bronchogenic carcinoma
Summary
Bronchogenic carcinoma is lung cancer arising from bronchial epithelium and is the leading cause of cancer death in the US. Major subtypes: adenocarcinoma (most common overall and in nonsmokers), squamous cell carcinoma, small cell carcinoma, and large cell carcinoma.
Detail
Adenocarcinoma is peripheral, associated with K-RAS/EGFR/ALK mutations, and is the most common in nonsmokers and women. Squamous cell carcinoma is central (hilar), strongly linked to smoking, cavitates, and classically causes hypercalcemia via PTHrP; histology shows keratin pearls and intercellular bridges. Small cell carcinoma is central, neuroendocrine in origin (chromogranin/synaptophysin/NSE positive), highly chemo-sensitive but rarely surgically resectable, and causes paraneoplastic syndromes (SIADH/ADH, ectopic ACTH/Cushing, Lambert-Eaton). Large cell carcinoma is peripheral, undifferentiated, with poor prognosis. Pancoast (superior sulcus) tumors cause Horner syndrome and brachial plexopathy. SVC syndrome and recurrent laryngeal nerve palsy are classic complications. Mnemonic for central tumors: 'Sentral = Small cell and Squamous.'
Sources
- First Aid for USMLE Step 1 2024
- Robbins Basic Pathology 10th ed
- Pathoma
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