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Clinical features Cough, haemoptysis, dyspnoea, chest pain, recurrent and slow
resolving pneumonia, anorexia, LOW and LOA
Cachexia, pallor, clubbing, HPOA, lymphadenopathy, Horners
syndrome
Pulmonary consolidation, collapse, or effusion
Mets: Bone tenderness, hepatomegaly, confusion, fits, local CNS
signs, cerebellar syndrome, proximal myopathy (dermatomyositis)
and peripheral neuropathy, supraclavicular lymph node (SCC)
Complication 1. Local
Recurrent laryngeal nerve and phrenic nerve, SVC
obstruction (headache, facial congestion, dilated veins),
Horners syndrome (sympathetic ganglion), rib erosion and
pericarditis, Pancoast Syndrome (invasion of lower trunks
(C8-T1) of brachial plexus (wasting of small muscles of hand)
2. Mets
Brain (spinal cord compression), bone, adrenal -> Addisons
and liver
3. Endocrine
Paraneoplastic syndrome (SIADH, high ADH and high ACTH
by SCC; high PTH by squamous cell carcinoma;
gynaecomastia by adenocarcinoma)
4. Neurological
Confusion, cerebellar syndrome, fits, neuropathy,
polymyositis/dermatomyositis, Lambert-Eaton Myasthenic
Syndrome (LEMS)