Patient Encounter Part 1

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A 53-year-old African American man presents at your clinic complaining of new-onset cough. He has had several upper respiratory infections in the last 2 months, with occasional hemoptysis. He has consistently smoked 1.5 packs per day for the last 20 years. He has worked as a bartender at a local restaurant for most of his life.

What risk factors for lung cancer are present?

Calculate this patient S pack-year history.

Table 90-1 Diagnostic Tools

Technique Deittlpli-on

ViiUiCi/dlion CXH T he lean erpensiw visualization method In (he diagnosis of lung cancer. flej(f>ly accessible and dûKrtûl ittiuiiù sysh-ih* ÂdMitàlMïiMlOf COfWiit dyt Huwcvci. il öIIcti (fcti^li löüöiiSUwl ane-notcancetows and is na rapaWe (/ awessing lymph nodesiams CT More actuiile when providing Iniotmalicri on si/e, location and invasion (hanCXR. II is

(«oriiWVJed «part at iheîiiTKJdf<J*Oi!imr>iri möü öS« PÇT sçanmnçj Uses ambsiarfpca'led SF[Xjlo prç>dLH;e a Functional ImatfpofHw lungs. Cflklhjt aie actively giûwintj Hfl dividing use tFftHw amounts of qIuîûk- J**] theictoieijfce uf>mc<e S-FD6. r« ji fefjioni of fluoniscerife tan fcf visujlii«! in «ntens« lesörn PfT kinning (ofinfcified writiaCT scan k mo*e accurate than CT scan atones however, (he exact terie ai Pf T scanning iri siagifi^ add irtonicoring is uf* Kar. T lie apparent btnclii and common tôle In it^ing ü to evaluate mediastinal disease i*tien it can airtvf nte ih? minoi iew ny llJIIHj Sjn1 Ijlinil

Fine-nettle aspiration


A method cí «ciijoifig teils fiorn ine tumor vü inserttm oí ¿ simll-tos- needle Into ine lesion and aspirating. fo"rnonk used to evaluate lymph nodes or «her poorty Kfessible-sne^H has UKíddvdrUjyeül Mw¡ fjste< jndlKi invasiv*? (fun other biútny mMlödi, iKJUrtver, S dooi nan pr«er*f ine anchit« ture of i he Tumo< and rnjy letum teils día are undergoing ceil dejnli. v.fitch ne^ales hislologk analysis

AffcertpK tjrmtJ t, inset led [hmxjh ilv jirwjys Doesunine Use d Ihe lusjxtled lesion, einreihe lesion is-vtaiabrcd.anxJ an^cfwjtotlv^c.wneiaalkiivs rev a usmk? biipsyMe*v« technologies ineorpoiale fluorescente to diffeiemiate malgrui [ksuefnom pemaiignarH lesions

Core needle biopsy A mell'od ct attaining lissueand preserving the tumor archilecture. A liirgebcma ne«Se c inserted into j lesiOrt. MdlHi it íiílv i tíHO Of tiiSuO out Itut [hin tin be óvjlu.jl!I Thoiacentetís IiwoIum romoviil of I hud In the pleural cavlly iu a ncedk?. 1 he fluid then Is aiia^ied for píeseme

í jrnerous Wfc. T his pröiiAi« hjs low senility ¿lid dependí on HV-preserKeof a pfcurjl effuilcn

Spuiiktn cytology Cenvtsianfeioi.s oHk thai become dislodqed from the anway^ Intn che spuitun. Sputum ¿yiabgyisuseíJ because ¡i ¡i ma invjsjwt. Jlihougiti it has much loy»cr ¡tnuiriviiy foi Meiling «ncer

CXR.thCít í rJvíPET.posillWi flmiSítOniOrrtO^rJphv. fJiYrl Bivf 13,

Table 90-2 Lung Tumor Histopathology

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The Smoker's Sanctuary

The Smoker's Sanctuary

Save Your Lungs And Never Have To Spend A Single Cent Of Ciggies Ever Again. According to a recent report from the U.S. government. Centers for Disease Control and Prevention, more than twenty percent of male and female adults in the U.S. smoke cigarettes, while more than eighty percent of them light up a cigarette daily.

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