Lung Cancer : Mnemonics


Most common cancer: Metastases

Primary lung cancer:

Small (oat) cell carcinoma15%Sentral (central)SmokerNeuroendocrine differentiation (Kulchitsky cells)
Aggressive (disseminate early – lymphadenopathy)
Paraneoplastic syndrome (ACTH, ADH, Antibodies – Lambert eaton)
Adenocarcinoma40%PeripheralNon-smoker (most common)k-Ras, EGFR, ALK mutations
Hypertrophic osteoarthropathy (clubbing)
Bronchio-alveolar subtype (pneumonia-like): Excellent prognosis, apparent “thickening” of alveolar walls
Squamous cell carcinoma25%Sentral (central)Smoker (most common)Hilar mass
Calcium (PTHrP)
Keratin pearls and intracellular bridge
Large cell carcinoma10%PeripheralSmokerPoor prognosis
Pleomorphic giant cells
Carcinoid tumor2%CentralNon-smokerExcellent prognosis
Mass effect
Carcinoid sydrome (rare)
Chromogranin A +
small cell cancer lung
“Small cell lung carcinoma simulating mesothelioma” by Pulmonary Pathology is licensed under CC BY-SA 2.0.

Growing rate (Doubling time)

Mnemonic: SmS LA

  1. Small cell carcinoma: 30 days
  2. Squamous cell carcinoma: 90 days
  3. Large cell carcinoma: 120 days
  4. Adenocarcinoma: 150-180 days


1. Small cell lung cancer (SCLC): Chemotherapy +/- Radiotherapy

2. Non-small cell lung cancer (NSCLC):

  • Stage I, II, IIIA: Surgical resection +/- Chemo-radiotherapy
  • Stage IIIB, IV: Chemo-radiotherapy
    • >1 lobe involvement (ipsilateral or contralateral)
    • 2 sides local nodes involvement (contralateral mediastinal/hilar)
    • Mediastinal structure invasion
    • Distant lymph node metastases
    • Distant metastases

Contra-indications to lung surgery:

  1. SVC obstruction
  2. FEV1 <1.5
  3. Malignant pleural effusion
  4. Vocal cord paralysis

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