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Flashcards in Respiratory neoplasia Deck (14)
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Lung tumours

benign andd malignant
mainly carcinomas (arising for lining epithelium)


Lung carcinomas

second most common cancer in the UK
incidence increased in females
risk factors: family history, smoking, immunodeficiency, industrial hazards eg. exposure to ionising radiation, asbestos, diesel, air pollution
symptoms = cough, chest pain, weight loss, dyspnoea
can metastasise - extension into pleural cavity = pericardium, tracheal/bronchial nodes
> distant spread to adrenls, liver, brain & bone


What are the local effects of lung tumour spread?

pneumonia, pleural effusion, dysphagia, rib destruction, pericarditis


What is a paraneoplastic syndrome?

ectopic hormone secretion by tumour
hormones include:
- ADH - hyponatraemia
- ACTH - cushing's syndrome
- parathyroid hormone, prostaglandins hypercalcaemia
- calcitonin - hypocalcaemia


Small cell carcinoma

strong relationship to smoking
Occur in major bronchi and at periphery
Rapidly invade bronchial wall and parenchyma; early lymphatic and blood-borne spread = mostly incurable by surgery
Most responsive to chemo – but worst prognosis as relapses early
HISTOPATHOLOGY: small, tightly packed, darkly stained ovoid tumour cells
Cells with little cytoplasm, absent nucleoli
Can be pure or cobined


Squamous cell carcinoma

Most commonly affects men
Closely correlated with smoking history
Arises close to hilum, usually in area of squamous metaplasia (due to cigarette smoke)

HISTOPATHOLOGY: well differentiatied resembles stratified squamous epithelium; characterised by keratin formation and/or inercellular bridges



Most common type in women and non-smokers
peripherally located
Grow more slowly than SCC but metastasize early and widely
Sometimes associated with scarring e.g. healed TB

HISTOPATHOLOGY: well differentiated have obvious glandular element 80% contain mucin


Large cell carcinoma

Undifferentiated malignant epithelial tumour
HISTOPATHOLOGY: large, anaplastic epithelial cells growing in islands and sheets
Neuroendocrine variant – highly malignant; nests and islands of tumour cells with granular cytoplasm, central necrosis, peripheral palisading


Lung metastases

Most common site of metastatic neoplasms
Arrive by blood, lymphatics or direct continuity
Usually multiple discrete nodules (cannonball lesions) scattered thoughout all lobes
Peripheral lesions
Common primary sites- bowel, prostate, breast, kidney


Pleural tumours

Secondary metastatic involvement more common than primary tumour
Most frequently lung or breast
Serous effusion often present containing neoplastic cells
Primary tumour
Malignant mesothelioma


What is malignant mesothelioma?

Increased incidence in people with exposure to asbestos
Latent period of 25-45 years
spreads widely in the pleural space
symptoms = chest pain, dyspnoea, pleural effusions
50% die within 12 months of diagnosis
can spread to other organs
- Extra-pleural pneumonectomy, chemo, radiotherapy
Doesn’t often improve prognosis


What is dyspnoea?

Diffucult/laboured breathing.


What is dysphagia?

Difficulty swallowing


What is tachypnea?

Rapid breathing