Internal Medicine (Theory) · MU Sofia

7. Lung cancer

Covers lung cancer from its definition as a malignant bronchial or alveolar tumour, through classification by primary versus metastatic origin and by location (central, peripheral, apical Pancoast-Tobias), to histologic types such as NSCLC subtypes and SCLC. It then addresses causes and predisposing factors, early and late symptoms with common sites of spread, physical examination findings, blood tests, and instrumental and cytology investigations.

Inside: 10 sections · 6 labelled pictures · 16 flashcards · 6 min

Topic 7 of 58 in the MU Sofia syllabus for Internal Medicine (Theory) (Medicine, Year 3). The free AceMed note covers it in 10 sections, about 771 words (6 min of reading), with 16 flashcards.

In this note

  1. Lung Cancer
  2. Definition
  3. Classification
  4. Based on localisation:
  5. Histologic Types:
  6. Causes & Predisposing Factors
  7. Symptoms
  8. Physical Examination
  9. Lab Tests
  10. Instrumental Tests

Definition

Lung cancer is a malignant tumour that affects the bronchi (99%) or alveoli (1%). The majority of cases are linked to bronchial involvement, which can lead to obstruction and local spread in the lung tissue.

Classification

  • Primary cancer: Grows into the bronchial lumen
  • Typically begins in the bronchial epithelium and can obstruct airflow.
  • Metastatic cancer: Infiltrates the bronchial wall and interstitial tissue
  • Metastases from other cancers can spread to the lungs, affecting both the parenchyma and pleura.

Based on localisation:

  • Central: Affects the main bronchi or their branches
  • Usually presents with obstruction symptoms, like coughing and SOB.
  • Peripheral: Affects small bronchi, located near the chest wall
  • More commonly found in the outer regions of the lungs and can grow silently in early stages.
  • Apical cancer (Pancoast-Tobias): Located at the lung apex, often involving the upper lobes, and can extend to the brachial plexus.
  • Pancoast tumors cause shoulder pain, nerve damage, and sometimes Horner’s syndrome (ptosis, miosis, enophthalmus).

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