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

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Presentation on theme: "Heme-Onc presentation Dr. Prudhvi Karumanchi Dr. Sohail Chaudhry."— Presentation transcript:

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

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

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

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

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

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

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8 Small Cell Lung Cancer Symptoms and Signs: Symptoms and Signs: Central or endobronchial growth: Central or endobronchial growth: CoughCough HemoptysisHemoptysis WheezeWheeze StridorStridor Post-obstructive pneumonitisPost-obstructive pneumonitis Peripheral Growth: Peripheral Growth: DyspneaDyspnea Lung abscessLung abscess Regional spread of tumor: Regional spread of tumor: Tracheal obstructionTracheal obstruction Esophageal compression with dysphagiaEsophageal compression with dysphagia Rec. laryngeal nerve paralysis with hoarsenessRec. laryngeal nerve paralysis with hoarseness Sympathetic nerve paralysis with hornersSympathetic nerve paralysis with horners Superior vena cava syndrome with vascular obstructionSuperior vena cava syndrome with vascular obstruction

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

10 ECOG Performance status

11 Gross pathology

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26 Questions


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