Carcinomas of lung By: Shefaa’ Qa’qa’.

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Presentation transcript:

Carcinomas of lung By: Shefaa’ Qa’qa’

important cause of cancer related deaths. lung Prostate Breast

Smokers ? Non smokers ? Males females

Small cell lung cancer (SCLC) Non–small cell lung cancer (NSCLC) Mets surgery chemotherapy?

Molecular changes: EGFR K-RAS ALK MET

Targeted therapy

Risk factors: Environmental Genetic/ P-450 monooxygenase enzyme system

Squamous cell carcinomas: Men ? Women ? Smoking ? Centrally ? Peripherally ? Mets ? Cavitation (central necrosis) ? Surgery ? squamous metaplasia --- dysplasia --- carcinoma in situ

Adenocarcinomas: Men ? Women ? Smoking ? Centrally ? Peripherally ? Mets ? Cavitation (central necrosis) ? Surgery ? Atypical adenomatous hyperplasia---- Adenocarcinoma in situ------ Minimally invasive adenocarcinoma----- Invasive adenocarcinoma

Large cell carcinomas: squamous cell adenocarcinomas

Small cell lung carcinomas: Centrally Smoking Mets chemotherapy

Combined patterns

Virchow node Vena caval syndrome Horner syndrome/Apical tumors Pancoast tumors

Paraneoplastic syndromes: Hypercalcemia Cushing syndrome Syndrome of inappropriate secretion of antidiuretic hormone Myasthenic syndrome Polymyositis Clubbing of the fingers and hypertrophic pulmonary osteoarthropathy Coagulation abnormalities, including migratory thrombophlebitis and DIC

Carcinoid Tumors: Typical (low-grade) Atypical (intermediate-grade) carcinoid Polypoid Mucosal plaque penetrating the bronchial wall Central Peripheral Only rarely do they induce the carcinoid syndrome, characterized by intermittent attacks of diarrhea, flushing, and cyanosis