1. 1. LUNG CANCERPROBLEM BASED LEARNING (PBL) PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB BACHELOR MEDICINE AND SURGERY (MBBS) UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN
2. 2. 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
3. 3. 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
4. 4. 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%
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6. 6. 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
7. 7. Small Cell Carcinoma Oat cell carcinoma It arises from endocrine cells (Kulchitsky cells). Closely associated with smoking
8. 8. 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)
9. 9. 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
10. 10. Metastatic Neoplasms Lung most frequent site (other than LN) Patterns of Metastasis: Multiple nodules Lymphangitic metastasis Solitary
11. 11. Metastatic Neoplasms From : Ovarian adenocarcinoma Breast cancer Prostatic cancer Colonic adenocarcinoma Renal carcinoma Melanoma, lymphoma, sarcoma
12. 12. Diagnostic Tests CXR CT Scans MRI Sputum cytology Fibreoptic bronchoscopy Transthoracic fine needle aspiration
13. 13. Diagnostic Tests CXR
14. 14. Diagnostic Tests CT Scans
15. 15. 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.
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