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]
Cough and or hemoptysis Cough is the most common presenting complain. Characteristicly cough changes from hacking cough to a paroxysmal cough. Squamous cell carcinomas usually present this way. [medicaljoyworks.com]
Case Summary A 56-year-old man with a 30-pack-year smoking history presented with respiratory distress. [rc.rcjournal.com]
Metastases Introduction primary cancers are most commonly breast colon kidney Presentation most commonly presents with dyspnea Please rate topic. [medbullets.com]
Entire Body System
- Weight Loss
Learn more about adenocarcinoma Symptoms of adenocarcinoma of the lung The symptoms of adenocarcinomas in the lung include: Persistent cough Shortness of breath Chest pain Raspy voice Cough that produces blood Unexplained weight loss Learn more about [cancercenter.com]
Nonspecific symptoms These include fatigue, anorexia, and weight loss. Nonspecific symptoms These include fatigue, anorexia, and weight loss. Chest discomfort or pain Chest discomfort is due to direct pressure effects of the tumor. [medicaljoyworks.com]
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]
Lungs Adenocarcinoma in the lungs can lead to: coughing hoarseness bloody mucus weight loss weakness exhaustion Breast Adenocarcinoma in the breast shows as a lump or unusual growth. [medicalnewstoday.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]
- Fever
Pulmonary embolism causes cough and or hemoptysis with dyspnea, syncope, fever and severe chest pain. [medicaljoyworks.com]
It is noteworthy that patients with PAF do not usually have fevers as high as healthy subjects; nevertheless, any fever will significantly lower their blood pressure and consequently decrease their functional capacity. [vumc.org]
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]
[…] 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]
- Arm Pain
Pain in the upper arm Compression of the brachial plexus by an apical tumor causes shooting pain in the ipsilateral upper arm. [medicaljoyworks.com]
Tumour originates in the apical portion of the lung Occurs in 5% of non-small cell lung cancer Invasion of brachial plexus causes pain and muscle wasting of arm and hand Invasion of superior cervical sympathetic ganglion leads to Horner syndrome: Loss [pathophys.org]
- Constitutional Symptom
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 of [amboss.com]
- Hodgkin Lymphoma
Lymphomas: These malignant tumors start in the lymphatic system and include Hodgkin's lymphoma and non-Hodgkin's lymphoma. [hopkinsmedicine.org]
Respiratoric
- Cough
Cough and or hemoptysis Cough is the most common presenting complain. Characteristicly cough changes from hacking cough to a paroxysmal cough. Squamous cell carcinomas usually present this way. [medicaljoyworks.com]
In both cases, there were improvements in cough and dyspnea. [journal.chestnet.org]
Lab test: A sample of sputum (saliva and mucus coughed up from the airways) is tested for cancer cells. [cancercenter.com]
When he had a paroxysmal cough, he expectorated tumor tissue (18 × 20 × 5 mm, see Fig. 1B) with some bloody sputum. This relieved his dyspnea and forceful cough. [rc.rcjournal.com]
[…] ache or pain when breathing or coughing You should see a GP if you have these symptoms. [nhs.uk]
- Pleural Effusion
Bevacizumab is known to exert the efficacy on malignant pleural effusion by reducing the activity of VEGF-A expressed in pleural effusion [5, 6]. [karger.com]
Symptoms due to pleural effusion Malignant pleural effusion presents with dyspnea. Symptoms due to pleural effusion Malignant pleural effusion presents with dyspnea. [medicaljoyworks.com]
[…] emergencies chapter Pleural 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 [pathophys.org]
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). Fluid accumulating in the chest can cause shortness of breath. [mayoclinic.org]
[…] involvement § Common: 10% § Hemorrhagic effusion denotes direct tumor invasion § Effusion carries a poor prognosis even if no malignant cells are found · Metastases o Bone § Marrow: in 40% at time of presentation § Gross lesions in 10-35% § Most often [learningradiology.com]
- Dyspnea
Most patients are asymptomatic at rest, dyspnea on exertion and decreased exercise tolerance can be the presenting complains. Symptoms due to pleural effusion Malignant pleural effusion presents with dyspnea. [medicaljoyworks.com]
In both cases, there were improvements in cough and dyspnea. [journal.chestnet.org]
Two weeks after bronchofiberscopy he was confined to bed due to severe dyspnea and a forceful productive cough. [rc.rcjournal.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
Pulmonary embolism causes cough and or hemoptysis with dyspnea, syncope, fever and severe chest pain. [medicaljoyworks.com]
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]
[…] part of unspecified bronchus or lung Diagrams / tables Images hosted on other servers: Histologic subtyping for surgeon Histologic pattern and prognosis Treatment Clinical features Cough, (productive if mucinous adenocarcinoma [Chest 2012;142:1338]), hemoptysis [pathologyoutlines.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]
- Chronic Cough
Clinically, this may manifest as a chronic cough, wheezing, dyspnea, hemoptysis, along with atelectasis downstream of airway obstruction. [pathwaymedicine.org]
When they finally appear, the signs are often less obvious than other forms of lung cancer, manifesting with a chronic cough and bloody sputum only in later, more advanced stages. [verywellhealth.com]
cough, reflecting the presence of alterations in the airways, as there are no cough receptors in the alveoli. [jped.elsevier.es]
"Chronic bronchitis is defined as the presence of chronic cough with sputum production most days (at least 4 per week) for at least 3 months per year for at least 2 consecutive years.. .. [haz-map.com]
The patients presented with persistent dyspnea, a chronic cough, sputum production and wheezing following the initial lung infection. Chest X‑rays indicated pulmonary overinflation and patchy ground‑glass opacity. [spandidos-publications.com]
Gastrointestinal
- Dysphagia
Dysphagia Compression of the esophagus due to the expanding tumor produces dysphagia. Pericardial infiltration and effusion may also contribute to dysphagia. Dysphagia Compression of the esophagus due to the expanding tumor produces dysphagia. [medicaljoyworks.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]
[…] and 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]
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]
- Constipation
Treatment of pure autonomic failure is symptomatic: Constipation: High-fiber diet and stool softeners Sweating abnormalities: Avoidance of hot conditions Pure autonomic failure, like Parkinson disease, multiple system atrophy, and Lewy body dementia, [msdmanuals.com]
Constipation and urinary problems such as frequent urination and frequent urinary infections may also occur as well as tiredness. A first sign in men can be impotence. [rarediseases.org]
If the carcinoma has already spread, it can present with jaundice, bone pains, constipation or bloody stools. Breast cancer, colon cancer, prostate cancer, and bladder can metastasize to the lungs. [lecturio.com]
The signs and symptoms of elevated calcium in the blood include: thirst, fatigue, constipation, polyuria (increased urination), and nausea. [en.wikipedia.org]
- Hematemesis
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]
Neurologic
- 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]
neuropathy Symptoms of metastatic disease Early lymphogenic and hematogenic metastasis (particularly in SCLC) Brain: headaches;, behavioral changes, seizures;, focal motoric deficits (see also brain metastases) Liver: nausea, jaundice, ascites (see also [amboss.com]
neuropathy Postoperative and Rehabilitation Care Patients undergoing thoracotomy will need aggressive respiratory care including incentive spirometry, physical therapy, and chest therapy. [ncbi.nlm.nih.gov]
Workup
• Careful history taking, physical exam, and meticulous workup are needed to rule out other similar differential diagnoses. • More sinister synucleinopathies, like multiple system atrophy, often start with a clinical picture that is very similar to [medlink.com]
[…] headache, impaired vision in left eye, and intermittent confusion that had begun a few weeks ago He is a current non-smoker with a 30-pack-year history Past medical history: hypertension diagnosed 3 years ago, well-controlled on losartan His cardiac workup [targetedonc.com]
20% Extensive disease Beyond one hemithorax Contralateral supraclavicular or hilar lymph node involvement Malignant pericardial or pleural effusion Distant metastasis M1 approx. 75% References:[8][17] Diagnostics Approach to suspected lung cancer and workup [amboss.com]
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]
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]
X-Ray
- 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]
T2: Tumour with any of the following features: >3cm in greatest dimension Involves main bronchus, 2cm or more distal to the carina Invades visceral pleura Associated with atelectasis or obstructive pneumonitis, extending to the hilar region but not involving [healthengine.com.au]
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]
Pleura
- Pleural Effusion
Bevacizumab is known to exert the efficacy on malignant pleural effusion by reducing the activity of VEGF-A expressed in pleural effusion [5, 6]. [karger.com]
Symptoms due to pleural effusion Malignant pleural effusion presents with dyspnea. Symptoms due to pleural effusion Malignant pleural effusion presents with dyspnea. [medicaljoyworks.com]
[…] emergencies chapter Pleural 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 [pathophys.org]
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). Fluid accumulating in the chest can cause shortness of breath. [mayoclinic.org]
[…] involvement § Common: 10% § Hemorrhagic effusion denotes direct tumor invasion § Effusion carries a poor prognosis even if no malignant cells are found · Metastases o Bone § Marrow: in 40% at time of presentation § Gross lesions in 10-35% § Most often [learningradiology.com]
Treatment
NSCLC that progresses or recurs after treatment If cancer continues to grow during treatment (progresses) or comes back (recurs), further treatment will depend on the location and extent of the cancer, what treatments have been used, and on the person [cancer.org]
These therapies are the standard of care in the treatment of EGFR mutation-positive lung adenocarcinoma. [journal.chestnet.org]
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]
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]
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]
This fact should be taken into consideration when assessing prognosis and treatment issues. [journalpulmonology.org]
Progression and prognosis in pure autonomic failure (PAF): comparison with multiple system atrophy. Mabuchi N et al., J Neurol Neurosurg Psychiatry. 2005 Jul;76(7):947-52. 4. [dysautonomiainternational.org]
Etiology
Etiology PAF is sporadic and its etiology is unknown. It is a synucleinopathy with Lewy bodies and neuronal rarefaction in the intermediate-lateral tract of the medulla and in the sympathetic ganglia. [orpha.net]
English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]
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]
Etiological agents The initial event that led to BO in the majority of the children was pneumonia. [spandidos-publications.com]
Etiology Several risk factors can lead to the development of bronchiolitis obliterans. It is one of the most common noninfectious complications after lung transplant and hematopoietic stem cell transplantation. [ncbi.nlm.nih.gov]
Epidemiology
2008 Allowable Qualifiers English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
Epidemiology Smoking increases the risk of all histological subtypes but is most strongly associated with squamous cell and small cell disease. [atlasgeneticsoncology.org]
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, [amboss.com]
Summary Epidemiology The exact prevalence is unknown. Clinical description The disease affects adults. PAF manifests initially with orthostatic hypotension, erectile dysfunction and urinary disorders. [orpha.net]
Below we discuss the subtypes, morphology, epidemiology, and clinical consequences of bronchogenic carcinomas. [pathwaymedicine.org]
Pathophysiology
Pathophysiology, diagnosis and treatment. Tykocki T et al., Kardiol Pol. 2010 Sep;68(9):1057-63. [dysautonomiainternational.org]
The author details the clinical features, pathogenesis and pathophysiology, and the often times difficult differential diagnosis. [medlink.com]
The pathophysiology of bronchorrhea in adenocarcinoma remains unknown. [journal.chestnet.org]
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 In response to injury from inhalational toxins or autoimmune responses, there is inflammation of subepithelial structures and dysregulated repair, leading to fibroproliferation and abnormal regeneration of epithelium of the small airways [ncbi.nlm.nih.gov]
Prevention
Bronchiolitis Obliterans Syndrome After Lung Transplantation Completed NCT01212406 Phase 4 Vitamin D 5 Randomized Double-blind Placebo-controlled Prevention Trial of Azithromycin in Lung Transplantation. [malacards.org]
Standing up slowly may prevent blood pressure from decreasing too much or too fast. [rarediseases.org]
Treatment While bronchiolitis obliterans is irreversible, there are treatments that can help prevent the progression of the disease and reduce your symptoms. [verywellhealth.com]
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]
Screening for Chronic Obstructive Pulmonary Disease: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016 Apr 5. 315 (13):1378-93. [Medline]. [Guideline] US Preventive Services Task Force. [medscape.com]