lung cancer
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LUNG CANCER PROBLEM BASED LEARNING (PBL)
PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB
BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN
Define lung cancer
• Lung cancer (malignancy of the lungs) is defined as an uncontrolled growth of abnormal cells in one or both of the lungs
Types of Lung Cancer
• Two main Types of Lung Cancer:
– Non Small Cell Lung Cancer (most common ~80%)• SQUAMOUS CELL CARCINOMA
• ADENOCARCINOMA
• LARGE CELL CARCINOMA
– Small Cell Lung Cancer (20-25% of all lung cancers)
• Combined patterns– Mixed sq.cell carcinoma + adenocarcinoma
– Mixerd sq.cell carcinoma + SCC
Squamous Cell Carcinoma
• Malignant bronchial epithelial tumour showing
keratinization and/or intercellular bridges.
• Strongly associated with smoking
• Majority arise centrally in major bronchi –
(obstruction and infection)
• Cavitations in 10%
Adenocarcinoma
• Malignant tumour with glandular
differentiation or mucin production.
• Gross : Adenocarcinoma of the lung. Usually found as white-tan nodule at the periphery of the lung.
• Many variants : Acinar, papillary,
bronchioloalveolar, solid, mixed subtypes
• Strongly associated with asbestose
Small Cell Carcinoma
• Oat cell carcinoma”
• It arises from endocrine cells (Kulchitsky
cells).
• Closely associated with smoking
Pathophysiology disease limited to air passage lining: has not invaded lung tissue; can usually be treated and eliminated
disease limited to lung tissue; has not invaded lymph nodes or other organs;
spread to lymph nodes and chest wall (chest pain)
continue• disease has invaded lymph nodes outside of
the lung area; (need surgery)
• disease has invaded organs and structures surrounding the lungs such as the heart, trachea and esophagus
• disease has invaded structures and organs throughout the body, such as liver, bones and brain; less than 2% chance of survival at 5 years if treated at this stage
Metastatic Neoplasms
• Lung most frequent site (other than LN)
• Patterns of Metastasis:
– Multiple nodules
– Lymphangitic metastasis
– Solitary
Metastatic Neoplasms
From :
• Ovarian adenocarcinoma
• Breast cancer
• Prostatic cancer
• Colonic adenocarcinoma
• Renal carcinoma
• Melanoma, lymphoma, sarcoma
Diagnostic Tests
• CXR
• CT Scans
• MRI
• Sputum cytology
• Fibreoptic bronchoscopy
• Transthoracic fine needle aspiration
Complication• Shortness of breath. Due to cancer has block the major
airways. Lung cancer can also cause accumulation fluid around the lungs, thus SOB
• Coughing up blood. Due to rupture of cappilary, bronchiolalviolar lead to blood cough (hemoptysis).
• Pain. Advanced lung cancer that spreads to the lining of a lung or to another area of the body, such as a bone, can cause pain.
• Fluid in the chest (pleural effusion). Lung cancer can cause fluid to accumulate in the space that surrounds the affected lung in the chest cavity (pleural space).
• Cancer that spreads to other parts of the body (metastasis). Lung cancer often spreads (metastasizes) to other parts of the body, such as the brain and the bones.
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