1. QUESTIONS OF LUNG CANCER

2. Case 11
A 50 year old male with a long smoking history, c/o cough since 1 month, off and on hemoptysis, & wt. loss. On exam: Thin and wasted appearance Vitals : Stable. No fever Chest: Decreased breath sounds over the right middle lobe and dullness to percussion. Hands: Clubbing present. Tar stained fingers WHAT IS THE MOST LIKELY CLINICAL DIAGNOSIS?

3. Answer case 11
Carcinoma of the lung

4. Questions case 11 Name any differential diagnosis?
What are the risk factors for Ca. lung?
What imaging test s will you do ?
Which is the confirmatory test for Ca lung?
Name 4 complications of Ca lung?
Name the 2 main types of lung cancer?
Name the 3 types of Non small cell lung cancers?
Which lung cancer is centrally located?
Which lung cancer is more peripheral?

5. Answers of case 11 D/D : Lung abscess, pneumonia,
Smoking, Radon gas, Asbestos
Chest X ray
Lung biopsy
Complications:
* Pleural effusion * Invasion of the chest wall * Superior vena cava syndrome
* Hoarseness of voice * Pneumonia * Horner’s syndrome * Brachial plexus damage
Small cell carcinoma & Non-small cell carcinoma

6. Answers of case 11 contd.
6) Non small cell cancer * adenocarcinoma * squamous cell carcinoma * large cell Ca. 7) Centrally located : Squamous cell 8) Peripheral location : Adenocarcinoma

7. Question
Name some paraneoplastic syndromes associated with lung cancer?

8. Answer Associated paraneoplastic syndromes are: SIADH
Syndrome of ectopic ACTH
Eaton-Lambert syndrome
Cerebellar degeneration
Ectopic PTH production ( parathyroid hormone)

9. Answer Associated paraneoplastic syndromes are: SIADH
Syndrome of ectopic ACTH
Eaton-Lambert syndrome
Cerebellar degeneration
Ectopic PTH production ( parathyroid hormone)

10. Case 12
A patient has lung carcinoma. Work up and staging shows that the carcinoma has spread to the local lymph nodes but not to the mediastinal nodes. What stage is this?

11. Answer case 12
Stage 2

12. STAGING
Staging of the tumor is done based on the investigations. It tells how far the cancer has spread. Stage 1: Cancer is located only in the lungs & has has not spread to any lymph nodes. Stage 2: Cancer is in the lungs & the nearby nodes Stage 3:Cancer is found in the lungs & in the nodes in the middle of the chest. This stage is further divided into stage 3 A & B Stage 4: Cancer has spread to both lungs, pleura or distant metastases.

13. QUESTIONS Name the different treatment modalities for lung carcinoma?
Name 2 drugs for cancer lung?

14. Answers
Surgery, chemotherapy, radiotherapy
Cisplatin, Carboplatin