squamous cell carcinoma
accounts for 30%, with a sharp decline in the past 20 years. the tumors are typically located near the hilus and project into bronchi. obstructive manifestations are non-specific and include nonproductive cough or hemoptysis, chest pain when tumor is bigger. Pneumonia and atelectasis are often associated with squamous cell carcinoma. tumors tend not to metastasize until late in the course of the disease. treatment is surgical resection, once metastasis has taken lace survival rates dramatically decrease.
tumor arising from glands. 35 to 40%. recent increase because of lung cancer in women, environmental and occupational carcinogens, and changes in the histologic criteria for diagnosis. tumor usually smaller than 4 cm, arise in the peripheral regions of the pulmonary tissue. may be asymptomatic and discovered by routine chest xray, or when a patient seeks treatment for pleuritic chest pain and shortness of breath. this type also includes bronchioloalveolar cell carcinoma with tumors that arise fro the terminal bronchioles and alveoli, slow growing and unpredictable metastasis. surgical resection, 5 year survival rate below 15%
undifferentiated large cell carcinoma
10 -15% of lung cancers. this cell type has lost all evidence of differentiation and is therefore commonly referred to as undifferentiated large cell anaplastic cancer. large cell carcinomas show none of the histologic findings of squamous cell carcinoma or adenocarcinoma, they are diagnosed by a process of exclusion. the cells are generally larger than leukocytes and contain large, darkly stained nuclei, the tumors commonly arise peripherally but are formed centrally and can grow to distort the trachea and cause widening of the carnia. once metastasis has occurred, surgical therapy is limited to palliative procedures, no radiation or chemotherapy
small cell carcinoma
14% . most of these tumors are central in origin. cell size range form 6 to 8. strongest correlation with cigarette smoking. tumors have rapid growth and metastasize early, this type has the worst prognosis. often associated with ectopic hormone production. neuroendocrine cells containing neuro-secretory granules exist throughout the tracheobronchial tree. these hormones (called paraneoplastic syndrome) may be the first manifestation of the cancer. (SIADH in 40%) also produce gastrin releasing peptide, calcitonin, arginine, vasopressin and adrenocorticotropic hormone (ACTH)..can cause cushing syndrome, weakness, facial edema, hypokalemia, alkalosis, hyperglycemia, hypertension and increased pigmentation. chemotherapy and radiation.
SQUAMOUS CELL CARCINOMA (NON SMALL CELL)
MISC=30%, NEAR HILUS, PROJECTS INTO BRONCHI
MANIFESTATION/TREATMENT=COUGH, SPUTUM PRODUCTION, AIRWAY OBSTRUCTION...SURGICAL AND ADJUVANT CHEMOTHERAPY.
ADENOCARCINOMA (NON SMALL CELL)
MANIFESTATION/TREATMENT=PLEURAL EDDUSION.SURGICAL TREATMENT AND ADJUVANT CHEMOTHERAPY
UNDIFFERENTIATED LARGE CELL CARCINOMA (NON SMALL CELL)
MISC=10-15%, PERIPHERAL, CAN GROW CENTRALLY
METASTASIS=EARLY AND WIDESPREAD
MANIFESTATION/TREATMENT=PAIN, PLEURAL EFFUSION....COUGH SPUTUM PRODUCTION, HEMOPTYSIS, AIRWAY OBSTRUCTION..SURGERY IS PALLATIVE
SMALL CELL CARCINOMA
GROWTH RATE=VERY RAPID
METASTASIS=VERY EARLY, AND VERY WIDESPREAD TO MEDIASTINUM
MANIFESTATION/TREATMENT=AIRWAY OBSTRUCTION, EXCESSIVE ECTOPIC HORMONE SECRETION..CHEMOTHERAPY AND RADIATION TO THORAX AND CNS