Confusable diagnoses · PANCE / PANRE

Lung Cancer vs Actinic Keratosis

Lung Cancer and Actinic Keratosis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Lung Cancer vs Actinic Keratosis at a glance

  • Lung Cancer: Leading cause of cancer death — NSCLC (~85%) and SCLC (~15%) with distinct biology and treatment.
  • Actinic Keratosis: UV-induced precancerous keratinocyte lesion on sun-damaged skin; ~10% lifetime risk of progression to invasive SCC per lesion.
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Side-by-side comparison

FeatureLung CancerActinic Keratosis
At a glanceLeading cause of cancer death — NSCLC (~85%) and SCLC (~15%) with distinct biology and treatment.UV-induced precancerous keratinocyte lesion on sun-damaged skin; ~10% lifetime risk of progression to invasive SCC per lesion.
Classic presentationPancoast tumor: shoulder pain + Horner syndrome + arm weakness. SVC syndrome with right upper lobe mass. Hypercalcemia in squamous cell. SIADH or Cushing in…Gritty sandpaper-textured pink scaly papule on a sun-damaged background of an older fair-skinned adult.; Usually asymptomatic; some lesions tender or pruritic…
Workup / key labsDefinitive diagnosis requires tissue (histology + molecular and immunohistochemistry). TNM staging (8th edition) for NSCLC; SCLC traditionally classified as…Clinical: characteristic rough scaly papule on sun-damaged skin of older adult; biopsy if suspicion of SCC.; Clinical diagnosis sufficient for typical…
ImagingChest CT with contrast — characterize mass, mediastinal nodes, pleural disease; PET-CT — staging (FDG avidity, distant metastases); MRI brain — staging for…Not indicated
First-line treatmentNSCLC Stage I-II (early): surgical resection (lobectomy preferred, VATS) + mediastinal nodal sampling; SBRT for non-surgical candidates; NSCLC Stage III:…Lesion-directed therapy for isolated AKs:; • Cryotherapy with liquid nitrogen — 5-10 seconds per lesion; most common; cure ~67-83%; possible hypopigmentation;…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.