para neoplastic syndromes in lung cancer
TRANSCRIPT
![Page 1: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/1.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 1/18
Stelson Natalia
![Page 2: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/2.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 2/18
MANIFESTATIONOF CANCER
RECURENCE OFCANCER
![Page 3: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/3.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 3/18
Neuromuscular
Vascular
Hematological
Metabolic
Involving skeletal, muscular system and skin
![Page 4: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/4.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 4/18
2-6% of initial tumors
8-12% during disease
51% squamosous cell carcinoma
22% adenocarcinoma
15% SCLC (small cell lung cancer)
Most patients III –IV stage or bony mts
![Page 5: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/5.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 5/18
Anorexia
Nausea
Vomiting
Constipation
Lethargy
Polyuria
polydipsia
Dehydratation
![Page 6: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/6.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 6/18
PTHrP (parathyroid hormon relatedprotein)
PTH ( parathormone)
Calciotriol
Cytockines ( osteoclast activatingfactors)
![Page 7: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/7.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 7/18
- 70% structure the same as PTH +13 aminoacids onN-terminus
- Uses the same receptor with PTH
-
Has the same activity as PTH- activating of osteoclastic resorbtion,
- increasing Ca++ reabsorption,
- decreasing of P reabsorbtion
- stimulation renal 1-alpha-hydroxilase,resulting of production of 1,25-(OH)2-D3 thenincreasing of Ca++ reabsorbtion.
PTHrP cancer cell surviving factor
![Page 8: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/8.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 8/18
80% SCLC and squamous cell carcinoma
![Page 9: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/9.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 9/18
IL-1, IL-6, transforming growth factor (TGFalpha), tumor necrosis factor (TNF), granulocytescolony stimular factor (G-CSF)
TGF alpha + TNF = increase osteoclastic activity
TGF alpha + TNF +IL-1+IL-6 = enhancing PTHrP
![Page 10: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/10.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 10/18
30-70% of all tumors, but most cases withoutsignificant symptoms
10% of SCLC product ADH
Symptoms – decrease Na+ and osmolarity od
blood, increase Na+ in urine
![Page 11: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/11.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 11/18
ACTH is produced by 50% of tumors
30% of SCLC
But clinically rare
Pulmonary carcinoids produce ACTH in 35-95%
SCLC with Cushing syndrome often resistant to
the chemotherapy
![Page 12: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/12.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 12/18
Anemia (38%) (IL-1, IL-6, IFN-gamma inhibiterytropoesis)
Leucocytosis (15%) ( G-CSF production bytumor)
Thrombocytosis (16-32%) bad prognosis
Eosinophilia (rare) bad prognosis
![Page 13: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/13.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 13/18
Trousseau’s syndrome (superficial thrombophlebitis)
Deep venous trombosis
![Page 14: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/14.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 14/18
Tissue factor production
Normal agent that
initiates clotting in caseof damage of tissue
(often NSCLC)
Cancer procoagulant
is a hypothesised
protein, most likely acysteine proteaseenzyme, that occurs onlyin fetal and malignant
cells. Its activity appearsto be the activation offactor X
![Page 15: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/15.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 15/18
Digital clubbing
Hypertrophic pulmonary osteoarthropathy
(HPO) -12% adenocarcinoma
Dermato- and polymyositis – associate 40%
SCLC
![Page 16: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/16.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 16/18
0,01% ; exclusively SCLC; almost all caused byantibodies to the neural tissue
Lambert-Eaton myastenic syndrome (LEMS) –antibodies to the voltage gated Ca++ channels
Limbic encephalitis (encephalopathy) –antibodiesthe RNA-binding proteins
Polyneuropathy
Neuromyothonia - antibodies to the voltage gatedK + channels
Autoimmune autonomic gangliopathy -antibodies to neuronal Ach receptors
![Page 17: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/17.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 17/18
Palmo-plantar hyperceratosis (tylosis) –canprecede of diagnosis of cancer for months or years.Poor prognosis
Akantosis nigricans ( some cases associate with
lung cancer) Acquired hypertrichosis languinosa Erythema gyratum repens Erythema multiforme
Erythroderma Exfoliative dermatitis Sweet syndrome Pruritus and urticaria
![Page 18: Para Neoplastic Syndromes in Lung Cancer](https://reader030.vdocuments.site/reader030/viewer/2022021115/577d20101a28ab4e1e91e98b/html5/thumbnails/18.jpg)
8/2/2019 Para Neoplastic Syndromes in Lung Cancer
http://slidepdf.com/reader/full/para-neoplastic-syndromes-in-lung-cancer 18/18
part of the general adaptation of the body
often seen in trauma, inflammation, infection, andcancer.
proinflammatory cytokines - (TNF)-alpha,(IL)-1,IL-6, interferon (IFN)-gamma, and ciliaryneutropic factor (CNTF) have been implicated incachexia
mediators - proteolysis-inducing factor (PIF)and
lipid mobilizing factor (LMF) anorexia and metabolic alterations. Cancer patients
frequently exhibit a relative glucose intoleranceand insulin resistance