Carcinoma of The Lungs

Carcinoma of The Lungs

Summarize

Lung cancer originates from lung tissue. The lungs are a pair of cone-shaped respiratory organs located in the chest. During inhalation, the lungs bring oxygen into the body. During exhalation, they release carbon dioxide, which is waste from the body's cells. Each lung consists of lobes. The left lung has two lobes, while the right lung, slightly larger, has three lobes. Two tubes, known as bronchi, connect the trachea to the left and right lungs. The lungs are composed of small air sacs (alveoli) and small tubes (bronchioles).

        In children, most lung tumors are malignant (cancer). The most common lung tumors are tracheobronchial tumors and pleural pulmonary blastomas.

 

 

 

Tracheobronchial tumors

 

 

        Tracheobronchial tumors originate from the surface cells of the lungs. Most tracheobronchial tumors in children are benign and occur in the trachea or large bronchi (the large airways of the lungs). Sometimes, a slowly growing tracheobronchial tumor may also become malignant and spread throughout the body.

 

The respiratory system anatomy shows the trachea and the two lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown in the figure. Oxygen is drawn into the lungs, through the membranes of the alveoli into the blood vessels (see small picture).

Epidemiological

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Etiology & Risk Factors

The following factors increase the risk of pleural pulmonary blastoma:

50. There is familial cancer syndrome of pleural pulmonary blastoma.
50. The DICER1 gene has specific changes.
50.         Serosalipemoma may cause any of the following symptoms and signs. If your child has any of these, consult a pediatrician: • Persistent cough
50.  expiratory dyspnea
50.  have  a fever
50. Lung infections, such as pneumonia
50.  be short of breath
50. Pain in the chest or abdomen
50.  anorexia
50. Unexplained weight loss
50. I feel very tired

        In addition to pleural pulmonary blastoma, other conditions may also cause these signs and symptoms.

Classification & Staging

50. Doctors usually do not perform biopsies on abnormal areas because that can cause severe bleeding. Other tests used to diagnose tracheobronchial tumors include:
50. Bronchography: This procedure is used to examine any abnormal areas within the trachea and the airways of the lungs. A bronchoscope, a thin, tube-like instrument equipped with a light source and an observation lens, is inserted through the nose or mouth into the trachea and lungs. By injecting contrast agent through the bronchoscope, the larynx, trachea, and airways become clearer on X-ray images.
50. Octreotide scan: This is a radiolabeled scanning technique used to detect carcinoids and other types of tumors. A very small amount of radioactive octreotide, a hormone that binds to carcinoid tumors, is injected into the vein and circulates through the bloodstream. Once the radioactive octreotide binds to the tumor, a specialized camera that detects radioactivity can be used to map the tumor's location in the body.

Clinical Manifestations

 S&S

 

 

Tracheobronchial tumors can cause any of the following signs and symptoms. If your child has any of these, consult a pediatrician:

 

 cough ​

 be short of breath

 expiratory dyspnea

Blood is coughed up from the airway or lungs

Frequent lung infections, such as pneumonia

        In addition to tracheobronchial tumors, other conditions can also cause these signs and symptoms. For example, asthma symptoms are similar to those of tracheobronchial tumors, which can interfere with cancer diagnosis.

Clinical Department

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Examination & Diagnosis

Diagnosis and staging

 

The diagnosis and staging of tracheobronchial tumors can be made by the following examinations:

 

Physical exam and medical history.

Chest X-ray examination.

CT scan 。

        For a description of these checks and processes, see the basic information section above.

 

 

The following examinations can be used to diagnose and stage pleural pulmonary blastoma:

Physical exam and medical history

Chest X-ray examination

CT scan

PET scan

        For a description of these checks and processes, see the basic information section above.

 

        Other tests used to diagnose pleural pulmonary blastoma include:

 

Bronchoscopy: This procedure is used to examine the trachea and the airways within the lungs for any abnormalities. The bronchoscope is inserted through the nose or mouth into the trachea and lungs. It is a thin, tubular instrument equipped with a light source and a lens for observation. Sometimes, the bronchoscope also includes a tool for obtaining tissue samples, which can be examined under a microscope for signs of cancer.

Thoracoscopy: A surgical procedure used to examine abnormal areas within the chest. The procedure involves making an incision between two ribs and inserting a thoracoscope into the chest. The thoracoscope is a thin, tube-like instrument equipped with a light source and a lens for observation. Sometimes, it also includes a tool for obtaining tissue or lymph node samples, which can be examined under a microscope for signs of cancer. In some cases, this surgery may also involve removing part of the esophagus or lung. If the thoracoscope cannot reach certain tissues, organs, or lymph nodes, a thoracotomy, a larger incision between the ribs and the chest, may be necessary.

        Even after surgical resection, pleural pulmonary blastoma can spread or recur.

Clinical Management

The treatment of tracheobronchial tumors depends on the type of cancer cells. Treatment for children with tracheobronchial tumors may include:

50. The tumor is surgically removed. Sometimes a procedure called a sleeve resection is used. If cancer cells have spread to the lymph nodes and blood vessels, they should also be removed during surgery.
50.  chemotherapy
50.  radiotherapeutics
50. Targeted therapy: Crizotinib (CZT)

        Children with recurrent tracheobronchial tumors may consider participating in clinical trials to test for changes in genes in the patient's tumor samples and to target the patient based on the type of gene change.

 

        For more information, see the section on neuroendocrine tumors (carcinoid tumors) below.

 

 

 

Thoracic pulmonary blastoma

 

        Pleural pulmonary blastoma (PPB) forms in the tissue of the lung and pleura (the tissue that covers the outside of the lung and is arranged inside the chest). Pleural pulmonary blastoma can also form in organs such as the heart, aorta, and pulmonary artery, or in the diaphragm (the main respiratory muscle below the lungs).

 

        There are three types of pleural pulmonary blastoma:

 

50. Type I tumors are cystic tumors of the lung that are most commonly seen in children under 2 years of age and are usually curable. Type Ir tumors are those that have shrunk, or not grown or spread from type I tumors. ​
50. Type II tumors are cystic and have some solid tumor parts. These tumors sometimes spread to the brain.
50. Type III tumors are solid tumors that often spread to the brain.

 

 

For information on the following treatments, see the treatment overview section above.

        The treatment of pleural pulmonary blastoma in children includes the following methods:

 

The surgery involves removing the entire lobe of the lung containing the tumor, and in some cases is supplemented with chemotherapy.

        Treatment of recurrent pleural pulmonary blastoma in children may involve the following approaches: • Clinical trials of targeted therapy using monoclonal antibodies.

 

Participate in clinical trials to detect changes in genes in patients' tumor samples. And based on the type of gene change, patients are treated with targeted therapy.

Prognosis

Unless the child has rhabdomyosarcoma, the prognosis (chance of recovery) for children with tracheobronchial cancer is very good.

 

The prognosis (chance of recovery) depends on the following:

Types of pleural pulmonary blastoma

Diagnose whether the tumor has spread to other parts of the body.

Whether the tumor was completely removed during surgery.

Follow-up & Review

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Daily Care

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Cutting-edge therapeutic and clinical Trials

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References

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Audit specialists

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