Lung Cancer

LECTURE 05

DR JAMEEL AHMED

DEMONSTRATOR AT PAQSJIMS GAMBAT

PIONEER OF “ESSENTIAL MEDICAL LEARNING WITH DR

JAMEEL AHMED” YOUTUBE CHANNEL
 Lung Cancer

Most common cause of cancer mortality.

Risk Factors
Cigarette Smoking (most common cause)
Radon (Second most common cause) formed by
decay of uranium
Presentation
Presenting symptoms are non-specific (cough,
weight loss, hemoptysis and postobstructive
pneumonia etc)
 Lung Cancer

Imaging reveals solitary nodule (coin-lesion). Biopsy is

necessary for diagnosis. But coin lesions are also found in
Granuloma (T.B or fungus) and bronchial hemartoma
(benign tumor composed of lung and cartilage tissue)
Classification
Non-small cell carcinoma (85%) – treated with surgical
resection & not respond well to radiotherapy. Subtypes
include adenocarcinoma (40%), SCC (30%), large cell
carcinoma (10%) & carcinoid tumor (5%).
Small Cell Carcinoma (15%) – treated with chemotherapy
but not with surgical resection.
 Lung Cancer

Small Cell carcinoma- poorly differentiated small cells arise from

neuroendocrine (kulchitsky) cells (histology). Occur in male Smokers and
located C(s)entral. Produce paraneoplastic syndromes all (ADH, ACTH,
lambert-Easton syndrome) except carcinoid and PTHrP.
SCC – Keratin pearls or intercellular bridges (histology). Occur commonly in
male smokers and located c(s)entral. Produce PTHrP.
Adenocarcinoma – glands/mucin (histology). Most common in non0smokers
and female smokers. Located peripheral.
Large cell carcinoma – poorly differentiated (lack of everything like keratin
pearls, intercellular bridges, glands or mucins). Occur in smokers and located
central or peripheral and has poor prognosis.
Bronchioalveolar carcinoma – a subtype of adenocarcinoma, arise from Clara
cells. Columnar cells that grow along preexisting bronchioles and alveoli. Not
related to smoking & located peripheral. May present with pneumonia like
consolidation on imaging & has good prognosis.
 Lung Cancer

TNM Staging
1) T-Tumor size & local extension. Pleural involvement is
classically seen in adenocarcinoma. SPHERE of
complications occur (SVC Syndrome, Pancoast (apical)
tumor, Hornor syndrome, Endocrine (paraneoplastic),
Recurrent laryngeal nerve compression (hoarseness),
Effusion (pleural or pericardial)
2) N- spread to regional lymph nodes (hilar &
mediastinal)
3) M – unique site of distant metastasis is the adrenal
gland.
THANKS