Malignant tumor of the

respiratory system

Nasopharygeal carcinomaLung cancer

Lung cancer

Pulmonary Carcinoma

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.

PathologyGross types: 1. Central type (hilar type):

2. Peripheral type (nodular

type):

single or multiple nodules

arise

in one of the small bronchi

or

bronchioles.

3. Diffuse type: rare

Peripheral type

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

Bronchiolo-alveolar carcinoma

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.

4. Large cell carcinoma

5. Adeno-squamous carcinoma

Large cell lung

cancer

Large cell lung cancer

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)

2. Lymphatic metastasis

3. Hematogenous metastasis

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

NASOPHARYNGE

AL CARCINOMA

IntroductionEtiology: The major risk factors are follows:1. Smoking2. Food with high carcinogen contents3. Virus infection: EB Virus4. Genetic and family history

Pathology

Location:

Nasopharyngeal roof,

lateral wall and

pharyngeal recess

Gross type: Nodular type Cauliflower type Submucosa type Ulcerative type Unclassified type.

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