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Heme-Onc presentation

Heme-Onc presentation. Dr. Prudhvi Karumanchi Dr. Sohail Chaudhry. Small Cell Lung cancer. 51 y/o wf Presented with tingling and numbness in all her fingers Diagnosed with carpal tunnel syndrome and sent home.

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Heme-Onc presentation

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  1. Heme-Onc presentation Dr. Prudhvi Karumanchi Dr. Sohail Chaudhry

  2. Small Cell Lung cancer • 51 y/o wf • Presented with tingling and numbness in all her fingers • Diagnosed with carpal tunnel syndrome and sent home. • 3 months later, pt developed asthmatic bronchitis with productive cough accompanied by mild hemoptysis. • She also began to have difficulty finding words and remembering names of family members.

  3. Small Cell Lung Cancer • Chest x ray: Hilar mass

  4. Small Cell Lung Cancer • CT: Hilar mass with mediastinal lymphadenopathy.

  5. Small Cell Lung Cancer • Bronchoscopy: • Diffuse mucosal infiltration • Thickening of main and upper lobe bronchi on right side with small mucosal nodules • Cytology was negative. • Fine needle aspiration • Undifferentiated small-cell carcinoma • Pt was treated with cisplatin and etoposide.

  6. Epidemiology • Small cell lung cancer accounts for 20-25% of all bronchogenic carcinomas. • Strong correlation with smoking. • Known genetic abnormality: • Deletions in chromosome 3

  7. Small Cell Lung Cancer • Symptoms and Signs: • Central or endobronchial growth: • Cough • Hemoptysis • Wheeze • Stridor • Post-obstructive pneumonitis • Peripheral Growth: • Dyspnea • Lung abscess • Regional spread of tumor: • Tracheal obstruction • Esophageal compression with dysphagia • Rec. laryngeal nerve paralysis with hoarseness • Sympathetic nerve paralysis with horner’s • Superior vena cava syndrome with vascular obstruction

  8. Metastasis • Brain metastasis: • Headache, nausea, neurological deficits • Bone metastases: • Pain and pathological fractures • Spinal cord compression syndromes • Bone marrow: Cytopenia/Leucoerythroblastosis • Liver metastases: • Biliary obstruction • Anorexia, pain.

  9. ECOG Performance status

  10. Gross pathology

  11. Questions

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