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Lung Cancer Epidemiology

Decent Essays

Anatomy
There are five lobes in the lung, three on the right and two on the left. Each lobe is divided by five segments, each supplied by tertiary bronchi, except for the right upper and right middle lobes, which are divided into three and two segments, respectively. Lymph nodes draining the lung are divided into intrapulmonary, hilar, and mediastinal nodal groups along the secondary bronchi, main bronchi, and surrounding tracheal and vascular structures within the mediastinum, respectively .

Epidemiology and Etiology
Worldwide, lung cancer is the most common cancer in both incidence and mortality.
Lung cancer is responsible for 28% of all cancer-related death each year (~160,000), more than all of breast, colorectal, and prostate cancers …show more content…

It accounts for 2–3% of lung cancer cancers (other than mesothelioma)

Occupational exposure: Arsenic, bischloromethyl ether, hexavalent chromium, mustard gas, nickel, polycyclic aromatic hydrocarbons are some of the chemicals linked to lung cancers

Pathology
Lung cancers are broadly categorized as non–small cell (NSCLC) and small cell (SCLC) lung cancers, accounting for around 85 and 15% of all lung cancers, respectively. The most common histologic subtypes of NSCLC are adenocarcinoma (50%), squamous cell carcinoma (35%), and large cell lung cancer (15%). Subtypes of adenocarcinoma include broncho-alveolar, acinar, and papillary; subtypes of large cell lung cancer include giant cell and clear cell carcinomas, both of which carry poor prognosis. Adenocarcinomas are the histologic type associated with smoking.

SCLC (a.k.a. oat cell cancer) contains dense neurosecretory granules containing neuroendocrine hormones such as adrenocorticotropic hormone (ACTH) and …show more content…

This tumor originates from type II pneumocytes, and it may present as a pneumonic infiltrate, as multiple nodules scattered throughout the lungs, and, occasionally, as a single nodule.

Route of spread
Local extension
. Direct involvement of pleural surfaces, chest wall, ribs, and mediastinal structures causing hemoptysis
 Apical tumors can cause superior sulcus syndrome, with involvement of vertebral body, brachial plexus, stellate ganglion (causing Horner’s syndrome), subclavian vasculature, and superior vena cava (causing SVC syndrome) .Most Pancoast tumors are non-small cell cancers
 Direct extension to recurrent laryngeal nerve can cause vocal cord paralysis and hoarseness. Involvement of phrenic nerve causes diaphragmatic paralysis.

N.B. recurrent laryngeal n. originate from Vagus n. The Rt is shorter than the LT as it curves under the Rt subclavian a. but the Lt curves under the aortic arch.

Regional lymph node metastasis
Into intrapulmonary, hilar, and mediastinal nodal

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