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Heme-Onc presentation
Dr. Prudhvi Karumanchi
Dr. Sohail Chaudhry
Small Cell Lung cancer
51 y/o wf Presented with tingling and numbness in all her
fingers Diagnosed with carpal tunnel syndrome and sent
home. 3 months later, pt developed asthmatic
bronchitis with productive cough accompanied by mild hemoptysis.
She also began to have difficulty finding words and remembering names of family members.
Small Cell Lung Cancer
Chest x ray: Hilar mass
Small Cell Lung Cancer
CT: Hilar mass with mediastinal lymphadenopathy.
Small Cell Lung Cancer Bronchoscopy:
Diffuse mucosal infiltration Thickening of main and upper lobe bronchi on right
side with small mucosal nodules Cytology was negative.
Fine needle aspiration Undifferentiated small-cell carcinoma
Pt was treated with cisplatin and etoposide.
Epidemiology
Small cell lung cancer accounts for 20-25% of all bronchogenic carcinomas.
Strong correlation with smoking.
Known genetic abnormality: Deletions in chromosome 3
Small Cell Lung Cancer Symptoms and Signs:
Central or endobronchial growth:• Cough • Hemoptysis• Wheeze• Stridor• Post-obstructive pneumonitis
Peripheral Growth:• Dyspnea• Lung abscess
Regional spread of tumor:• Tracheal obstruction• Esophageal compression with dysphagia• Rec. laryngeal nerve paralysis with hoarseness• Sympathetic nerve paralysis with horner’s• Superior vena cava syndrome with vascular obstruction
Metastasis
Brain metastasis: Headache, nausea, neurological deficits
Bone metastases: Pain and pathological fractures Spinal cord compression syndromes
Bone marrow: Cytopenia/Leucoerythroblastosis Liver metastases:
Biliary obstruction Anorexia, pain.
ECOG Performance status
Gross pathology