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Pulm III: Neoplasms Cheat Sheet by

Pulmonology

Bronch­iogenic Carcinoma

What is the leading cause of cancer deaths in men and women
lung cancer (more than colon+­bre­ast­+pr­ostate combined)
Number 1 risk factor
smoking
Two major categories of lung cancer
SCLC (small cell lung cancer, oat cell) and NSCLC (non-small cell lung cancer)
SCLC
25-35% of cases, poor prognosis, not amenable to surgery, early metast­asis, aggressive clinical course
NSCLC
1) Squamous cell carcinoma: 25-35% of cases, hemopt­ysis, bronchial in origin. 2) Adenoc­arc­inoma: the most common* type of lung cancer, 35-40% of cases, arises from mucus glands. 3) Large cell carcinoma
Clinical features
cough, hemopt­ysis, pain, anorexia, weight loss, asthenia
Treatm­ent­-SCLC
combin­ation chemot­herapy
NSCLC
surgery
 

Solitary Pulmonary Nodule

AKA
coin lesion
When is it referred to as a "­mas­s"?
>3cm
What are most solitary nodules?
infectious granulomas from old/active TB, fungal infix, foreign body reaction, malignancy
What percentage of solitary nodules are malignant?
40%: carcinoma, hamartoma, metast­asis, and 95% of malignant nodule are bronchial adenomas*
What may suggest a benign cause of a solitary nodule?
If the lesion has not enlarged in >2 years, and most are infectious granulomas
Treatment if lesion has high probab­ility of malignancy
resection

Carcinoid Tumors

AKA
carcinoid adenomas or bronchial gland tumors
Definition
Well-d­iff­ere­ntiated neuroe­ndo­crine tumors that affect men and women equally (usually <60yo)
Clinical features
hemopt­ysis, focal wheezing, recurrent pneumona, bleeding, obstru­ction, carcinoid syndrome
Lab findings
bronch­oscopy shows pink/p­urple central lesion that is well-v­asc­ula­rized
Treatment
surgery (resistant to radiation and chemo)
                       

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