About lung metastasis, which is true?

Ans: b (Bilateral and multiple) Ref: Davidson, 20th ed,p. 711SECONDARY TUMOURS OF THE LUNGBlood-borne metastatic deposits in the lungs may be derived from many primary tumours. The secondary deposits are usually multiple and bilateral. Often there are no respiratory symptoms and the diagnosis is made by radiological examination. Breathlessness may occur if a considerable amount of lung tissue has been replaced by metastatic tumour. Endobronchial deposits are uncommon but can cause haemoptysis and lobar collapseCOMMON CELL TYPES OF BRONCHIAL CARCINOMA (Harrison)Cell type%Adenocarcinoma32Squamous29Small-cell18Large-cell9(This Table is given in Harrison pg 506, the values in Davidson are differenet)COMMON CELL TYPES OF BRONCHIAL CARCINOMA (Davidson)Cell type%Squamous35Adenocarcinoma30Small-cell20Large-cell15Note:Small cell carcinomas are very notorious and they usually have already spread at the time of presentation such that surgery is unlikely to be curative, and they are managed primarily by chemotherapy with or without radiotherapy.The most common form of lung cancer arising in lifetime non-smokers, in women, and in young patients (< 45 years) is adenocarcinoma.Squamous and small cell cancers usually present with endobronchial growth, while adenocarcinomas and large cell cancers tend to present as peripheral nodules or masses, frequently with pleural involvement.Squamous and large cell cancers cavitate in ~ 10-20% of casesBronchoalveolar carcinoma, a form of adenocarcinoma arsisng from peripheral airways, can present radiographically as a single mass; as a diffuse, multinodular lesion; or as a fluffy infiltrateAdrenal metastasis is common in lung cancer but rarely cause adrenal insufficiencyClubbing and hypertrophic pulmonary osteoarthropathy are more common in adenocarcinomas.