SlideShare a Scribd company logo
1 of 68
Download to read offline
Lung and Mediastinal
Tumours
Dr. Manu Mohan. K
Associate Professor
Pulmonary Medicine
Epidemiology
Most common form of malignant
diseases
40,000 new patients per year
8% male deaths and 4% of all
female deaths
Men > women, middle age
Etiological factors
Tobacco smoking
Cigarette smokers are 8-20
times more likely to develop
lung cancer than life long non
smokers.
Squamous and small cell
carcinoma have clear
association with smoking.
Adenocarcinoma is commonest
histological type in a non
smoker
Atmospheric pollution
Controversial
Radon - radiation
Occupational factors
Asbestos – mining, processing,
usage.
Radioactivity – metal ore mining,
uranium mining.
Nickel – refining.
Chromium salt – extraction,
production, usage.
Arsenic – metal refining, chemical
industry, insecticides.
Pulmonary scarring
Localised areas of pulmonary scarring
Diffuse pulmonary fibrosis
Cryptogenic fibrosing alveolitis is
associated with adenocarcinoma
Tuberculosis – scar carcinoma,
adenocarcinoma
Bronchioloalveolar carcinoma also occur
in areas of scarring
Lung mediastinal tumors_mbbs
Histological classification
1. Squamous cell carcinoma
(epidermoid carcinoma)
2. Small cell carcinoma
a. oat cell carcinoma
b. intermediate cell type
c. combined oat cell
carcinoma
3. Adenocarcinoma
a. acinar
b. papillary adenocarcinoma
c. bronchioloalveolar
d. solid carcinoma with mucous
4. Large cell carcinoma
5. Adenosquamous carcinoma
6. Carcinoid tumours
7. Bronchial gland carcinoma
a. adenoid cystic carcinoma
b. mucoepidermoid carcinoma
c. others
Growth factors
Polypeptides that take part in the
control of cell differentiation and
proliferation
Bombesin/gastrin releasing peptide
– growth factor for small cell
carcinoma
Non small cell carcinoma – few
growth factors are recognized, EGF,
TGF
Genetic abnormalities
Loss of short arm of
chromosome in small cell
carcinoma (p14, p23)
CDKN2 gene on chromosome 9
– Non small cell lung carcinoma
Oncogenes
myc genes – small cell lung
carcinoma
Kras – adenocarcinoma
Tumour markers
Substances produced by
tumour cells that are released
in to blood stream.
Neuron specific enolase,
creatinine phophokinase BB,
CEA
Modes of presentation
Worsening of preexisting respiratory
state.
No symptoms, detected by the chance
of finding an opacity.
Nonspecific symptoms of malignancy
like malaise, anorexia, and weight loss
Metastatic disease
Central tumours
Cough – most common symptom
New cough that persists longer than 2
weeks in a patient of 40 years who is a
smoker.
Hemoptysis – usually streaky
Breathlessness – due to central airway
narrowing, partial or total collapse of a
distal segment
Chest pain – deep chest discomfort,
due to peribronchial and perivascular
nerve involvement.
Peripheral tumours
Cough and hemoptyis
Bronchorrhoea
Dyspnoea
Chest pain
Distant spread
Skeletal metastasis – bone
pain, pathological fractures
Cerebral metastasis –
progressive neurological
symptoms
Clinical features
Frequently no abnormal
findings
Hoarseness
Bovine cough
Clubbing
HPOA
Lymphatic involvement –
scalene and supraclavicular
Axillary lymph nodes due to
chest invasion
Stridor, wheezes
Atelectasis
Pleural effusion
SVC obstruction
Diaphragm palsy
Enlarged liver
Raised intracranial pressure
Dysphagia
Investigations
Chest radiography
Nearly always abnormal
Collapse
Pleural effusion
Elevated hemi diaphragm
Widening of mediastinum
Lymphangitis carcinomatosa
Pneumonic shadow –
bronchioloalveolar carcinoma
Pancoast tumour
Solitary pulmonary nodule (SPN)
Opacity of less than 3 cm without
surrounding atelectasis and or
adenopathy.
Doubling time
Calcification
Solitary pulmonary nodule
Sputum cytology – more yield
in central tumours
60-70% positive yield in
experienced hands
Single sample – 40%
4 samples – 80%
Bronchoscopy – most useful
for central tumours
Tumours beyond bronchoscopic
view – Transbronchial needle
biopsy, blind brushing and
washing
Other investigations
Percutaneous needle biopsy
Aspiration of subcutaneous
swelling
Pleural fluid study
Thoracoscopic lung biopsy
Mediastinoscopy
Thoracotomy
Staging
Non small cell carcinoma
TNM staging
Primary tumour (T)
Tx, T0, T1s, T1, T2, T3, T4
Nodal involvement (N)
N0, N1, N2, N3.
Distant metastasis (M)
M0, M1
Staging
Small cell lung carcinoma
Limited
Extensive
Treatment
Non small cell lung carcinoma
 Surgery – best result, but only a small
minority
 Types of surgery
 Pneumonectomy
 Lobectomy
 VATS – segmentectomy
 5 year survival rate overall 35%
 Radiotherapy
 Stage I&II – inoperable due to
medical contraindications
 Indications
 Hemoptysis, pain, cough, dyspnoea
due to large bronchus obstruction,
mediastinal compression, symptoms
due to intracranial metastasis,
symptoms due to spinal cord
compression.
Endobronchial treatment
 Laser therapy
 Endobronchial radiotherapy
 Photodynamic therapy
Chemotherapy
 Poor response to chemotherapeutic agents
 Combined modalities
Small cell carcinoma
At presentation 70% have extensive
disease
Chemotherapy
More sensitive to chemotherapy
Combined therapy preferred than
monotherapy
Radiotherapy
Primary tumour control
Prophylatic cranial irradiation
Surgery
Paraneoplastic syndrome
 Non metastatic
metabolic/neuromuscular
manifestations
 Hypercalcemia
 SIADH
 Ectopic ACTH
 HPOA
 Gynaecomastia – large cell and
adeno carcinoma
 Eaton-Lambert syndrome,
polymyositis/dermatomyositis
 Peripheral neuropathy
 Cerebellar ataxia
Superior venacava obstruction
 Small cell carcinoma
 Diagnosis – swelling of face and upper
torso and distension of veins across the
chest, upper arms and neck.
 Treatment – chemotherapy,
radiotherapy and stenting
Superior sulcus tumour
Pancoast
Pain in lower part of shoulder and
inner aspect of the arm (C8, T1
and T2)
Sympathetic ganglion
involvement – stellate
Diagnosis
Treatment - radiotherapy and
surgery
Prevention
Primary prevention
Stop smoking
Mediastinum lies centrally
within the chest and spans the
region vertically from the
thoracic inlet to the
diaphragmatic hiatus,
transversally between the
parietal pleura, and coronally
between the sternum and
vertebral column.
Mediastinal Compartments
3 compartments
Anterior compartment
Middle compartment
Posterior compartment
Lung mediastinal tumors_mbbs
Lung mediastinal tumors_mbbs
Lung mediastinal tumors_mbbs
Symptoms and Mechanisms
Symptoms Mechanisms
cough Airway narrowing,
compression
Chest pain Chest wall invasion,
neural invasion
Dyspnoea Airway compromise,
pericardial tamponade,
pleural effusions,
pulmonary stenosis,
heart failure.
Hemoptysis Bronchogenic
carcinoma, airway
invasion, pulmonary
stenosis, heart failure
Dysphagia Oesophageal
narrowing/obstructio
n, oesophageal
motor dysfunction
Hoarseness Vocal cord paralysis
Facial swelling Superior vena cava
syndrome
Incidence
Adults
65% in Anterosuperior, 10% in the
middle and 25% in the posterior
compartments
Children
28% Anterosuperior, 10% in middle,
62% in the posterior compartment
Investigations
• Noninvasive diagnostic procedures
• Computed tomography
• Magnetic resonance imaging
• Ultrasonography
• Radio nuclides
Biochemical Markers
 CEA
 AFB, HCG – nonseminomatous germ cell
tumour, Teratoma, Carcinoma
 Catecholamines,vanillylmandelic acid,
homovanillic acid – Pheochromocytoma
 Nor epinephrine, epinephrine –
paraganglioma,ganglioneuroma,
neuroblatoma
Invasive biopsy procedures
FNAB
Surgical procedures
Lesions masquerading as
mediastinal tumours
• Substernal Goiter
• Cystic Hygroma
• Lesions originating from thoracic
skeleton
• Vascular lesions
• Oesophageal lesions
• Pulmonary lesions
• Sub diaphragmatic Lesions
Paraneoplastic syndromes
associated with Thymoma
Well established
Myasthenia gravis
Pure red cell aplasia
Acquired
hypogammaglobulinemia
Non Thymic cancers
Less well established
Pancytopenia
Lambert-Eaton
Peripheral neuropathies
CNS changes
Multiple endocrine defects
Multiple rheumatologic disorders
Nephrotic syndrome
Thymoma is the most common
primary neoplasm of the mediastinum
15% of Thymic lesions
Equal frequency in male and female
40-60 years
75% in anterior mediastinum
More than 90% are visible on chest
radiograph
Surgical resection
Radiotherapy
Unresectable, recurrent or
metastatic Thymoma-
chemotherapy
Tumours of lymph nodes
Lymphomas
10-14% of mediastinal tumours
Rare in posterior mediastinum
 Hodgkin’s and Non Hodgkin’s
20-30% asymptomatic
60-70% symptoms of local
invasion
30-35% systemic symptoms
Non-Hodgkin’s lymphoma
5% with mediastinal involvement
Large irregular anterior and
superior mediastinal involvement
Radiation therapy effective in low
grade lymphoma
chemotherapy
Germ cell tumours
Benign and malignant
Benign germ cell tumours
(Teratoma)
Constitute 70% of the lesions in
children and 60% in adults.
Contain multiple tissues that
are foreign to the part of the
body in which they develop.
Symptomatic only when
infected
Malignant germ cell tumours
Malignant mediastinal teratoma
Mediastinal seminoma
Nonseminomatous tumours-
embryonal carcinoma,
choriocarcinoma, endodermal
sinus tumours, teratocarcinoma
Chemotherapy and
radiotherapy, surgery
Middle mediastinal tumours
Bronchogenic cysts
Mediastinal cysts form
20% of mediastinal
tumours
60% of mediastinal cysts
are bronchogenic cyst
Oesophageal cysts
 Neuroenteric cysts
Mesothelial cysts
Pericardial or
pleuropericardial cysts
Thoracic duct cyst
• Neurogenic tumours
• Most common malignancy in
children
• In children 50% malignant,
adults 10%
• Dumbbell tumours – intraspinal
extension
• CT, MRI, myelography
Posterior mediastinal tumours
Tumours of nerve sheath origin
Benign – neurilemoma or
neurofibroma
Malignant tumours-incidence
of malignancy more in von
Recklinghausen’s disease
Poor prognosis
Tumours of autonomic nervous
system
Neuroblatoma,
ganglioneuroblastoma rare in
adults
Endocrine tumours
Mediastinal pheochromocytoma
Parathyroid adenoma
Lung mediastinal tumors_mbbs

More Related Content

What's hot (20)

Diagnosing Lung cancer
Diagnosing Lung cancerDiagnosing Lung cancer
Diagnosing Lung cancer
 
Carcinoma lung
Carcinoma lungCarcinoma lung
Carcinoma lung
 
Lung tumors
Lung tumorsLung tumors
Lung tumors
 
Lung cancer anatomy to pathological classification
Lung cancer anatomy to pathological classificationLung cancer anatomy to pathological classification
Lung cancer anatomy to pathological classification
 
Lung cancer
Lung cancerLung cancer
Lung cancer
 
Bronchial carcinoma and Mesothelioma
Bronchial carcinoma and MesotheliomaBronchial carcinoma and Mesothelioma
Bronchial carcinoma and Mesothelioma
 
6 lungcancer
6 lungcancer6 lungcancer
6 lungcancer
 
Lung cancer
Lung cancerLung cancer
Lung cancer
 
Bronchogenic carcinoma
Bronchogenic carcinomaBronchogenic carcinoma
Bronchogenic carcinoma
 
Lung Cancer - Rivin
Lung Cancer - RivinLung Cancer - Rivin
Lung Cancer - Rivin
 
Lung Carcinoma
Lung CarcinomaLung Carcinoma
Lung Carcinoma
 
Staging of bronchogenic carcinoma
Staging of bronchogenic carcinomaStaging of bronchogenic carcinoma
Staging of bronchogenic carcinoma
 
Pulmonary neoplasia
Pulmonary neoplasiaPulmonary neoplasia
Pulmonary neoplasia
 
Ca lung (Workup and Diagnosis)
Ca lung (Workup and Diagnosis)Ca lung (Workup and Diagnosis)
Ca lung (Workup and Diagnosis)
 
Lung cancer.
Lung cancer.Lung cancer.
Lung cancer.
 
Bronchogenic carcinoma
Bronchogenic carcinomaBronchogenic carcinoma
Bronchogenic carcinoma
 
Lung cancer guidelines
Lung cancer guidelinesLung cancer guidelines
Lung cancer guidelines
 
Carcinoma bronchus
Carcinoma bronchusCarcinoma bronchus
Carcinoma bronchus
 
Non small cell lung cancer
Non small cell lung cancerNon small cell lung cancer
Non small cell lung cancer
 
Lung cancer
Lung cancerLung cancer
Lung cancer
 

Viewers also liked

24 anterior mediastinal lesions on computed tomography
24 anterior mediastinal lesions on computed tomography24 anterior mediastinal lesions on computed tomography
24 anterior mediastinal lesions on computed tomographyDr. Muhammad Bin Zulfiqar
 
SWU CXR interpretation
SWU  CXR interpretationSWU  CXR interpretation
SWU CXR interpretationvora kun
 
Physiological considerations and patient positioning during anesthesia for th...
Physiological considerations and patient positioning during anesthesia for th...Physiological considerations and patient positioning during anesthesia for th...
Physiological considerations and patient positioning during anesthesia for th...Abeer Nakera
 
Anesthesia for toracic surgery
Anesthesia for toracic surgeryAnesthesia for toracic surgery
Anesthesia for toracic surgeryshmahdy1
 
Anaesthetic consideration for one lung ventilation
Anaesthetic consideration  for one lung ventilationAnaesthetic consideration  for one lung ventilation
Anaesthetic consideration for one lung ventilationBHUSHANKUMAR KINGE
 
Anesthesia concerns in the elderly
Anesthesia concerns in the elderlyAnesthesia concerns in the elderly
Anesthesia concerns in the elderlyMarc Evans Abat
 
Mediastinum masses
Mediastinum massesMediastinum masses
Mediastinum massesNavdeep Shah
 
Mediastinum-RADIOLOGY
Mediastinum-RADIOLOGYMediastinum-RADIOLOGY
Mediastinum-RADIOLOGYNavdeep Shah
 

Viewers also liked (9)

24 anterior mediastinal lesions on computed tomography
24 anterior mediastinal lesions on computed tomography24 anterior mediastinal lesions on computed tomography
24 anterior mediastinal lesions on computed tomography
 
SWU CXR interpretation
SWU  CXR interpretationSWU  CXR interpretation
SWU CXR interpretation
 
Physiological considerations and patient positioning during anesthesia for th...
Physiological considerations and patient positioning during anesthesia for th...Physiological considerations and patient positioning during anesthesia for th...
Physiological considerations and patient positioning during anesthesia for th...
 
Anesthesia for toracic surgery
Anesthesia for toracic surgeryAnesthesia for toracic surgery
Anesthesia for toracic surgery
 
Pathology of mediastinal masses
Pathology of mediastinal massesPathology of mediastinal masses
Pathology of mediastinal masses
 
Anaesthetic consideration for one lung ventilation
Anaesthetic consideration  for one lung ventilationAnaesthetic consideration  for one lung ventilation
Anaesthetic consideration for one lung ventilation
 
Anesthesia concerns in the elderly
Anesthesia concerns in the elderlyAnesthesia concerns in the elderly
Anesthesia concerns in the elderly
 
Mediastinum masses
Mediastinum massesMediastinum masses
Mediastinum masses
 
Mediastinum-RADIOLOGY
Mediastinum-RADIOLOGYMediastinum-RADIOLOGY
Mediastinum-RADIOLOGY
 

Similar to Lung mediastinal tumors_mbbs

Similar to Lung mediastinal tumors_mbbs (20)

Lung mediastinal tumors
Lung mediastinal tumorsLung mediastinal tumors
Lung mediastinal tumors
 
Lung mediastinal tumors
Lung mediastinal tumors Lung mediastinal tumors
Lung mediastinal tumors
 
A Case of Mesothelioma
A Case of MesotheliomaA Case of Mesothelioma
A Case of Mesothelioma
 
4 lung cancer
4 lung cancer4 lung cancer
4 lung cancer
 
Lung cance - April'18
Lung cance - April'18Lung cance - April'18
Lung cance - April'18
 
IMAGING IN LUNG MALIGNANCY
IMAGING IN LUNG MALIGNANCYIMAGING IN LUNG MALIGNANCY
IMAGING IN LUNG MALIGNANCY
 
Pulmonary neoplasm final
Pulmonary neoplasm    finalPulmonary neoplasm    final
Pulmonary neoplasm final
 
Evaluation of neck tumors
Evaluation of neck tumorsEvaluation of neck tumors
Evaluation of neck tumors
 
Lung cancer by Dr. Aabidullah Rahimee
Lung cancer by Dr. Aabidullah RahimeeLung cancer by Dr. Aabidullah Rahimee
Lung cancer by Dr. Aabidullah Rahimee
 
Lung cancer-1.pptx
Lung cancer-1.pptxLung cancer-1.pptx
Lung cancer-1.pptx
 
9. Lung ca.pptx
9. Lung ca.pptx9. Lung ca.pptx
9. Lung ca.pptx
 
bronchogenic.pptx
bronchogenic.pptxbronchogenic.pptx
bronchogenic.pptx
 
THYROID NEOPLASMS
THYROID NEOPLASMSTHYROID NEOPLASMS
THYROID NEOPLASMS
 
Radiological imaging of pulmonary neoplasms
Radiological imaging of pulmonary neoplasmsRadiological imaging of pulmonary neoplasms
Radiological imaging of pulmonary neoplasms
 
Lung cancer.ppt
Lung cancer.pptLung cancer.ppt
Lung cancer.ppt
 
442781291-Lung-cancer presentation -ppt.pdf
442781291-Lung-cancer presentation -ppt.pdf442781291-Lung-cancer presentation -ppt.pdf
442781291-Lung-cancer presentation -ppt.pdf
 
Carcinoma - Lung
Carcinoma - LungCarcinoma - Lung
Carcinoma - Lung
 
Lung Cancer presentation final.pdf
Lung Cancer presentation final.pdfLung Cancer presentation final.pdf
Lung Cancer presentation final.pdf
 
2 Solid Tumors1
2 Solid Tumors12 Solid Tumors1
2 Solid Tumors1
 
lung tumors.pptx
lung tumors.pptxlung tumors.pptx
lung tumors.pptx
 

More from Dr.Manish Kumar (20)

Udt
UdtUdt
Udt
 
Tracheo esophageal fistula
Tracheo esophageal fistulaTracheo esophageal fistula
Tracheo esophageal fistula
 
Tb sp.condition
Tb sp.conditionTb sp.condition
Tb sp.condition
 
Tb path & pathogenesis
Tb path & pathogenesisTb path & pathogenesis
Tb path & pathogenesis
 
Tb treatment new
Tb treatment newTb treatment new
Tb treatment new
 
small intestinal obstruction
small intestinal obstructionsmall intestinal obstruction
small intestinal obstruction
 
Sarcoidosis
SarcoidosisSarcoidosis
Sarcoidosis
 
Pulmonary embolism 2
Pulmonary embolism 2Pulmonary embolism 2
Pulmonary embolism 2
 
Pulmonary defense
Pulmonary defensePulmonary defense
Pulmonary defense
 
Intusussception1
Intusussception1Intusussception1
Intusussception1
 
Pneumonia part1
Pneumonia part1Pneumonia part1
Pneumonia part1
 
Peumonia part2
Peumonia part2Peumonia part2
Peumonia part2
 
Oesophageal atresia
Oesophageal atresiaOesophageal atresia
Oesophageal atresia
 
Intusussception
IntusussceptionIntusussception
Intusussception
 
Obstructive jaundice
Obstructive jaundiceObstructive jaundice
Obstructive jaundice
 
Lung mediastinal tumors_mbbs
Lung mediastinal tumors_mbbsLung mediastinal tumors_mbbs
Lung mediastinal tumors_mbbs
 
Ischemia
IschemiaIschemia
Ischemia
 
Interstitial lung diseases 2012_pdf
Interstitial lung diseases 2012_pdfInterstitial lung diseases 2012_pdf
Interstitial lung diseases 2012_pdf
 
Infantile hypertrophic pyloric stenosis
Infantile hypertrophic pyloric stenosisInfantile hypertrophic pyloric stenosis
Infantile hypertrophic pyloric stenosis
 
Duodenal obstruction (neonates)
Duodenal obstruction (neonates)Duodenal obstruction (neonates)
Duodenal obstruction (neonates)
 

Recently uploaded

ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyMedicoseAcademics
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 

Recently uploaded (20)

ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before Pregnancy
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
 

Lung mediastinal tumors_mbbs