(Clinical Imaging) (Cancer)

Overview

• Leading cause of cancer death worldwide, with around 90% of cases attributable to smoking
• M>F, peak incidence at 65-75 years old
• Aetiology → tobacco smoking, occupational and environmental exposure to carcinogens (eg. radon, asbestos), family history
• Non-Small Cell Lung Cancer (80%)
• Small Cell Lung Cancer (20%)

<aside> 💡 Squamous cell and Small cell lung cancer are both Sentrally located.

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• Pancoast Tumour → apical lung carcinoma. May lead to horner syndrome (ipsilateral miosis, ptosis, anhidrosis). Can also cause recurrent laryngeal nerve damage and SVC obstruction. (Other causes of Horner’s include carotid artery’s dissection).

Making Diagnosis

Clinical Features:

• Cough + Haemoptysis
• Progressive Dyspnoea
• Wheezing
• Constitutional Symptoms → weight loss, fever, weakness
• SVC Obstruction (SCLC) → tumour in right lung apex. Compression of SVC impairs venous blackflow into right atrium, resulting in venous congestion in the head, neck and upper extremities. Causes dyspnoea, swelling of face, neck and arms, headache worse in mornings, visual disturbance and raised JVP.
  • Positive Pemberton’s Test
  • Immediate Mx ⇒ oral dexamethasone