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

Questions