Q) A 73 year male, old heavy smoker presents with haemoptysis. On examination he is cachectic and shows evidence of clubbing. Imaging shows a main bronchial tumour with massive mediastinal lymphadenopathy together with widespread visceral metastases. Which of the following variant is likely in him?
( Theme from mock test 12- 24)
a) Adenocarcinoma
B. Small cell lung cancer
C. Large cell lung cancer
D. Squamous cell carcinoma
Patient: 73-year-old male, heavy smoker
Symptoms: Hemoptysis, cachexia, clubbing
Imaging: Main bronchial tumor with massive mediastinal lymphadenopathy and widespread visceral metastases
Likely Variant:
B. Small cell lung cancer (SCLC) is the most likely diagnosis.
Rationale:
Small Cell Lung Cancer: This type of cancer is strongly associated with heavy smoking and is characterized by aggressive behavior and early metastasis. Most patients present with disseminated disease, as seen in this case.
Clinical Features: The combination of hemoptysis, cachexia, and clubbing aligns well with SCLC, which can also lead to various paraneoplastic syndromes.
Other Tumors:
Adenocarcinoma: More common in never smokers and typically peripheral, not fitting the profile here.
Squamous Cell Carcinoma: Generally grows slower and is also typically centrally located, but not usually associated with such widespread metastasis at presentation.
Large Cell Lung Cancer: While it can be aggressive, it’s less commonly associated with extensive lymphadenopathy and visceral metastases compared to SCLC.
