The clinical manifestations of lung cancer
The clinical manifestations of lung cancer depends on the primary site of tumor, whether there is intrathoracic and (or) distant metastasis, is generated ectopic endocrine syndrome with cancer; also and have a certain relationship between histological types.
Located in the central lung tumor large bronchi, often cough, hemoptysis. Obstructive pneumonia or atelectasis, the performance of varying degrees of infection or breathing difficulties. Aged men over the age of 45 smoking patients, if there is inflammation in the lung, it must be alert to the inflammatory track dissipated; if repeated in the same area of lung inflammation, even taking into account the lung cancer the possibility of obstructive pneumonia And for further examination.
General symptoms of early peripheral lung cancer. Large mass can cause hemoptysis. Pleural mass violations of the limitations of the fixed part can produce chest pain. Lung tumors occurred in the ditch around the apex of lung cancer. When the invasion of the brachial plexus and lung on the trench neuralgia can occur when, confined in the 8th and 1st thoracic nerve cervical nerve distribution. Sympathetic chain after the invasion, causing Horner syndrome (ipsilateral eye is not closed, drooping eyelids and facial anhidrosis). Destruction of local tumor spread when 1,2 rib and thoracic spine, resulting in severe chest and back pain.
Tumor invasion of mediastinal structures can cause a series of clinical symptoms: recurrent laryngeal nerve invasion led to vocal cord paralysis, hoarseness, phrenic nerve involvement and a reverse nickname (or) phrenic paralysis, diaphragm contradictions. Involvement or pressure on the vena cava superior vena cava syndrome caused by neck and head and arm venous obstruction, local venous stasis, engorgement, chest and back appear collateral circulation, head and facial swelling, purple clamp. Mediastinal lymph nodes or tumor in direct violation of the spread of the esophagus, can cause swallowing difficulties. Lung cancer caused by superior vena cava obstruction syndrome and esophageal pressure is most common in small cell carcinoma, 345 cases concluded in Medical Oncology Hospital of small cell carcinoma, of which 13 are swallowing difficulties treatment of the chief complaint.
Pleural metastasis can cause large pleural effusion, lung compression have difficulty in breathing, to adenocarcinoma is most common. Lung cancer patients with pleural effusion are many reasons, in addition to direct pleural involvement, the poor can still be due to lymphatic drainage obstruction. Thoracic duct involvement may cause chylothorax, pneumonia, hypoalbuminemia, pulmonary embolism, etc., can cause secondary pleural effusion. Pleural effusion were detected only in malignant cells in pleural metastasis is the real.
When local severe bone pain, pathological fractures have become more common. Spinal epidural metastasis, tumor can cause spinal cord compression sensory or motor deficits, or even paraplegia.
Can not produce the symptoms of brain metastases can also cause increased intracranial pressure, headache, vomiting, or focal neurological symptoms, or even paralysis. Peripheral lung cancer brain metastases often the first symptom treatment.
Liver metastasis at the few not cause symptoms or signs of abnormal liver function tests do not necessarily performance, only in the conventional staging examination or CT scan for B-only to be found. Or transfer of a huge majority of the liver, the liver enlargement, abnormal liver function.
Transfer the digestive tract may be asymptomatic or may have gastrointestinal bleeding. Kidney, adrenal gland, abdominal lymph nodes, or contralateral lung metastases, generally does not show clinical symptoms, occasional large mass mainly due to local complaints and seek treatment.
Can produce a variety of lung cancer with tumor syndrome (Paraneoplastic syndrome), can be detected in the lung appears before the original lesion, the most common in small cell carcinoma. Tumor syndrome associated with the performance of the following:
1. Systemic manifestations loss of appetite, weight loss and general weakness.
2. Acanthosis nigricans skin, pigmentation, keratosis, dermatomyositis.
3. Bones pulmonary osteoarthropathy.
4. Cardiovascular system in the non-bacterial thrombotic endocarditis (occur in the mitral valve), migration of embolic vasculitis, are more common in primary adenocarcinoma; artery thrombosis.
5. Neuromuscular system in the encephalopathy, cerebellar cortical degeneration, peripheral neuropathy, polymyositis, Lambert-Eaton syndrome (manifested as myasthenia gravis).
The clinical manifestations of lung cancer 6. Ectopic endocrine system in the excessive secretion of adrenocorticotropic hormone (Cushing syndrome), excessive secretion of anti-Lee urea (low sodium acidosis, plasma osmolality decreased), hypercalcemia (more common in scale carcinoma and large cell carcinoma, for unknown reasons, in addition to extensive bone metastases can also cause increased blood calcium), growth hormone, human chorionic gonadotropin, calcitonin, prolactin, and serotonin caused increased secretion of a variety of symptoms were occasionally seen to.
The clinical manifestations of lung cancer