Lung Cancers

Syndrome of inappropriate antidiuretic hormone (SIADH) can be caused by a multitude of conditions, including tumors, drugs, and disorders of the chest and central nervous system. SIADH is associated with normovolemic hyponatremia and, in this case, is caused by small cell carcinoma (Choice D). In SIADH, the urine is concentrated but the patient is not volume depleted. Initially, the symptoms are mild and nonspecific, but as the serum sodium declines (especially <120 mEq/L), neurologic symptoms, seizures, and coma may ensue.

Squamous cell carcinoma (Choice E) accounts for 25-30% of all lung cancers and typically manifests on CXR as a cavitary lesion in a bronchus. Symptoms may include cough, dyspnea, wheezing, and hemoptysis. This type of lung cancer is sometimes associated with hypercalcemia due to parathyroid like hormone production.

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