Lung Cancer

Lung Cancer

1. Classification

   • Primary tumors
     • Epithelial
       • Carcinoid tumors
       • Bronchogenic carcinoma
         • Small cell cancer
           • Cells are large, with scant cytoplasm + areas of necrosis+ mitotic figures are frequent + Molding with large nuclei
         • Adenocarcinoma
           • gland forming adenocarcinoma (Acinar subtype)
         • Squamous cell carcinoma
           • nests of squamous cells with central areas of keratinization
         • Large call carcinoma
           • Lacks the histological features
     • Non-epithelial
       • Hamartoma
         • disorganised mixture of normal lung tissues
         • Coin-lesion xray
       • Mesenchymal
       • Lymphoma
   • Secondary tumors

2. Causes

   • Tobacco smoking
   • Industrial hazards
     • radiation
     • uranium
     • aromatic hydrocarbon
     • Asbestos
   • Air pollution
   • Scars
   • Genetic mutations
     • RAS genes
     • Epidermal growth factor receptor
     • Anaplastic lymphoma kinase
     • TP53
     • c-Met receptor

3. Clinical presentation

   • Cough
   • Weight loss
   • Chest pain
   • Dyspnea
   • Hemoptysis
     • Other causes
   • Loss of appetite
   • Obstructive symptoms
   • Paraneoplastic syndrome
     • Cushing's syndrome
     • hyponatremia
     • Hypercalcemia
     • Acromegaly
     • Lambert-Eaton mysthenic syndrome
     • Peripheral neuropathy

4. Complications

   • Pleural effusion
   • Metastasis
   • Compression of the sympathetic chain
     • Horner’s syndrome
   • Involvement of the recurrent laryngeal nerve
   • Obstruction of the SVC

5. Management

   • Chemotherapy
   • Radiotherapy
   • Surgery
   • Targeted therapy
   • Immunotherapy

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