Case History 1: Lung Cancer

Return to Main Page Chief Complaint: 68-year-old man with a cough and dyspnea ("shortness of breath") for the past week. History: Daniel McDonald, a 68-year-old white male with a 40-pack-year smoking history suffered from chronic bronchitis for which he had been on antibiotics for several months. Two weeks ago, he began coughing up a bloody sputum ("hemoptysis"). In the past week he's become increasingly short of breath. A routine chest X-ray revealed two silver dollar-sized opacities on the right side of the carina. Bronchoscopic examination revealed a tumor that was nearly occluding the right mainstem bronchus. A bronchial biopsy revealed the diagnosis: bronchogenic carcinoma. Questions: 1. Define the term "bronchogenic carcinoma." Enter your answer here. Answer 2. Ninety percent of all cancers arise from epithelial tissue. Why do you suppose this is? Enter your answer here. Answer 3. Describe the structure of the bronchial epithelium. Enter your answer here. Answer 4. What is the "mucociliary escalator"? Enter your answer here. Answer 5. This man has a long history of infectious bronchitis. Why would this chronic smoker be especially susceptible to infections of the bronchi? Enter your answer here. Answer 6. Explain why this man has bloody sputum ("hemoptysis"). Enter your answer here. Answer 7. Explain why this man has shortness of breath ("dyspnea"). Enter your answer here. Answer 8. If you examined the cancerous tissue under the microscope, how might the cells differ in appearance from normal bronchial epithelium? Enter your answer here. Answer 9. How might this type of cancer metastasize (i.e. spread to other parts of the body)? In other words, by which routes might the cancer cells reach other organs? Enter your answer here. Answer 10. Why is the surgical removal of a lung cancer so ineffective in halting the disease? Enter your answer here. Answer Return to Main Page Copyright ©2000 The McGraw-Hill Companies. All rights reserved. Any use is subject to the Terms of Use and Privacy Policy. McGraw-Hill Higher Education is one of the many fine businesses of The McGraw-Hill Companies. If you have a question or a problem about a specific book or product, please fill out our Product Feedback Form. For further information about this site contact mhhe_webmaster@mcgraw-hill.com or let us know what you think by filling out our Site Survey.