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Passive smoking is also a carcinogen factor.
Etiology
2.Atmospheric pollution.It was found that carcinogenic factor is benzpyrene .
3.Occupational factors. 4Radioactivity in the atmosphere . 5.Diets and Nutrition. 6.Chronic irritation. 7.Genetic factors.
2.Symptoms caused by the near organs or tissue involved by tumor.
(1).Dysphagia. (2).Hoarseness. (3).Pleural effusion due to inRadiographic Findings
2 Central type (1) Direct appearance :Unilateral
enlargement of the hilar shadow due to the tumor itself or enlarged lymph nodes. (2) Indirect appearance :Including local emphysema;obstructive pneumonia either lobal or segmental; obstractive atalectasis (collapse) lobe or segment.
Clinical features
There are no symptoms of early lung cancer in some patients.
Symptoms caused by lung cancer are nonspecific:perhaps an audible wheeze or a slight cough,symptoms of infection (fever ,purulent sputum) , of obstruction (wheezing,dyspnea), or ulceration of bronchial mucosa (hemoptysis).
Pathology And Classification
1. According to the position of tumor arising from ,it can be divided into two types .
Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .
Fig5 Cavitating Bronchial Carcinoma
Examination of sputum
Cytologic examination of bronchial secretions(or sputum)may reveal exfoliated malignant cells recognizable to the pathologist who is specially trained for such work.The sputum must to be fresh, send on time, repeat(4-6 times)..
Bronchogenic Carcinoma (Lung Cancer)
Respiratory department
Definition
Bronchogenic carcinoma refers to the malignant tumor which grows in the bronchus. Originating from mucus or gland of bronchus.
(2) Lymph nodes along hilar or mediastina can be found by CT.
Fig1 Atelectasis,Right upper lobe
Fig3 Mass With Fuzzy,Right Upper
Fig4 Mass In right Lobe,Lateral portion
Advantage of CT:
(1) Some small lesion, lesion behind of cardiac or blood vessel,and pathology located in apical of lung can be found by CT which can’t be found by chest x-ray.
cell carcinoma).
Pathology And Classification
According to the different principles of management,it is divided into two types.
SCLC:small cell lung carcinoma. NSCLC:non small cell lung carcinoma.
Clinical Features
(4).Horner’s syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.
(3) Neuropathic or myopathic disorders including polyneuritis ,cerebellar degeneration,mental abnormalitis etc
(4) others.
Radiographic Findings
The appearance on the x-ray film depends on the position ,size and stage of the tumor 1.Peripheral type :It may be various such as infiltrative or nodular, lobulated or umbilicus sign,liner protrusions from the shadow into the surrounding lung, cavitation which is often eccentric irregular in the inner wall owing to the necrosis of the neoplasm.
Bronchoscope
Bronchoscope may verify the existence of tumor , of Central type, and cytologic diagnosis of lung cancer should be obtained though FBC
.Blind biopsy may be help to the diagnosis of the tumor beyond the range of bronchoscope vision
(1) Collagen tissue disorder such as finger clubbing , hypertrophic pulmonray osteoarthropathy 。
Clinical features
(2)Endocrine disorders including Cushing’s syndrome ,syndrome of inappropriate antiduretic hormone secretion(SIADHS),
3.Symptoms caused by metastasis.liver, skeleton,brain, supra clavicle lymph nodes.
Clinical fetures
4.Paraneoplastic syndrome.Because tumor cell can secrete ectopic hormone，antigen or enzyme the patients with Lung Cancer sometimes may have some paraneoplastic syndrome Including:
Incidence and mortality
Bronchogenic carcinoma has increased remarkable in incidence and mortality during half of the century and has become the most frequent visceral malignant diseases of men.The mortality of lung cancer hold the first place among all kinds carcinomas.
Etiology
The cause of lung cancer is unknown.It is believed that there are following related factors.
1. Excessive cigarette smoking:Smoking index(Brinkman Index) is equal to cigarettes per day smoking time(years).
(5)Cardiac effusion
