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Lung, Primary Malignancies

Brian P. Bateson, DO, Nathaniel Walsh, MD and Carsten Schroeder, MD, PhD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Lung cancers (primary) are the leading cause of cancer-related death in the United States (estimated 159,260 deaths in 2015, 27% of all cancer-related deaths).

  • Divided into two broad ...

DIAGNOSIS

HISTORY

  • May be asymptomatic for most of course

  • Respiratory

    • Cough (new or change in chronic cough)

    • Wheezing and stridor

    • Dyspnea

    • Hemoptysis

    • Pneumonitis (fever and productive cough)

  • Constitutional

    • M...

TREATMENT

GENERAL MEASURES

  • NSCLC

    • Stage I, stage II, and selected stage III tumors are surgically resectable. Neoadjuvant or adjuvant therapy is recommended for many patients with high risk IB, II, and...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Depends on clinical history; in general, postoperative visits every 3 to 6 months in the first 2 years after surgery with physical exam and CT s...

REFERENCES

1
Aberle DR, Adams AM, Berg CD, et al; and the National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med.  20...

ADDITIONAL READING

National Cancer Institute. Small cell lung cancer treatment (PDQ)–health professional version. http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq#section/_1CODES. Acc...

CODES

ICD10

  • C34.90 Malignant neoplasm of unsp part of unsp bronchus or lung

  • C34.10 Malignant neoplasm of upper lobe, unsp bronchus or lung

  • C34.30 Malignant neoplasm of lower lobe, unsp bronchus or lung

  • C3...

CLINICAL PEARLS

  • Two types: NSCLC and SCLC

    • NSCLC (>85% of all lung cancers); normally originate in periphery

      • Adenocarcinoma (~40% of NSCLC)

      • Squamous cell carcinoma (~25% of NSCLC)

      • Large cell (~10% o...

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