已阅读5页,还剩31页未读, 继续免费阅读
版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领
文档简介
Bronchogenic Carcinoma(Lung Cancer)Respiratory departmentDefinitionlBronchogenic carcinoma refers to the malignant tumor which grows in the bronchus. Originating from mucus or gland of bronchus.Incidence and mortalityl Bronchogenic carcinoma has increased remarkable in incidence and mortality during half of the century and has become the most frequent visceral malignant diseases of men.The mortality of lung cancer hold the first place among all kinds carcinomas.Etiologyl The cause of lung cancer is unknown.It is believed that there are following related factors.l 1. Excessive cigarette smoking:Smoking index(Brinkman Index) is equal to cigarettes per day smoking time(years). l Passive smoking is also a carcinogen factor.Etiologyl 2.Atmospheric pollution.It was found that carcinogenic factor is benzpyrene .l 3.Occupational factors. l 4Radioactivity in the atmosphere .l 5.Diets and Nutrition.l 6.Chronic irritation.l 7.Genetic factors.Pathology And Classificationl 1. According to the position of tumor arising from ,it can be divided into two types .l Central type:Tumor arises from main bronchus, lobar and segmental bronchus . Peripheral type : Tumor arises beyond segmental bronchus .Pathology And Classificationl 2.According to cytology,it is convenient to classify into four kinds of types.l (1).Squamous cell carcinoma.l (2).Small cell anaplastic carcinoma.l (3).Large cell anaplastic carcinoma.l (4).Adenocarcinoma(including alveolar cell carcinoma). Pathology And ClassificationlAccording to the different principles of management,it is divided into two types.lSCLC:small cell lung carcinoma.lNSCLC:non small cell lung carcinoma.Clinical featuresl There are no symptoms of early lung cancer in some patients.l Symptoms caused by lung cancer are non-specific:perhaps an audible wheeze or a slight cough,symptoms of infection (fever ,purulent sputum) , of obstruction (wheezing,dyspnea), or ulceration of bronchial mucosa (hemoptysis).Clinical featuresl 1.Respiratory symptoms.l (1).Cough:l (2).Hemoptysis:l (3).Dyspnea.:l (4).Wheeze or stridor:l (5).Chest pain :l (6).Fever:Clinical featuresl2.Symptoms caused by the near organs or tissue involved by tumor.l (1).Dysphagia.l (2).Hoarseness.l (3).Pleural effusion due to invasion of the pleura.Clinical Featuresl (4).Horners syndrome.It is caused by invading the cervical sympathetic ganglia on the involved side the pupil is small ptosis of the up eyelids,retraction of the eyeball and no sweat of the face.l (5)Cardiac effusionClinical feturesl (6).Superior vena caval syndrome. Due to obstruction of the superior vena caval,the patient may have noticed that his collar is tight, the neck is enlarged and the jugular vein and the veins of anterior chest wall are distension and edema of the face.l 3.Symptoms caused by metastasis.liver, skeleton,brain, supra clavicle lymph nodes. Clinical feturesl 4.Paraneoplastic syndrome.Because tumor cell can secrete ectopic hormone, antigen or enzyme the patients with Lung Cancer sometimes may have some paraneoplastic syndrome Including:l (1) Collagen tissue disorder such as finger clubbing , hypertrophic pulmonray osteoarthropathy 。Clinical featuresl (2)Endocrine disorders including Cushings syndrome ,syndrome of inappropriate antiduretic hormone secretion(SIADHS),l (3) Neuropathic or myopathic disorders including polyneuritis ,cerebellar degeneration,mental abnormalitis etc l (4) others.Radiographic Findingsl The appearance on the x-ray film depends on the position ,size and stage of the tumor 1.Peripheral type :It may be various such as infiltrative or nodular, lobulated or umbilicus sign,liner protrusions from the shadow into the surrounding lung, cavitation which is often eccentric irregular in the inner wall owing to the necrosis of the neoplasm.Radiographic Findingsl 2 Central typel (1) Direct appearance :Unilateral enlargement of the hilar shadow due to the tumor itself or enlarged lymph nodes.l (2) Indirect appearance :Including local emphysema;obstructive pneumonia either lobal or segmental; obstractive atalectasis (collapse) lobe or segment.Advantage of CT:l (1) Some small lesion, lesion behind of cardiac or blood vessel,and pathology located in apical of lung can be found by CT which cant be found by chest x-ray.l (2) Lymph nodes along hilar or mediastina can be found by CT.Fig1 Atelectasis,Right upper lobeFig3 Mass With Fuzzy,Right Upper LObeFig4 Mass In right Lobe,Lateral portionFig5 Cavitating Bronchial Carcinoma Examination of sputum l Cytologic examination of bronchial secretions(or sputum)may reveal exfoliated malignant cells recognizable to the pathologist who is specially trained for such work.The sputum must to be fresh, send on time, repeat(4-6 times)Bronchoscopel Bronchoscope may verify the existence of tumor , of Central type, and cytologic diagnosis of lung cancer should be obtained though FBCl .Blind biopsy may be help to the diagnosis of the tumor beyond the range of bronchoscope visionFig 1 Normal Trachea Fig 2 Normal CarinaFig 3 Squamous Cell Carcinoma, TracheaFig 4 AdenocarcinomaLeft Lingular BronchusFig 5 AdenocarcinomaRight Truncal Intermedus Fig 6 Extrinsic Pressure TracheaLung Biopsyl 1.Biopsy with fiberoptic bronchoscope; 2.Transthoracic neddle biopsy with CT directed or B type ultrasonic;l 3.Biopsy with thoracoscopy ;l 4.Biopsy with medistinoscopy;l 5.Exploratory thoracotomy.Diagnosisl 1.Symptom -free: General investigation of high risk group (male,morn than 40 years old,cigarette consumption 20/per day). Taking a x-ray film and examining sputum for cancer cell every half year l Early stage of the bronchogenic carcinoma Refers to the tumor is still located at the bronchus ,no invade t
温馨提示
- 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
- 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
- 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
- 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
- 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
- 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
- 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
最新文档
- 内贸软件采购软件使用许可合同
- 2016年上海监理工程师合同管理:除外责任考试试题
- 2024届高考语文二轮复习 散文阅读训练(含答案)
- FZ∕T 96027-2012 摩擦盘式假捻器
- 广东省汕头市2023–2024学年度高三年级上册期中调研测试语文试题及答案解析
- 《移动互联系统运维技术》 教案 17 移动电商运维自动化实操
- 木板材加工相关行业投资方案范本
- 2024年国家高级机修钳工技能考试题库(含答案)
- 描写大自然的英语单词
- 信息安全技术 关键信息基础设施边界确定方法
- 小班教案《多变的情绪》
- 2023年浙江1月普通话语音与发声自考试题
- 高压旋喷桩水泥用量计算
- GB/T 17245-2004成年人人体惯性参数
- 单位工程竣工验收报告用表江苏空白
- 深圳市企业职工养老保险养老金申请表空表
- PPT用中国地图(可编辑)
- 2023年新疆维吾尔自治区煤矿生产安全事故应急预案管理办法
- 初中语文人教八年级上册《“读懂”话题作文指导》PPT
- 护士交接班护理质量评价标准
- 实验室5S管理讲义课件
评论
0/150
提交评论