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Bronchial Adenocarcinoma

Peripheral Lung Adeno Carcinoma Stage IIIa


Presentation

  • A patient with an aspergilloma developing in a cavitary bronchial adenocarcinoma is presented. The case fulfilled the clinical, radiological and laboratory criteria of pulmonary mycetoma.[ncbi.nlm.nih.gov]
  • .: Cardiac tamponade as the initial presentation of malignancy: is it as rare as previously supposed? Postgrad. Med. J ., 70, 703-707, 1994. 9. Haskell R.J., French W.J.: Cardiac tamponade as the initial presentation of malignancy.[degruyter.com]
  • A number of studies have attempted to determine whether asbestosis is present in all cases of asbestos-related lung cancer.[mesotheliomacenter.org]
  • Thirteen cases (28.9%) showed lymph node metastasis as follows: acinar pattern was present in 13 cases (100%); solid and micropapillary patterns were present in 3 cases each (23%); and papillary pattern in 2 cases (15.4%).[revportpneumol.org]
Weight Loss
  • Snap Shot A 69-year-old male with a 50-pack-year smoking history presents with worsening cough, weight loss, and repeated episodes of hemoptysis. A chest radiograph is taken and shown at right.[medbullets.com]
  • See your doctor promptly if you experience symptoms of lung cancer, including: recurrent cough shortness of breath chest pain coughing up blood unintentional weight loss There are three main subtypes of NSCLC: adenocarcinoma : starts in the outer part[healthline.com]
  • There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition eventually develop symptoms including: a persistent cough coughing up blood persistent breathlessness unexplained tiredness and weight loss an[nhs.uk]
  • However, chemotherapy is a powerful intervention and can have side effects including extreme nausea and weight loss. Radiation therapy: This approach uses high-energy rays to kill cancerous cells.[medicalnewstoday.com]
  • Diarrhea started about 4 years but has increased over the last week weeks to months leading to 10 kg weight loss. As for vomiting it is for old undigested food and it is not as persistent or bothering as the diarrhea.[hakeem-sy.com]
Fever
  • Patient denies heartburn, fever, chills, night sweats ,joint pains or skin rashes. الأجهزة الأخرى ROS Review of systems: negative other wise. No cardiac, neurologic, pulomary, hepatic, urinary, skin, or joint symptoms.[hakeem-sy.com]
  • Extrapulmonary symptoms Constitutional symptoms ( weight loss, fever, weakness) Clubbing of the fingers and toes Signs or symptoms of tumor infiltration or compression of neighboring structures Superior vena cava syndrome ( SVC syndrome ): Compression[amboss.com]
  • […] not improve despite treatment with antibiotics Breathlessness Constant chest pain Phlegm, either with or without blood Swelling of the neck and face Loss of appetite or major weight loss, general loss of strength Paralysis or severe pain, episodes of fever[international.medac.de]
  • Lung Adenocarcinomas form the largest subset of lung cancers observed in non-smokers (and are mostly women) Invasive Mucinous Adenocarcinoma of Lung can cause chest pain, breathing difficulties, fatigue, and other general signs and symptoms, such as fever[dovemed.com]
  • Case Report A 42-year-old man presented with a 2month history of shortness of breath, nonproductive cough,fever on and off, chest pain on the right side, and loss of weight.[cancerjournal.net]
Soft Tissue Mass
  • Painful soft tissue masses may in rare instances correspond to intramuscular metastases from an unknown malignant neoplasia.[ncbi.nlm.nih.gov]
Cough
  • […] ache or pain when breathing or coughing You should see your GP if you have these symptoms.[nhs.uk]
  • Snap Shot A 69-year-old male with a 50-pack-year smoking history presents with worsening cough, weight loss, and repeated episodes of hemoptysis. A chest radiograph is taken and shown at right.[medbullets.com]
  • Symptoms of primary lung cancers include cough , coughing up blood, chest pain , and shortness of breath. A new cough in a smoker or a former smoker should raise concern for lung cancer.[emedicinehealth.com]
  • See your doctor promptly if you experience symptoms of lung cancer, including: recurrent cough shortness of breath chest pain coughing up blood unintentional weight loss There are three main subtypes of NSCLC: adenocarcinoma : starts in the outer part[healthline.com]
  • Symptoms such as dyspnea, cough, hemoptysis, and chest pain typically develop in advanced stages of disease. New onset cough or pneumonia constitute warning signs, particularly in smokers.[amboss.com]
Pleural Effusion
  • effusion Chest pain Dyspnea Benign pleural effusion may be due to lymphatic obstruction, post-obstructive pneumonitis, or atelectasis Malignant pleural effusion occurs when malignant cells are present in pleural fluid Dysphagia Enlargement of the subcarinal[pathophys.org]
  • effusion (10%) o Dysphagia o Enlarged nodes o Esophageal invasion · Roentgenographic findings o Airway obstruction § Atelectasis most common sign § No air bronchogram § Also postobstructive pneumonia o Hilar enlargement § From either the carcinoma itself[learningradiology.com]
  • Small-cell lung cancer Limited stage, when the tumour is confined to one hemithorax, Extensive stage when there are distant metastases or presence of pleural effusion.[wiki.cancer.org.au]
  • effusion are uncommon air bronchograms may be seen (also known as the open bronchus sign ) CT angiogram sign Nuclear medicine 18 F-FDG-PET is often negative 6,7.[radiopaedia.org]
  • Extra-pulmonary Contiguous Growth Extension into the pleura and chest wall may cause chest pain while obstruction of the pleural lymphatics or direct involvement of the pleura may result in pleural effusions.[pathwaymedicine.org]
Hemoptysis
  • Snap Shot A 69-year-old male with a 50-pack-year smoking history presents with worsening cough, weight loss, and repeated episodes of hemoptysis. A chest radiograph is taken and shown at right.[medbullets.com]
  • Symptoms such as dyspnea, cough, hemoptysis, and chest pain typically develop in advanced stages of disease. New onset cough or pneumonia constitute warning signs, particularly in smokers.[amboss.com]
  • Hemoptysis (25-50%) Tumour in the central airway Blood vessels resulting from tumour-induced angiogenesis are leaky and tortuous, predisposing them to easy rupture and causing hemoptysis Dyspnea (25%) Extrinsic or intraluminal airway obstruction Activation[pathophys.org]
  • Clinically, this may manifest as a chronic cough, wheezing, dyspnea, hemoptysis, along with atelectasis downstream of airway obstruction.[pathwaymedicine.org]
  • Tumours with a central location are more likely to produce early symptoms such as cough, dyspnea, wheezing, hemoptysis, and pneumonia.[histopathology-india.net]
Dyspnea
  • Symptoms such as dyspnea, cough, hemoptysis, and chest pain typically develop in advanced stages of disease. New onset cough or pneumonia constitute warning signs, particularly in smokers.[amboss.com]
  • Bronchogenic carcinomas usually present with cough, weight loss, chest pain, and dyspnea.[histopathology-india.net]
  • Central tumours generally produce symptoms of cough, dyspnea, atelectasis, postobstructive pneumonia, wheezing, and hemoptysis; whereas, peripheral tumours , in addition to causing cough and dyspnea, can lead to pleural effusion and severe pain as a result[pathophys.org]
  • Later these may be followed by fever, chills, productive cough, headache, perspiration, foul-smelling sputum, and sometimes dyspnea.[medical-dictionary.thefreedictionary.com]
Dry Cough
  • The patient starts with a rather dry cough, or his “smokers cough” changes into an increased nightly cough. Also bloody discharge or shortness of breath may be the first sign of the disease.[hyperthermia-centre-hannover.com]
  • Presentation of lung cancer Respiratory symptoms of persistent dry cough, haemoptysis, wheezing, “recurrent” pneumonia or dyspnoea.[wiki.cancer.org.au]
  • The first symptoms include a dry cough and chest pain. Later these may be followed by fever, chills, productive cough, headache, perspiration, foul-smelling sputum, and sometimes dyspnea.[medical-dictionary.thefreedictionary.com]
Dysphagia
  • […] upper extremities Paralysis of the recurrent laryngeal nerve : hoarseness Paralysis of the phrenic nerve : results in diaphragmatic elevation and dyspnea Malignant pleural effusion : dullness on percussion, reduced breath sounds on the affected side Dysphagia[amboss.com]
  • […] often small cell · Associated clinical findings o Horner's syndrome § Pancoast tumor o Elevated hemidiaphragm § Phrenic nerve paralysis o Hoarseness § Recurrent laryngeal nerve (left right) o SVC obstruction § Small cell ca o Pleural effusion (10%) o Dysphagia[learningradiology.com]
  • No hematemesis and no dysphagia are present. As for the abdominal pain it is mid abdominal ,described as cramps and decreases after he passes the stool (diarrhea). No aggravating factors ,yet he is afraid of eating.[hakeem-sy.com]
  • Esophageal involvement may cause dysphagia. Pericardial involvement may result in pericardial effusions. Lung tumors may grow to place pressure on the recurrent laryngeal nerve, resulting in hoarseness.[pathwaymedicine.org]
  • Obstruction of any nearby structure can occur (either by pressure from contained tumour or invasion) and often include SVC obstruction, vocal cord paralysis due to damage to recurrent laryngeal nerve, dyspnoea due to lobar collapse, and dysphagia.[willroberts.com]
Peripheral Neuropathy
  • . - Parathormone or prostaglandin E (hypercalcemia) - Calcitonin (hypocalcemia) - Gonadotropin (gynecomastia) - Serotonin (carcinoid syndrome) Other paraneoplastic syndromes include myopathy, peripheral neuropathy, acanthosis nigricans, and hypertrophic[histopathology-india.net]
  • Paraneoplastic syndrome• Lambert-Eaton syndrome• Peripheral neuropathy• Acanthosis nigricans• Leukemoid reaction• Hypertrophic pulmonary osteoarthropathy• Horner syndrome• Pancoast tumor 36.[slideshare.net]
Meningism
  • Meningitis as the first manifestation of a malignancy is very rare.[ncbi.nlm.nih.gov]
  • Active or previously treated carcinomatous meningitis 9. Truly non-measurable disease by RECIST 1.1 criteria, such as patients with one or more of the following without any RECIST measurable disease: a. Bone lesions b. Ascites c.[clinicaltrialsregister.eu]
Jacksonian Seizure
  • . - A 72-year-old man was admitted to our department after a Jacksonian seizure. The MRI showed a left temporal mass lesion.[ncbi.nlm.nih.gov]

Workup

  • Tumors previously classified as non-small-cell carcinoma, not otherwise specified, because of the lack of clear squamous or adenocarcinoma morphology should be classified further by using a limited immunohistochemical workup to preserve tissue for molecular[histopathology-india.net]
  • References: [7] [16] Diagnostics Approach to suspected lung cancer and workup of a solitary pulmonary nodule Chest x-ray and comparison to previous images if available CT imaging for further evaluation indicated if New lesion detected on chest x-ray Changes[amboss.com]
  • A complete staging workup for NSCLC should be carried out to evaluate the extent of disease. (See Workup .) Treatment primarily involves surgery, chemotherapy, or radiation therapy.[emedicine.medscape.com]
  • […] underlying lung cancer at younger ages. [5] Importantly, many of these signs are commonly due to other causes which are not cancer. [6] A detailed medical history should be obtained from each patient to determine the relevance of further diagnostic workup[en.wikipedia.org]
  • Targeted inhibitors of many of these genes are in various stages of clinical development and may become available in the future as targeted therapies for which additional molecular testing will be required in the diagnostic workup of NSCLC patients.[jtd.amegroups.com]
Atelectasis
  • Osteosarcoma o Wilm's tumor o Eosinophilic granuloma · Types of bronchogenic carcinoma o Squamous cell ca (30-35%) o Adenocarcinoma (25-35%) o Small cell or oat cell (25%) o Large cell undifferentiated (10%) · Squamous cell ca o Central Location (2/3) o Atelectasis[learningradiology.com]
  • Central tumours generally produce symptoms of cough, dyspnea, atelectasis, postobstructive pneumonia, wheezing, and hemoptysis; whereas, peripheral tumours , in addition to causing cough and dyspnea, can lead to pleural effusion and severe pain as a result[pathophys.org]
  • Staging of LUNG CANCER• T1 - Tumor 3 cm without pleural / main stem bronchus involvement• T2 - Tumor 3 cm / involvement of main stem bronchus 2 cm from carina, visceral, pleural, lobar atelectasis• T3 - Tumor with involvement of chest wall, diaphragm,[slideshare.net]
  • Squamous cell carcinoma and small cell carcinoma often are centrally located and may appear to be pneumonia (inflammation of the lungs), atelectasis (collapsed lung), or pit-like masses.[healthcommunities.com]
  • Clinically, this may manifest as a chronic cough, wheezing, dyspnea, hemoptysis, along with atelectasis downstream of airway obstruction.[pathwaymedicine.org]
Pleural Effusion
  • effusion Chest pain Dyspnea Benign pleural effusion may be due to lymphatic obstruction, post-obstructive pneumonitis, or atelectasis Malignant pleural effusion occurs when malignant cells are present in pleural fluid Dysphagia Enlargement of the subcarinal[pathophys.org]
  • effusion (10%) o Dysphagia o Enlarged nodes o Esophageal invasion · Roentgenographic findings o Airway obstruction § Atelectasis most common sign § No air bronchogram § Also postobstructive pneumonia o Hilar enlargement § From either the carcinoma itself[learningradiology.com]
  • Small-cell lung cancer Limited stage, when the tumour is confined to one hemithorax, Extensive stage when there are distant metastases or presence of pleural effusion.[wiki.cancer.org.au]
  • effusion are uncommon air bronchograms may be seen (also known as the open bronchus sign ) CT angiogram sign Nuclear medicine 18 F-FDG-PET is often negative 6,7.[radiopaedia.org]
  • Extra-pulmonary Contiguous Growth Extension into the pleura and chest wall may cause chest pain while obstruction of the pleural lymphatics or direct involvement of the pleura may result in pleural effusions.[pathwaymedicine.org]

Treatment

  • The patient is alive without recurrence more than 8 years after treatment for tonsillar metastasis. This is the first report of successfully treated tonsillar metastasis from a malignant tumor.[ncbi.nlm.nih.gov]
  • This book is an attempt to assemble these views in the light of 33 years of surgical experience and is intended for those specialists who will be concerned with the diagnosis and treatment of lung cancer in the foreseeable future.[books.google.it]
  • .: Which treatment in pericardial effusion? J. Cardiovasc. Surg ., 43, 735-739, 2002. 7. Gilhert I., Henning R.J.: Adenocarcinoma of the lung presenting with pericardial tamponade: Report of a case and review of the literature.[degruyter.com]

Prognosis

  • Tonsillar metastasis from neoplasms, including lung cancer, are extremely rare, and the prognosis for patients with tonsillar metastases is rather poor.[ncbi.nlm.nih.gov]
  • This fact should be taken into consideration when assessing prognosis and treatment issues.[revportpneumol.org]
  • In contrast, overexpression of cyclin E, p53 or Bcl-2 and mutation of p53 or K-ras had no influence on disease prognosis.[edoc.hu-berlin.de]
  • Mucinous subtypes have worse prognosis 4, probably due to aerogenous spread that forms infiltrating, multifocal, or satellite tumors 11.[radiopaedia.org]
  • The prognosis of the condition is generally guarded, since the tumors are aggressive.[dovemed.com]

Etiology

  • Other etiologic factors include exposure to radiation (atomic bomb survivors, uranium miners), asbestos (especially combined with smoking), air pollution (radon, particulates), and miscellaneous occupational inhaled substances (Example: Nickel, chromates[histopathology-india.net]
  • Etiology Risk factors Nicotine : smoking causes approx. 90% of lung cancers Occupational and environmental exposure to carcinogens : passive smoking ;, asbestos, arsenic, radon, uranium, chromium, nickel, fumes from industry, and traffic Family history[amboss.com]
  • Etiology of Bronchogenic carcinoma• 40 - 70 yrs [peak 50 - 60 yrs]• Tobacco smoking• Industrial hazards• Air pollution• Dietary factors• Genetic factors• Scarring of lung tissue 8. Tobacco smoking1. Statistical evidence2. Clinical evidence3.[slideshare.net]
  • Etiology Surg Oncol Clin N Am. 2011 Oct;20(4):605-18. Clin Chest Med. 2011 Dec;32(4):605-44. Biochem Pharmacol. 2011 Oct 15;82(8):1015-21.[pathophys.org]
  • Etiology Bronchial carcinoids are thought to arise from Kulchitsky cells. These neuroendocrine cells, formerly classified as amine precursor uptake and decarboxylation cells, produce and store biogenic amines and peptides.[emedicine.medscape.com]

Epidemiology

  • Epidemiology Incidence : : second most common carcinoma ; leading cause of cancer death (worldwide) Peak incidence : 50–70 years Sex : ( 3:1 ) Adenocarcinoma is an exception : ( 1:6 ) References: [1] [2] [3] Epidemiological data refers to the US, unless[amboss.com]
  • Below we discuss the subtypes, morphology, epidemiology, and clinical consequences of bronchogenic carcinomas.[pathwaymedicine.org]
  • Lung cancer is the leading cause of malignancy-related mortality There are several types of lung cancer (ordered from most to least common) adenocarcinoma squamous cell carcinoma small cell carcinoma large cell carcinoma carcinoid tumor mesothelioma Epidemiology[medbullets.com]
  • […] subdivides into mucinous and non-mucinous variants ( WHO: WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart, 4th Edition, 2015 ) Adenocarcinoma represents the most common type of lung cancer in females, nonsmokers and younger males Epidemiology[pathologyoutlines.com]
  • EPIDEMIOLOGY• Cigarette smoking• Asbestos• Industrial chemicals • PETROCHEMICAL • METAL REFINING • ARSENIC• Diet - Deficiency of • Vit-E • ß-Carotene 5. 5 main histologic types of lung cancer1. Squamous cell ca (3 to 50%)2.[slideshare.net]
Sex distribution
Age distribution

Pathophysiology

  • Symptoms Mechanism and pathophysiology Primary lung lesion symptoms Cough (50-70%) Presence of a mass irritates the cough receptors in the airway More common in squamous cell carcinoma andSCLC (more commonly found in the central airways) Obstruction from[pathophys.org]
  • Pathophysiology [ edit ] The respiratory tract can be divided into two main components: the conducting airways and the gas exchange airways.[en.wikipedia.org]
  • Only a small number of reports have been published of cases with AFP-producing lung cancer; therefore, the pathophysiology and clinical characteristics of AFP-producing lung cancer have not yet been adequately clarified.[wjso.biomedcentral.com]
  • Pathophysiology Symptoms develop from the growth of the tumors within the tracheobronchial tree, with consequent obstruction leading to cough, hemoptysis, atelectasis, or pneumonia. [1] Adenoid cystic carcinoma behaves very similar to major and minor[emedicine.medscape.com]

Prevention

  • These therapies can derail the cancer’s growth by preventing or changing chemical reactions linked to particular mutations. For example, some target therapies prevent cancer cells from receiving chemical “messages” telling them to grow.[drugs.com]
  • Q: What is the best way to prevent lung cancer? A: The best way to prevent lung cancer is not to smoke cigarettes or to quit smoking if you are a smoker. Adithya Cattamanchi, MD Answers represent the opinions of our medical experts.[medicalnewstoday.com]
  • While there’s no current cure for this type of lung cancer, there are several treatment options, including: surgery chemotherapy radiation targeted drugs immunotherapy The purpose of treatment is to improve your quality of life and prevent the cancer[healthline.com]
  • How to Prevent Lung Cancer Prevention is primarily focused on smoking cessation.[emedicinehealth.com]
  • Cigarettes with filter tips, and discarding half-smoked cigarettes may prevent the early onset of bronchial carcinoma, but are by no means protective.[health24.com]

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