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Introduction No doubt it is the leading
cause of cancer-related deaths.
The incidence is increasing at a
fast rate for both male and
female. So it is the commonest
cancer in the world.
Etiology:1. Smoking and atmospheric pollution2. Oncogenes and suppressor genes over express or/and mutation3. Others: virus infection, asbestosis, radioactive substances inhalation et, al.
2. Peripheral type (nodular
type):
single or multiple nodules
arise
in one of the small bronchi
or
bronchioles.
3. Diffuse type: rare
Carcinoma in situ in bronchial muc
osa or only invade the wall of bronchi,
mass<2cm, no LN metastasis.
Early lung cancer:
Occult lung cancer
Exam of sputum(+)
Clinical feature (-)
X-ray exam (-)
Pathology: carcinoma
in situ or early
invasive carcinoma
Histologic types:1. Squamous cell carcinoma: The commonest type and most closely associated with cigarette smoking.
•Well- differentiated•Poorly-differentiated•Undifferentiated
2. Adenocarcinoma Usually shown as peripheral type, grow rapidly; hematogenous metastasis may happen early and widely spread. Special types:
Bronchiolo-alveolar carcinomaColloid carcinomaScar cancer
3. Small cell (or oat cell) carcinoma: * Probably derived from neuroscretory cells (a kind of APUD cells) of bronchial mucosa. * Highly malignancy; * Growth rapidly; * Metastasis early and widely; * Radiosensitive.
Patterns of spread and complications: 1. Direct extention (1). Obstruction of airway (2). Pleurisy with effusion, often hemorrhagic in nature.
(3). Extension of apical lung cancers may involve the lower cords of bronchial plexus and cervical sympathetic plexus ( Horner’s Syndrome: ptosis, miosis, anhydrosis)
Clinical manifestation:
Methods for lung cancer diagnosis:1. Sputum cytology, pleural effusion
cytology
2. Fiberbronchoscope examination
and biopsy
3. X-ray examination and CT
4. Fine-needle aspiration biopsy
IntroductionEtiology: The major risk factors are follows:1. Smoking2. Food with high carcinogen contents3. Virus infection: EB Virus4. Genetic and family history
Histologic type:1. Keratinizing squamous cell carcinoma
2. Non-keratinizing carcinoma
Differentiated carcinoma
Undifferentiated carcinoma
Vesicular nuclear cell carcinoma
3. Adenocarcinoma
1. Direct extension Upward to base of skull Laterally to auditory tube and middle ear Forward to nasal cavity, orbit
Spread and metastasis:
2. Lymphatic metastasis: Retropharyngeal LN
Upper deep LN Internal jugular vein LN Superior cervical LN
Important: Cervical LN enlargement may be the first scene of NPC
3. Hematogenous metastasis
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