Overview
Signs of Lung Cancer
General Signs
- Oxygen
- Respiratory distress - tachypnoea, pursed lip breathing, accessory muscle use, intercostal / subcostal recession
- Cough
- Sputum - purulent, bloody
- Lymphadenopathy - cervical, supraclavicular, axillary
Signs of Complications
- Pleural effusion - dull percussion note, reduced breath sounds, reduced vocal resonance
- Laryngeal nerve involvement - hoarse voice, dysphonic cough
- SVC obstruction - facial swelling, plethora, upper limb oedema, positive Pemberton's sign
- Pancoast tumour - Horner's syndrome (partial ptosis, miosis, anhydrosis), wasting of the small muscles of the hand
- Hypertrophic pulmonary osteodystrophy
Signs of Management
- Scars - from lobectomy or pneumonectomy
- Radiation tattoos
Pathogenesis
Risk Factors for Lung Cancer
- Genetic factors
- Smoking (active or passive)
- Air pollution
- Occupational exposure - asbestosis, silicosis,
- Chronic scarring - interstitial lung disease, tuberculosis, COPD
- Alcohol
Complications
Complications of Lung Cancer
- Pleural effusion
- Metastases - brain, liver, adrenal, bone
- Local compression - SVC obstruction, sympathetic chain compression (Pancoast tumour) , laryngeal nerve palsy, phrenic nerve palsy, brachial plexopathy
- Paraneoplastic syndromes - hypercalcaemia, SIADH, Cushing's, hypertrophic pulmonary osteoarthropathy, neurologic syndromes
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