Question

chief Complaint: 40-year-old man with a cough and dyspnea. History: Joe Butt, a 40-year-old white male with a 52-pack-year smoking history suffered from chronic bronchitis. For the last several months he has been on an antibiotics treatment. Three weeks ago, his otherwise normal smoker’s cough started producing bloody sputum ("hemoptysis"). In the past week Joe has become increasingly short of breath ("dyspnea"). A routine chest X-ray revealed a couple of quarter-sized opacities in his right lung around the alveoli. Bronchoscopic examination revealed the tumors were nearly occluding two major bronchioles in his right lung. A bronchial biopsy revealed the diagnosis: bronchogenic carcinoma. Questions: 1. What is "bronchogenic carcinoma"? What medical professional most likely confirmed the nature of the biopsy? 2. Describe the structure of the bronchial epithelium. How many layers of cells make up this tissue? 3. Describe what the “mucociliary escalator" is and it’s function in the respiratory system. 4. What two conditions do you think have led to Joe experiencing a shortness of breath ("dyspnea")? 5. What is the most likely or common way that this type of cancer may metastasize (i.e. spreading to other parts of the body)?

Answer 1

Questions:

1.What is "bronchogenic carcinoma"? What medical professional most likely confirmed the nature of the biopsy?

Bronchogenic carcinoma is a malignant neoplasm of the lung. It arises from the epithelium of the bronchus or bronchiole.

Pathology: Bronchogenic carcinomas begin as a small focus of atypical epithelial cells within the bronchial mucosa.

An oncologist is the medical professional who confirms carcinoma.

2.Describe the structure of the bronchial epithelium. How many layers of cells make up this tissue?

The bronchial epithelium is a complex structure made up of 3 layers of cells: Ciliated cells,Goblet cells,, and basal cells.

The ciliated cells:They are columnar epithelial cells with specialized ciliary modifications.

Goblet cells:They are columnar epithelial cells that contain membrane-bound mucous granules and secrete mucus.

The basal cells: They are small, nearly cuboidal cells which have some ability to differentiate into other cells types found within the epithelium.

3.Describe what the “mucociliary escalator" is and it’s function in the respiratory system.?

The mucociliary escalator is one of the major defence mechanisms which protect the lung.

The goblet cells in the epithelial lining secrete a protective mucus. The foreign particles and waste get stick on to this mucus.The epithelium lining the respiratory tract is covered in small hairs called cilia. The rhythmic ciliary movement propels out secreted mucus and foreign particles toward the laryngopharynx upwards and outwards. This process called the mucociliary escalator.

Function of mucociliary escalator: keeps the lower respiratory tract sterile, and prevents mucus accumulation in the lungs.

4. What two conditions do you think have led to Joe experiencing a shortness of breath ("dyspnea")?

1.Smoking

2.Obstruction of bronchus by carcinoma

5. What is the most likely or common way that this type of cancer may metastasize (i.e. spreading to other parts of the body)?

Lung cancers can spread when cells break off from the tumor, and travel through the bloodstream or the lymphatics to distant regions of the body and grow. This process is called metastasis.

Lung cancer can spread to nearly any region of the body. The most common areas for lung cancer to spread are the regional lymph nodes, liver, bones, brain, and adrenal glands. Most lung cancers first spread to lymph nodes in the chest near the tumor.