Lec 5

What are the most frequent benign lung tumors?

What are the most frequent benign lung tumors?

Hamartomas and carcinoid tumors.

What percentage of pulmonary neoplasms are benign tumors?

Only 1%.

1. The most common cause of cancer-related death worldwide is ____________.

Benign tumors of the lungs often show a _____________ edge on imaging, in contrast to malignant tumors with spiky projections.

(Answer: lung cancer)

(Answer: well-circumscribed)

Question: What imaging technique is sometimes used to confirm benign lung lesions?

A. Bronchoscopy

B. CT-guided biopsy

C. MRI

D. PET scan

Answer: B. CT-guided biopsy

Features suggestive of benign tumours include:

?

 slow growth (compare with previous chest films)

 calcification

 Well-circumscribed edge (in contrast, cancers show spiky projections as they invad

: What are the two primary gross types of malignant lung tumors?

1. Hilar type (75%)

2. Peripheral type (25%).

What syndrome is associated with Pancoast's tumors?

Horner's syndrome.

The hilar type of malignant tumor leads to ____________ obstruction.

The peripheral type often remains __________ for a long time.

bronchial

symptomless

A tumor at the apex of the lung, involving the brachial plexus and causing Horner's syndrome, is known as:

A. Peripheral adenocarcinoma

B. Pancoast's tumor

C. Large-cell carcinoma

D. Squamous cell carcinoma

Answer: B. Pancoast's tumor

Name the main histological types of non-small cell lung cancer (NSCLC).

1. Squamous cell carcinoma 25_35%

2. Adenocarcinoma 40%

3. Large-cell carcinoma 10_15 %

4. Carcinoid.

What is the survival rate for untreated small cell lung cancer (SCLC)?

2–4 months.

Small cell lung cancer (SCLC) spreads through __________ and __________ dissemination.

The tumor type most common in nonsmokers is ____________.

(Answer: lymphatic, hematogenous)

(Answer: adenocarcinoma)

Which of the following produces paraneoplastic syndromes like ACTH secretion?

A. Squamous cell carcinoma

B. Small cell lung carcinoma

C. Adenocarcinoma

D. Large-cell carcinoma

: B. Small cell lung carcinoma

1. The hilar type arises in __________ and leads to __________.

Answer: main bronchi, bronchial obstruction)

1. Squamous cell carcinoma typically presents as __________ masses with bronchial obstruction.

Adenocarcinoma is the most common subtype in __________ and metastasizes rapidly to __________.

__________ cancer is neuroendocrine in nature and associated with paraneoplastic syndromes.

(Answer: central bulky)

(Answer: nonsmokers, brain/adrenals)

(Answer: Small cell lung)

A tumor at the apex of the lung is most likely to invade:

A. Pulmonary veins

B. Cervical lymph nodes

C. Brachial plexus

D. Phrenic nerve

Answer: C. Brachial plexus

A highly malignant lung tumor with neuroendocrine properties is:

A. Squamous cell carcinoma

B. Large-cell carcinoma

C. Small cell lung carcinoma

D. Adenocarcinoma

C. Small cell lung carcinoma

What does "T4" in TNM classification indicate?

What is the significance of N3 in TNM staging?

Tumor of any size with mediastinal invasion, malignant pleural effusion, or distant spread.

2Metastasis to contralateral mediastinal or supraclavicular nodes.

1. Stage III lung cancer involves ___________ metastases.

2. __________ staging system is used for lung cancer

(Answer: regional lymph node)

Answer: TNM

Which of the following describes N1 in TNM classification?

A. No lymph node metastasis

B. Contralateral mediastinal metastasis

C. Ipsilateral hilar node metastasis

D. Supraclavicular node metastasis

Answer: C. Ipsilateral hilar node metastasis

A T3 lung tumor is characterized by:

A. Involvement of the main bronchus less than 2 cm from the carina

B. Tumor size < 3 cm with no invasion

C. Distant metastases to the brain

D. Malignant pleural effusion

Answer: A. Involvement of the main bronchus less than 2 cm from the carina

Secondary Pulmonary metastases most common form of intrathoracic malignancy. ?

a. Carcinoma (especially breast, kidney)

b. Sarcoma (especially bone)

c. Melanoma.

What is the primary risk factor for lung cancer?

Cigarette smoking (80% of cases).

Question: What are some non-smoking-related risk factors?

1. Asbestos exposure

2. Radon exposure

3. Arsenic and chromium exposure

Nickel exposure, organic chemical,

iatrogenic radiation exposure

Up to __________% of heavy smokers develop lung cancer.

__________ is a radioactive gas that increases the risk of lung cancer

(Answer: 15)

(Answer: Radon)

Squamous cell carcinoma: They are relatively slow growing, are late to metastasize, and may present as central bulky masses with bronchial obstruction or as peripheral lesions with …………l

cavitation

Bronchoalveolar Carcinomas is an uncommon form of …………

develops in the very distal airways and lines the alveoli. It often presents as a peripheral nodule or multifocal carcinoma.

adenocarcinoma

Bronchoalveolar Carcinomas

is an uncommon form of adenocarcinoma

develops in the very distal airways and lines the alveoli. It often presents as a

peripheral nodule or multifocal carcinoma.

………………: Large cells containing abundant cytoplasm and without evidence of squamous or glandular differentiation

Large - cell carcinoma

Small Cell Lung Cancer properties 5 point

.

1,The small cell anaplastic carcinoma (also known as oat cell carcinoma) is a highly malignant, rapidly growing neoplasm,

2.located centrally because of its origin from a proximal bronchus

3.. It spreads by lymphatic and hematogenous dissemination and local invasion

4.neuroendocrine properties and produces peptides giving rise to paraneoplastic syndrome

5.The tumour comprises small cells with little cytoplasm. It has a poor prognosis, has generally spreaded by the time of diagnosis and is best treated by chemotherapy

What are the primary ways lung tumors spread?

1. Direct spread to local tissues

2. Lymphatic spread to axillary and cervical nodes

3. Transcoelomic spread across the pleural cavity

4. Blood-borne metastasis to organs like bone, liver, and brain.

1. Lung cancer can spread to __________ nodes and __________ through the bloodstream

2. The spread of cancer cells across the pleural cavity is known as __________ spread.

(Answer: axillary, liver)

(Answer: transcoelomic)

Which type of spread is most likely to affect the brain in lung cancer patients?

A. Lymphatic

B. Direct

C. Blood-borne

D. Transcoelomic

Answer: C. Blood-borne

Direct spread of lung cancer can lead to involvement of:

A. Cervical lymph nodes

B. Suprarenal glands

C. Mediastinal pleura

D. Cerebral cortex

C. Mediastinal pleura

What are the common local symptoms of lung cancer?

1. Cough

2. Dyspnoea (shortness of breath)

3. Haemoptysis

4. Chest pain

What is a common paraneoplastic syndrome associated with small cell lung carcinoma?

Production of adrenocorticotrophic hormone (ACTH)

1. __________ is a sign that might indicate involvement of the recurrent laryngeal nerve in lung cancer.

2. __________ is a common symptom in lung cancer and may occur in less than 50% of patients.

(Answer: Hoarseness of voice)

(Answer: Haemoptysis)

Which clinical feature is more likely in small cell lung carcinoma?

A. Hypercalcemia

B. Cushing's syndrome

C. Pancoast's tumor

D. Cavitary lesions

B. Cushing's syndrome

: Finger clubbing in a lung cancer patient is often associated with:

A. Small cell lung carcinoma

B. Hypertrophic pulmonary osteoarthropathy

C. Benign pulmonary hamartoma

D. Blood-borne metastasis

Hypertrophic pulmonary osteoarthropathy

squamous carcinomas may produce parathormone (PTH) and

present with hypercalcaemia

Clinical examination

For evidence of stridor or hoarseness of the voice due to recurrent laryngeal nerve involvement by the cancer. The heart may be invaded, resulting in atrial fibrillation or cardiac failure. There may be enlarged lymph nodes, especially at the root of the neck.

Signs in the chest of consolidation, fluid or collapse.Clubbing of the fingers, which are usually nicotine stained

Define T1 in the TNM classification.

Tumor less than 3 cm with no bronchoscopic evidence of invasion.

1. A lung tumor larger than 7 cm with chest wall invasion is classified as __________.

2. __________ represents metastasis to the contralateral mediastinal or supraclavicular nodes in the TNM system.

(Answer: T3)

(Answer: N3)

Which stage in TNM classification indicates distant metastasis?

A. M0

B. T2

C. N1

. M

Answer: D. M1

In the TNM classification, a tumor involving the diaphragm and mediastinal pleura is classified as:

A. T2

B. T1

C. T3

D. T4

D. T4

What non-invasive imaging is initially used for lung cancer evaluation?

What procedure is indicated for peripheral lung lesions?

Chest X-ray and thoracic CT scan.

Transthoracic needle aspiration.

1. __________ is recommended for suspected cases of mediastinal involvement before resection.

2. __________ is often used to assess the presence of "cannonball" lesions from metastatic cancer

(Answer: Lymph node biopsy)

(Answer: CT scan)

Which investigation is commonly performed to assess for lung metastasis in bone?

A. MRI

B. PET scan

C. Bone scan

D. Chest X-ray

Answer: C. Bone scan

For a suspected central lung lesion, which diagnostic procedure is preferred?

A. Bronchoscopy

B. Transthoracic needle biopsy

C. MRI

D. Thoracentesis

: A. Bronchoscopy

What surgical options are available for early-stage lung cancer?

What is the primary treatment for inoperable cases with small cell lung carcinoma?

Answer: Segmentectomy, lobectomy, pneumonectomy.

Answer: Chemotherapy combined with radiotherapy.

1. Radical resection is primarily indicated for lung cancer stages __________ and __________.

2. __________ is a palliative option to control symptoms of bronchial obstruction or skeletal metastasis pain.

(Answer: I, II)

Answer: Radiotherapy)

Which treatment is most suitable for a small cell lung carcinoma?

A. Lobectomy

B. Segmentectomy

C. Combined chemotherapy and radiotherapy

D. Local excision

: C. Combined chemotherapy and radiotherapy

For patients with inoperable lung cancer, which option is used for palliation?

A. Lobectomy

B. Chemotherapy only

C. Radiotherapy

D. Observation

Answer: C. Radiotherapy

What factors significantly influence lung cancer prognosis?

What is the 5-year survival rate for operable primary lung cancers?

Answer: Tumor histology, stage, and patient’s general health.

Approximately 45

1. Patients with advanced squamous cell lung cancer have a __________ 5-year survival rate.

2. The median survival without treatment for small cell lung carcinoma is __________ months

(Answer: 2%)

(Answer: 2–4)

Which lung cancer type has a slightly better prognosis if detected early?

A. Small cell carcinoma

B. Adenocarcinoma

C. Large-cell carcinoma

D. Squamous cell carcinoma

Answer: D. Squamous cell carcinoma

Define a solitary pulmonary nodule

: A sharply circumscribed lesion up to 3-4 cm, potentially benign or malignant, surrounded by normal lung tissue

What type of calcification suggests a benign lesion in a pulmonary nodule?

"Popcorn" calcification.

1. The probability of malignancy in solitary pulmonary nodules increases in __________ aged smokers over 50 years.

2. A "wait and watch" strategy is used for solitary pulmonary nodules if stable over __________ years

Answer: male)

(Answer: 2)

Question: In solitary pulmonary nodules, which finding would indicate a benign diagnosis?

A. Rapid growth

B. Spiky projections

C. Popcorn calcifications

D. Invasion of adjacent structures

Answer: C. Popcorn calcifications

Question: If a solitary pulmonary nodule is accompanied by hypertrophic osteoarthropathy, the likelihood of carcinoma is:

A. 30%

B. 50%

C. 75%

D. 90%

Answer: C. 75%