Chronic Cough Due to Lung Tumors
Primary bronchogenic carcinoma is the most common lethal malignancy in the United States, with > 172,000 new cases expected in 2003. Moreover, malignancies that arise in other organs will often metastasize to the lungs. As the entire blood flow must traverse the lungs during a normal circuit, malignant cells that enter the bloodstream may become entrapped in the pulmonary capillaries. Far less frequently, the bronchial arterial supply gives rise to metastases from other primary organ sites into the conducting airways. Any form of cancer involving the lungs may be associated with cough. However, cough is more likely to indicate involvement of the airways than the lung parenchyma because of the location of cough receptors. Adenocarcinoma of the lung usually occurs in the periphery of the lung, and it may not cause cough as an early symptom. Cancer cell types that are centrally located in the airways (ie, squamous cell carcinoma and small cell undifferentiated lung cancer) are more likely to cause cough at the time of presentation. Carcinoid tumors, mucoepidermoid carcinoma, and adenoid cystic carcinoma usually arise in the more central conducting airways, and cough is often a presenting symptom for these less common airway neoplasms.
Bronchoalveolar cell carcinoma, a type of primary lung cancer that is parenchymal in location, accounts for 2 to 4% of all primary lung cancers. This cell type may be confused with pneumonia because of its airspace opacification pattern that is apparent on a chest radiograph. While cough that is productive of large amounts of thin sputum is the paradigm often used to characterize the clinical presentation of patients with bronchoalveolar cell carcinoma, most patients with this type of lung cancer have a nonproductive cough. canada-neighbor.com
A MEDLINE literature review was conducted (through March 2004) for all studies published in the English language, including case series and case reports, since 1966 using the medical subject heading terms “cough” and “lung neoplasms.” The focus of this section is to review the management of cough associated with tumors in the lung. While hemoptysis means that the patient has coughed up blood, this section will not focus on the management of hemoptysis. For those readers who wish to read more about hemoptysis, see the review article by Jean-Baptiste.
Category: Respiratory Symptoms
Tags: ablative methods, antitussives, brachytherapy, bronchoscopy, chemotherapy, electrocautery, endobronchial treatment, laser, lung cancer, metastatic carcinoma (to lungs), radiation therapy, stents, Surgery