Longkanker Epidemiologie:
- 88% van de mensen die longkanker krijgt overlijdt hieraan
Diagnostiek:
- Weefseldiagnose → biopt
- Stadium → PET, EUS/EBUS, mediastinoscopie
- Fitheid → long- en hartfunctie
- Beeldvorming → CT, MRI
Behandeling:
- Chirurgisch (alleen effectief als):
- Tumor geheel verwijderen
- Geen afstandmetastasen
- Patient operabel
Pancoast tumor met
Hornersyndroom
Syndroom van Symptomen:
Pierre-Marie-Bamberger - Overmatige vorming van huid en bot aan distale uiteinden van het
lichaam → vingers en tenen = clubbing
Vena cava superior Veroorzaakt bij doorgroei van een tumor in de
syndroom long.
Grootcellig carcinoom - Slecht gedifferentieerd
- Metastaseert snel
Kleincellig longcarcinoom - Kleine cellen met grote kern
- Neuro-endocrine cellen
- Hormoonproductie
- Vaak rokers
- Centraal
- Snelle metastasering
- Veel necrose
Paraneoplastische symptomen:
- Neurologisch → anti-VGLC
- Hormoonproductie → SIADH, ACTH productie
- Musculoskeletaal → hypertrofische pulmonlae osteoarthropathie
Mesothelioom - Longvlieskanker
- Maligne mesotheelcellen
- Slechte prognose
- Diagnose moeizaam
Oorzaak:
- Asbestexposure
Symptomen:
- Pijn
- Dyspnoe
- Pleuravocht
- Verkleining van long
- Geen metastasering op afstand
Squamous cell carcinoma Incidentie → afgenomen <35%
- Plaveiselcelcarcinoom
- Epitheelcellen
- Keratine productie
- Cavitatie met centrale necrose
- Proximaal → obstructie
- Rel. late metastasering
- Hypercalciëmie
KR Hemoptoë
Community-acquired - Vaker bij jonge kinderen en ouderen
pneumonia (CAP) - Infectie gelokaliseerd in bepaalde lob of diffuus aanwezig
Risicofactoren:
- Leeftijd onder 16 of boven 65 jaar oud
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