Pulmonology
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What is the leading cause of cancer deaths in men and women
lung cancer (more than colon+breast+prostate combined)
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Number 1 risk factor
smoking
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Two major categories of lung cancer
SCLC (small cell lung cancer, oat cell) and NSCLC (non-small cell lung cancer)
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SCLC
25-35% of cases, poor prognosis, not amenable to surgery, early metastasis, aggressive clinical course
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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
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Clinical features
cough, hemoptysis, pain, anorexia, weight loss, asthenia
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Treatment-SCLC
combination chemotherapy
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NSCLC
surgery
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AKA
coin lesion
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When is it referred to as a "mass"?
>3cm
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What are most solitary nodules?
infectious granulomas from old/active TB, fungal infix, foreign body reaction, malignancy
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What percentage of solitary nodules are malignant?
40%: carcinoma, hamartoma, metastasis, and 95% of malignant nodule are bronchial adenomas*
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What may suggest a benign cause of a solitary nodule?
If the lesion has not enlarged in >2 years, and most are infectious granulomas
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Treatment if lesion has high probability of malignancy
resection
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AKA
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carcinoid adenomas or bronchial gland tumors
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Definition
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Well-differentiated neuroendocrine tumors that affect men and women equally (usually <60yo)
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Clinical features
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hemoptysis, focal wheezing, recurrent pneumona, bleeding, obstruction, carcinoid syndrome
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Lab findings
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bronchoscopy shows pink/purple central lesion that is well-vascularized
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Treatment
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surgery (resistant to radiation and chemo)
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