PULMONARY NEOPLASMS QUESTIONS AND ANSWERS A+
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lung CA screening
low-dose CT for adults aged 55 to 80 with a 30 pack-year smoking history and currently
smoke or have quit within the past 15 years
stop lung CA screening
discontinued once a person has not smoked for 15 years or develops a health problem
that substantially limits life expectancy or the ability or willingness to have curative lung
surgery
Solitary Pulmonary Nodule
-AKA Coin Lesion
-< 3 cm isolated, round opacity on the chest imaging that is outlined by normal lung
-Not associated w/ infiltrate, atelectasis, or adenopathy
-Asymptomatic
-Carries a significant risk of malignancy and incidence of malignancy increases with
age, smoking, and past h/o malignancy
-Larger lesions (> 2 cm) are more likely to be malignant
-Review old vs. new CXR, obtain CT chest.
Low risk Solitary Pulmonary Nodule
Treated w/ watchful waiting
intermediate risk Solitary Pulmonary Nodule
Treatment is controversial, biopsy
high risk Solitary Pulmonary Nodule
Treated w/ resection following staging
Solitary Pulmonary Nodule
-TTNA
-Bronchoscopy
-PET scans
-Sputum cytology
-VATS
Bronchial carcinoid tumors
-Low-grade malignant tumors, pedunculated/sessile growths in the central bronchi
-Men = Women, < 60 y/o
-CT helpful to localize the lesion and follow its growth over time
-Grow slowly and rarely metastasize
-Carcinoid Syndrome
-Complications: bleeding, airway obstruction
-Treatment: surgical resection for symptomatic tumors, resistant to radiation and
chemotherapy
Bronchial carcinoid tumors
-Hemoptysis
-cough
, -wheezing
-recurrent pneumonia
carcinoid syndrome
-flushing
-diarrhea
-wheezing
-hypotension
Mediastinal Mass
-Chest pain, dysphagia, dyspnea
-May be asymptomatic or have vague symptoms
-Imaging: CT, Barium swallow (if esophageal disease suspected), MRI, Doppler studies
of brachiocephalic veins and SVC
-Biopsy if neoplasm suspected
-Treatment depends on underlying cause of mass
Anterior Mediastinal Mass
-Thymoma
-teratoma
-thyroid lesions
-lymphoma
-lipoma
-fibroma
Middle Mediastinal Mass
-Lymphadenopathy
-pulmonary artery enlargement
-aortic aneurysm developmental cyst
-dilated vein
-foramen of Morgagni hernia
Posterior Mediastinal Mass
-Hiatal hernia
-neurogenic tumor
-meningocele
-esophageal tumor
-foramen of Bochdalek hernia
-thoracic spine disease
-extramedullary hematopoiesis
SCC, adenocarcinoma, LCC, SCLC
What are 4 categories of lung CA?
SCLC
-Very aggressive
-Rarely amenable to surgical resection
-Median survival is 6-18 wks if untreated
NSCLC
-All other types combined
-May be cured in the early stages following resection
-May also need chemo
SCC
GRADED .Buy Quality Materials!
lung CA screening
low-dose CT for adults aged 55 to 80 with a 30 pack-year smoking history and currently
smoke or have quit within the past 15 years
stop lung CA screening
discontinued once a person has not smoked for 15 years or develops a health problem
that substantially limits life expectancy or the ability or willingness to have curative lung
surgery
Solitary Pulmonary Nodule
-AKA Coin Lesion
-< 3 cm isolated, round opacity on the chest imaging that is outlined by normal lung
-Not associated w/ infiltrate, atelectasis, or adenopathy
-Asymptomatic
-Carries a significant risk of malignancy and incidence of malignancy increases with
age, smoking, and past h/o malignancy
-Larger lesions (> 2 cm) are more likely to be malignant
-Review old vs. new CXR, obtain CT chest.
Low risk Solitary Pulmonary Nodule
Treated w/ watchful waiting
intermediate risk Solitary Pulmonary Nodule
Treatment is controversial, biopsy
high risk Solitary Pulmonary Nodule
Treated w/ resection following staging
Solitary Pulmonary Nodule
-TTNA
-Bronchoscopy
-PET scans
-Sputum cytology
-VATS
Bronchial carcinoid tumors
-Low-grade malignant tumors, pedunculated/sessile growths in the central bronchi
-Men = Women, < 60 y/o
-CT helpful to localize the lesion and follow its growth over time
-Grow slowly and rarely metastasize
-Carcinoid Syndrome
-Complications: bleeding, airway obstruction
-Treatment: surgical resection for symptomatic tumors, resistant to radiation and
chemotherapy
Bronchial carcinoid tumors
-Hemoptysis
-cough
, -wheezing
-recurrent pneumonia
carcinoid syndrome
-flushing
-diarrhea
-wheezing
-hypotension
Mediastinal Mass
-Chest pain, dysphagia, dyspnea
-May be asymptomatic or have vague symptoms
-Imaging: CT, Barium swallow (if esophageal disease suspected), MRI, Doppler studies
of brachiocephalic veins and SVC
-Biopsy if neoplasm suspected
-Treatment depends on underlying cause of mass
Anterior Mediastinal Mass
-Thymoma
-teratoma
-thyroid lesions
-lymphoma
-lipoma
-fibroma
Middle Mediastinal Mass
-Lymphadenopathy
-pulmonary artery enlargement
-aortic aneurysm developmental cyst
-dilated vein
-foramen of Morgagni hernia
Posterior Mediastinal Mass
-Hiatal hernia
-neurogenic tumor
-meningocele
-esophageal tumor
-foramen of Bochdalek hernia
-thoracic spine disease
-extramedullary hematopoiesis
SCC, adenocarcinoma, LCC, SCLC
What are 4 categories of lung CA?
SCLC
-Very aggressive
-Rarely amenable to surgical resection
-Median survival is 6-18 wks if untreated
NSCLC
-All other types combined
-May be cured in the early stages following resection
-May also need chemo
SCC
