Lung cancer

Lung cancer, or frequently, if somewhat incorrectly, known as bronchogenic carcinoma, is the most common cause of cancer in men, and the 6th most frequent cancer in women worldwide. It is the leading cause of cancer mortality worldwide in both men and women and accounts for approximately 20% of all cancer deaths 1.

Epidemiology

Lung cancer is the most common fatal malignancy worldwide both in male and female. 

Clinical presentation

Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dypnoea are rather non-specific symptoms that are common amongst those with lung cancer.

Central tumours may result in haemoptysis and peripheral lesions with pleuritic chest pain.

Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to metastases (brain, liver, bone) or to paraneoplastic syndromes.

Pathology

The term bronchogenic carcinoma is somewhat loosely used to refer to primary malignancies of the lung that are associated with inhaled carcinogens 1 and includes four main histological subtypes. These are broadly divided into non small-cell carcinoma and small cell carcinoma as they are differ clinically in terms of presentation, treatment and prognosis:

Other malignant pulmonary neoplasms include lymphoma and sarcoma (rare)

As each subtype has a different radiographic appearance, demographic, and prognosis:

Risk factors

The major risk factor is cigarette smoking which is implicated in 90% of cases and increase the risk of lung cancer, which can be divided by histological subtype 10:

  • squamous cell lung cancer: 11x (men), 15x (women)
  • small cell lung cancer: 10x (men), 25x (women)
  • large cell lung cancer: 7x (men), 8x (women)
  • lung adenocarcinoma: 4x (men and women)

Other risk factors:

Staging
Associations

Various paraneoplastic syndromes can arise in the setting of lung cancer:

Treatment and prognosis

Treatment and prognosis varies not only with stage, but also with cell type. In general, surgery, chemotherapy, and radiotherapy are offered according to stage, resectability, operability, and functional status.

Non small cell carcinoma
  • treatment
    • operable disease (stage I to IIIA): surgery
    • unresectable disease: neoadjuvant chemotherapy, radiotherapy
    • advanced disease: palliative combined chemotherapy
  • prognosis: 5 year survival rates)
    • local (stage I): 55-67%
    • locally advanced (stages II-IIIA): 23-40%
    • advanced (stages IIIB and IV): 1-3%
Small-cell carcinoma
  • treatment
    • limited disease: chemoradiotherapy
    • extensive disease: palliative combined chemotherapy
  • prognosis: poor
    • limited: 5 year survival rate 15-25%
    • extensive: 2 year survival 20% (with palliative combined chemotherapy and supportive care)

See also


Edit Article Share
URL of Article

Article Information

rID: 1022
System: Chest
Section: Pathology
Synonyms or Alternate Spellings:
  • Bronchogenic cancer
  • Lung cancer: general
  • Primary lung cancer
  • Bronchogenic malignancy
  • Primary lung malignancy
  • Bronchogenic carcinoma
  • Lung cancer: overview
  • Primary lung cancers
  • Drag
    Figure 1: gross pathology - squamous cell carcinoma
    Drag here to reorder.
  • Drag
    Case 2: squamous cell carcinoma
    Drag here to reorder.
  • Drag
    Bronchoalveolar c...
    Case 3
    Drag here to reorder.
  • Drag
    Bronchogenic carc...
    Case 5
    Drag here to reorder.
  • Drag
    Case 6: with SVC obstruction
    Drag here to reorder.
  • Drag
    Lung Ca
    Case 7
    Drag here to reorder.
  • Drag
    Lung cancer
    Case 8
    Drag here to reorder.
  • Drag
    Case 9
    Drag here to reorder.
  • Drag
    Case 10
    Drag here to reorder.
  • Drag
    Bronchogenic Carc...
    Case 11: plain film
    Drag here to reorder.
  • Drag
    Bronchogenic Carc...
    Case 11: CT
    Drag here to reorder.
  • Drag
    Case 12: undifferentiated large cell carcinoma
    Drag here to reorder.
  • Drag
    Bronchogenic aden...
    Case 13
    Drag here to reorder.
  • Drag
    Bronchogenic carc...
    Case 14
    Drag here to reorder.
  • Drag
    Case 15: squamous cell carcinoma
    Drag here to reorder.
  • Drag
    Case 16: plain film
    Drag here to reorder.
  • Drag
    Case 16: CT
    Drag here to reorder.
  • Drag
     Case 17
    Drag here to reorder.
  • Drag
     Case 18
    Drag here to reorder.
  • Drag
     Case 19
    Drag here to reorder.
  • Drag
    Case 20
    Drag here to reorder.
  • Drag
    Case 21: left hilar lesion
    Drag here to reorder.
  • Drag
    Case 22
    Drag here to reorder.
  • Drag
    Case 23
    Drag here to reorder.
  • Drag
    Case 24
    Drag here to reorder.
  • Drag
    Case 25
    Drag here to reorder.
  • Drag
    Case 26
    Drag here to reorder.
  • Drag
    Case 27
    Drag here to reorder.
  • Drag
    Case 28
    Drag here to reorder.
  • Drag
    Case 29
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert_accept

    Error Unable to process the form. Check for errors and try again.

    Alert_accept Thank you for updating your details.