What causes pulmonary adenocarcinoma

Clinical picture

Different forms of cancer

Medical professionals differentiate between two types of lung cancer
This is the space in the rib cage between the two lungs that houses the thoracic viscera - i.e. the heart, associated nerves, vessels and lymph nodes. The pleurs (pleura and pleura), which line the two pleural cavities with the lungs, form a partition between the mediastinum and the lungs. To the front and back, this space is bounded by the breastbone and thoracic spine, and from above and below it extends approximately from the level of the collarbone down to the diaphragm.
: the small cell lung cancer), which grows particularly quickly and accounts for around 15 percent of cases, and that non-small cell lung cancer (NSCLC: non small cell lung cancer), which occurs most frequently at around 85 percent.

In the case of non-small-cell lung carcinomas, a further distinction is made between the so-called adenocarcinoma adenocarcinoma
This is a carcinoma of the tissue that forms the gland. It is the most common cancer among non-smokers. Adenocarcinomas account for 40% of all bronchial carcinomas. In the case of lung cancer, one also speaks of an alveolar cell carcinoma - a rare, usually small-nodular, sometimes fuzzy (diffuse) lung tumor (pneumonic form) made of mucus-forming, highly differentiated cells (so-called columnar epithelial cells), which often have individual lung sections on both sides or the right AND affects the left lobe. Adenocarcinoma mostly originated in the tissue cells (alveolar epithelial cells) surrounding the alveolar sacs, but sometimes also in the tissue cells surrounding the bronchioles (bronchiolar epithelial cells - then one speaks of "bronchioloalveolar carcinoma").
(40 percent of all lung cancers), squamous cell carcinoma
Tumor of the skin and mucous membranes, in the respiratory tract, can particularly affect the oral mucosa, tongue, throat, windpipe and bronchi. Squamous cell carcinomas make up about 25% of all lung cancers.
(25 percent) and large cell carcinoma (15 percent). Non-small cell lung cancers grow more slowly and therefore have a better prognosis overall. What type of tumor it is can only be determined by examining the cancerous tissue under a microscope.

All carcinomas rarely cause discomfort at the beginning of their growth. That is why they are almost always discovered by chance at an early stage, for example during x-ray examinations that are carried out for a different reason. Only in advanced stages do symptoms appear that could indicate a carcinoma, but for which other causes are also conceivable.

Possible symptoms of bronchial carcinoma

Early signs that could indicate lung cancer include, in particular, a prolonged cough for four weeks, difficulty breathing, and chest pain. However, firstly, such symptoms are not necessarily typical for a tumor disease; secondly, they also occur in many other diseases. In this respect, lung cancer is often not discovered early enough. On the other hand, there are only good chances of recovery if bronchial carcinoma is treated as early as possible. In advanced stages of the disease, there is often rapid weight loss, bloody sputum, breathing difficulties and / or fever, mostly triggered by accompanying infections.

The following symptoms can indicate bronchial carcinoma and should therefore be clarified by a doctor:

  • "Smoking bronchitis" (i.e. persistent cough with expectoration due to years of cigarette consumption)
  • Persistent cough that doesn't go away even after several weeks and then suddenly changes
  • Persistent hoarseness
  • Bronchitis or a cold that doesn't get better despite treatment with antibiotics
  • Shortness of breath
  • Constant chest pain
  • Night sweats
  • Expectoration with or without blood
  • Swelling of the neck and face
  • Loss of appetite or severe weight loss
  • General feeling of illness and loss of strength
  • Paralysis
  • Strong pain
  • Fever flare-ups

Mostly in later stages of the disease, especially in small cell lung cancer, cancerous settlements can develop in the brain (so-called brain metastases). By damaging their nerves, they cause headaches, nausea, impaired vision and balance, or even paralysis. Some tumors also release hormones into the blood and thus disrupt the natural hormone balance.

Grading & staging of a tumor

During a microscopic examination, in addition to the type of tumor, the aggressiveness and growth rate of a tumor - and thus its prognosis - can be estimated. In the so-called "grading", the tumors are divided into four grades:

  • G1 tumors: very similar to their original tissue, still well differentiated, grow slowly and not very aggressively.
  • G2 tumors: moderately differentiated
  • G3 tumors: poorly differentiated
  • G4 tumors: undifferentiated, hardly recognizable as a bronchial cell, grow quickly and tend to grow aggressively into neighboring tissue.

Information on the degree of differentiation through grading is only useful for squamous cell and adenocarcinomas. Large and small cell carcinomas always correspond to grade 4 tumors.

The spread of a lung cancer is assessed by means of “staging” according to the so-called TNM classification. The stage of cancer is characterized using the following three criteria:

  • the size and extent of the tumor (T1-4),
  • the number and location of the affected lymph nodes nodes, N0-3) and
  • the absence or presence of metastases
    Daughter tumors spreading from cancer
    (M0 or M1).

For example, small tumors (such as T1 and T2) without lymph node involvement (N0) and without daughter tumors (M0) have a more favorable prognosis. In the case of small cell lung cancer, doctors also differentiate between a spatially limited limited) and a more extensive or advanced disease extensive disease). While the tumor is limited to one lung in the limited disease, the disease is called advanced when the cancer has spread to neighboring tissue in the chest and other parts of the body.