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%

Click to add title

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

Diagnostic Tests

• CXR

Diagnostic Tests

• CT Scans

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.

THANK YOU