Carcinoma bronchus
-
Upload
airwave12 -
Category
Health & Medicine
-
view
223 -
download
1
Transcript of Carcinoma bronchus
Dr shaista khan
AETIOLOGYTobacco:Latent period of 10-30 yearsThe primary determinants are:Number of cigarettes consumedAge of onset of smoking (those under 16 years of age
at start have irreversible damage to their bronchial genetic makeup
Length of time of smokingType of tobacco (cigarettes or pipe, filter or non-filter)Passive exposure to tobacco smokeAsbestos exposure Irradiation Toxic metals Certain chemicals
Types of bronchial carcinoma:
Squamous cell carcinoma (SCC) Adenocarcinoma Small cell carcinoma (oat cell carcinoma) Alveolar cell or bronchoalveolar carcinoma
Squamous cell carcinoma:60% of all lung tumors Associated with smoking and is rare in non-
smokers Squamous metaplasia -> carcinoma in situ ->
invasive carcinoma
Adenocarcinoma:15% of lung tumours Has a tendency to be more peripheral,
arising in the small bronchial glands Most common in women Is the type seen in non-smokers
Small cell (oat cell) carcinoma:20% of lung tumours Arises from the chromaffin cells Highly malignant Hormone production by the tumour is
common A benign form of a small cell carcinoma is a
carcinoid tumour
Alveolar cell carcinoma:5% of lung tumours Arises in the distal airways Often diffuse, multifocal and bilateral Resistant to radio-/chemotherapy Very poor prognosis
TNM STAGING (T)T1 - tumorDiameter of 3 cm or smaller and surrounded
by lung or visceral pleura or endobronchial tumor distal to the lobar
bronchus
T2 - tumorGreater than 3 and smaller than 7 cm Invasion of the visceral pleura Atelectasis or obstructive pneumopathy
involving less than the whole lung Tumor involving the main bronchus 2 cm or
more distal to the carina.
T3 - tumorTumor with atelectasis or obstructive
pneumonitis of the entire lung Tumor in the main bronchus within 2 cm of the
carina but not invading it Tumor of any size with invasion of non-vital
structures such as the chest wall, mediastinal pleura, diaphragm, pericardium.
Separate tumour nodules in the same lobe as the primary tumor.
T4 - tumorInvasion of vital mediastinal structures: fat,
heart, trachea, esophagus, great vessels, recurrent laryngeal nerve, carina.
Invasion of vertebral body. Malignant pleural or pericardial effusion
(cytologically proven). Separate tumour nodule(s) in a different
ipsilateral lobe to that of the primary tumor.
Lymph nodes (N)
N1 - NodesN1-nodes are ipsilateral nodes within the
lung up to hilar nodes.N1 alters the prognosis but not the management.
N 2 NODES.Nodes in the ipsilateral mediastinum
N3 - NodesN3-nodes are clearly unresectable.
These are contralateral mediastinal or contralateral hilar nodes or any scalene or supraclavicular nodes.
CALCIFICATION
FDG UPTAKE
STAGE ??
STAGE ??
PANCOAST TUMOR
OPERABLE OR NOT?
THANKS