The pathology report indicated that the patient had squamous cell carcinoma (SCC) of the lung, a diagnosis that was consistent with an x-ray and computed tomography (CT) scan that were also done.
Lung cancer is a malignant neoplasm of the lung arising from the respiratory epithelium (bronchi, bronchioles/alveoli). The 4 major cell types responsible for 88% of cases are:
○ adenocarcinoma (including bronchoalveolar)—32% of cases
○ squamous cell carcinoma—29% of cases
○ small cell (or oat cell) carcinoma—18% of cases
○ large cell (or large cell anaplastic)—9% of cases.
Smoking is the major risk factor for lung cancer; a smoking history (current or former) is present in 90% of cases, with a risk ratio (RR) of 13 (passive smoke exposure has a RR of 1.5). Skin nodules from lung cancer metastases may not be painful but are a poor prognostic sign.
Any time spent helping your patients quit smoking may help avert a fatal outcome. In this case, the patient opted not to receive treatment. She passed away 10 months later.
Photos courtesy of Leonard Chow, MD, Ross Lawler, MD, and David Kasper, DO. Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith M. Lung cancer. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:355-364.
To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/
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