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: Fine needle aspiration
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

8. 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

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

10. ECOG Performance status

11. Gross pathology

26. Questions