2. Carcinoma of the Lung
• In United States:-
• 6.5 % of all deaths & 29% of cancer -related
death.
• #1 cause of cancer deaths in males & females
– 31% of male cancer deaths in 2008
– 26% of female cancer deaths
3. Annual Age-adjusted Cancer Death Rates for Selected
Cancers, United States, 1930-2004
MalesFemales
CA Cancer J Clin 2008;58:81-82
9. Adenocarcinoma
• Malignant epithelial tumors with tubular, acinar, or
papillary growth patterns, and/or mucus production
by the tumor cells.
• Adenocarcinoma is the predominant histological subtype of
lung carcinoma in most countries (40-50% of all cases).
• Most prevalent form of lung cancer in younger males (<50 yr)
and in women of all ages, in never smokers, and in former
smokers
• Adenocarcinoma has flipped with squamous tumors as most
common over the past 20 years. Why? Thought that smoking
with filters, light tobacco, profound inhalation favor the
development of distal bronchiolar and alveolar
adenocarcinomas
10. Adenocarcinoma
Bronchioloalveolar type
• Frequency: 2 %
• Smoking: yes
• Males = females
• Survival (5 years): 25 a 40 %.
• Presentation:
– Single or multiple tumor nodules
– Miliary tumor
– “Pneumonic form”
12. 1. Definition: noninvasive tumors with bland cytology and lepidic
spread (line alveolar surfaces)
2. New proposal to classify these as “adenocarcinoma in situ”
or atypical adenomatous hyperplasia
Adenocarcinoma
Bronchioloalveolar type
13. Squamous cell carcinoma
• Frequency: 28%
• Smoking: X 25 (increased risk)
• Males > females
• Survival (5 years): 15 - 20%
• Arises in bronchial squamous
metaplasia
• Centrally located
• May cavitate
14. Squamous cell carcinoma
• Malignant epithelial tumor with morphologic
evidence of keratinization, intercellular bridges
or both.
• Second most common type of lung cancer.
• 2/3 central 1/3 peripheral.
17. Large Cell Carcinoma
• Frequency: 14%
• Gross
– Peripheral lesion
• Microscopic
– group of tumors that do not fit the criteria of a
squamous cell carcinoma, adenocarcinoma, or
small cell carcinoma
• Prognosis
– Similar to adenocarcinoma
18.
19.
20. Small cell carcinoma
• Frequency: 16%
• Smoking: 95% of patients
• Survival (5 years): 1 - 5 %
21. • Malignant epithelial tumor consisting of small cells
with minimal/scant cytoplasm, finely granular
nuclear chromatin, absent or inconspicuous
nucleoli, displaying prominent nuclear molding,
high mitotic/apoptotic activity and extensive
necrosis
• Highly associated with cigarette smoking, central
location, early spread, common paraneoplastic
syndromes
Small cell carcinoma
22. Small cell carcinoma
• Still a dismal lesion: over 75% of cases
present with stage III or IV disease
• In many series long term survival is less
than 5%
• Takes one importance because it essentially
removes a patient from consideration of
resection in most cases
23.
24. Presenting Symptoms of Lung
Cancer
• Potentially curable
– asymptomatic
– cough
– hemoptysis
• Usually incurable
– dyspnea & chest pain
– anorexia & weight loss
– hoarseness
– bone pain
– Horner’s syndrome (Pancoast tumor)
27. Mesothelioma
• Mesothelioma:
– Malignant tumor of
mesothelial cells
– Highly malignant
neoplasm with short
survival
– Most patients (70%)
have an asbestos
exposure history
• Asbestos exposure
also increases the risk
of pulmonary cancer
• Smoking is not related
to mesothelioma
