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Lung Cancer 4

Lung cancer
pathology

Question

Vignette: A 55-year-old man with a past medical history of smoking and chronic alcohol use presents to his primary care physician complaining of a persistent cough and unintentional weight loss over the past few months. Physical examination reveals a frail man with pallor, lymphadenopathy, and clubbing of the fingers. A chest X-ray shows a large mass in the right upper lobe of the lung. Biopsy of the mass reveals atypical cells with large, irregular nuclei. What is the most likely pathology reflected in these findings?

Choices

A. Small cell lung cancer

B. Squamous cell lung cancer

C. Adenocarcinoma of the lung

D. Large cell lung cancer

E. Carcinoid tumor of the lung

Answer

A. Small cell lung cancer

Explanation

The patient's history of smoking, symptoms of persistent cough and weight loss, physical findings of lymphadenopathy and clubbing, and chest X-ray findings of a lung mass all point to lung cancer. The biopsy finding of atypical cells with large, irregular nuclei is characteristic of small cell lung cancer (SCLC). SCLC is a neuroendocrine tumor that is strongly associated with smoking. It often presents with distant metastasis and is known for its aggressive behavior. The presence of clubbing and lymphadenopathy suggest that the tumor has spread beyond the lung.

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