1. LUNG CANCERPROBLEM BASED LEARNING (PBL)
PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB
BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN
2. Define lung cancer
• Lung cancer (malignancy of the lungs) is
defined as an uncontrolled growth of
abnormal cells in one or both of the lungs
3. Types of Lung Cancer
• Two main Types of Lung Cancer:
– Non Small Cell Lung Cancer (most common ~80%)
• SQUAMOUS CELL CARCINOMA
• ADENOCARCINOMA
• LARGE CELL CARCINOMA
– Small Cell Lung Cancer (20-25% of all lung cancers)
• Combined patterns
– Mixed sq.cell carcinoma + adenocarcinoma
– Mixerd sq.cell carcinoma + SCC
4. Squamous Cell Carcinoma
• Malignant bronchial epithelial tumour showing
keratinization and/or intercellular bridges.
• Strongly associated with smoking
• Majority arise centrally in major bronchi –
(obstruction and infection)
• Cavitations in 10%
6. Adenocarcinoma
• Malignant tumour with glandular
differentiation or mucin production.
• Gross : Adenocarcinoma of the lung. Usually
found as white-tan nodule at the periphery of
the lung.
• Many variants : Acinar, papillary,
bronchioloalveolar, solid, mixed subtypes
• Strongly associated with asbestose
7.
8. Small Cell Carcinoma
• Oat cell carcinoma”
• It arises from endocrine cells (Kulchitsky
cells).
• Closely associated with smoking
9. Pathophysiology
disease limited to air passage lining: has not
invaded lung tissue; can usually be treated and
eliminated
disease limited to lung tissue; has not
invaded lymph nodes or other organs;
spread to lymph nodes and chest wall
(chest pain)
10. continue
• disease has invaded lymph nodes outside of
the lung area; (need surgery)
• disease has invaded organs and structures
surrounding the lungs such as the heart,
trachea and esophagus
• disease has invaded structures and organs
throughout the body, such as liver, bones and
brain; less than 2% chance of survival at 5
years if treated at this stage
11. Metastatic Neoplasms
• Lung most frequent site (other than LN)
• Patterns of Metastasis:
– Multiple nodules
– Lymphangitic metastasis
– Solitary
12. Metastatic Neoplasms
From :
• Ovarian adenocarcinoma
• Breast cancer
• Prostatic cancer
• Colonic adenocarcinoma
• Renal carcinoma
• Melanoma, lymphoma, sarcoma
16. Complication
• Shortness of breath. Due to cancer has block the major
airways. Lung cancer can also cause accumulation fluid around
the lungs, thus SOB
• Coughing up blood. Due to rupture of cappilary,
bronchiolalviolar lead to blood cough (hemoptysis).
• Pain. Advanced lung cancer that spreads to the lining of a lung
or to another area of the body, such as a bone, can cause pain.
• Fluid in the chest (pleural effusion). Lung cancer can cause
fluid to accumulate in the space that surrounds the affected
lung in the chest cavity (pleural space).
• Cancer that spreads to other parts of the body
(metastasis). Lung cancer often spreads (metastasizes) to other
parts of the body, such as the brain and the bones.