

Review old films (comparison)

CT or PET
(Smooth, well-defined = likely benign)
(Lobular, spiculated / corona radiata, peripheral halo = often malignant)

Biopsy by pulm

5
Q
#1 cancer-related death
Older age (usually)
Smoking hx (usually)
A

Bronchogenic carcinoma

6
Q

RFs (Bronchogenic carcinoma)

A

SMOKING
Asbestos, radon gas, formaldehyde, metals
Radiation
HIV

7
Q

Screening (Bronchogenic carcinoma)

A

Currently not recommended

Low-dose CT

8
Q

Classification (Bronchogenic carcinoma)

A

1) Non-Small cell (NSCLC - 80%)
AC, SCC, Large cell

2) Small cell (SCLC - 20%)
Much worse

9
Q

30-40% NSCLC
Usually peripheral (mid-clavicular or lateral)
Nodule or mass
Usually underlying lung dz

A

Adenocarcinoma (NSCLC)

10
Q

20-30% NSCLC
Usually central, endobronchial mass (marble)
Persistent cough, hemoptysis, recurrent PNA
Sputum cytology

A

SCC (NSCLC)

11
Q

10% (NSCLC)
Poorly differentiated
Usually peripheral mass
Can look like AC

A

Large cell carcinoma (NSCLC)

12
Q
Neuroendocrine tumor
"Oat cell" subtype
Bronchial origin, starts central
Narrows/obstructs bronchi
Hilar mass on imaging
A

Small cell (SCLC)

13
Q

H A SS L E

A

A & L are outer / peripheral
(Adenocarcinoma, Large cell)

S & S are inner / central
(SCC, Small cell)

14
Q

Clinical signs/sxs (Bronchogenic Ca)

Primary lesion

A
Cough - chronic
Dyspnea
Chest pain - "fullness"
Hemoptysis
"B" signs: Fever, Night sweats, Weight loss
15
Q

Clinical signs/sxs (Bronchogenic Ca)

Intrathoracic spread

A

Pleural effusion
Hoarseness (compress of recurr laryng n.)
**Superior vena cava synd (esp SCC); crimp SVC, venous backup/plethora, edema nipples up (neck/face), hoarse, hemoptysis
**Pancoast tumor/syndrome (apical lung); assoc c Horner’s syndrome (ptosis, miosis, anhidrosis), rib destruc, brachial plexopathy

16
Q

Clinical signs/sxs (Bronchogenic Ca)

Extrathoracic spread

A

Mets to:
Bone (pain, fx)
Liver (poor px)
Brain (HA, N/V, seizure, focal deficits)

17
Q

Dx (Bronchogenic Ca)

A

Confirm & stage
CXR, CT, ??? bone scan, PET, brain MRI
Tissue sampling (sputum cytology, thoracent, bronchoscopy, needle bx, VATS)
TNM stage

18
Q

Tx (Bronchogenic Ca)

A

NSCLC - surgery if caught early
Adjuvant chemo/rad

SCLC - Chemo; poor px

19
Q

Primary tumor of pleural surface lining
M&raquo_space; F; > 60 yrs
Occupational exposure

A

Mesothelioma

20
Q

Clinical presentation (Mesothelioma)

A

Slow onset dyspnea (2/2 pleural effusion)
Non-pleuritic chest pain
Weight loss

21
Q

Dx (Mesothelioma)

A

CXR, CT, thoracentesis, pleural bx, VATS

22
Q

Tx (Mesothelioma)

A

Surgery, radiation, chemo

Poor px

23
Q

Neuroendocrine tumor
Synth/store/secrete neuroamine/peptides
Slow-growing, rarely mets, but arise thru-out body (GI&raquo_space; lung&raquo_space; thymus & ovary)
Young adults, usually male

A

Carcinoid tumor

24
Q

Carcinoid tumor
Signs/sxs
Dx
Tx

A
Hemoptysis, cough, recurrent PNA
Carcinoid syndrome rare (syst release serotonin - FLUSHING, DIARRHEA, BRONCHOSPASM - wheezing)
Paraneoplastic - SIADH
CT, bronchoscopy, bx
Surgical excision
25
Q
Associated Findings (Paraneoplastic)
NSCLC
A

Hypercalcemia
Hypophosphatemia
Hypoglycemia
Migratory thrombophlebitis

26
Q
Associated Findings (Paraneoplastic)
SCLC
A
Acanthosis nigracans
SIADH
Dermatomyositis
Cushing's Syndrome
Nephrotic Syndrome