<prompt> Hoarseness of voice in lung carcinoma is due to invasion of which structure?Recurrent laryngeal nerveInternal laryngeal nerveGlossopharyngeal nerveVagus nerve  <response>: Ans. is a i.e., Recurrent laryngeal nerve Following table illustrates the effects of local invasion of lung carcinoma:Local Effects of Lung Tumor SpreadClinical FeaturePathologic BasisCough 50-75Involvement of central airwaysHemoptysis 25 - 50Hemorrhage from tumor in airwayChest pain 20Extension of tumor into mediastinum, pleura or chest wallPneumonia, abscess, lobar collapseAirway obstruction by tumorLipoid pneumoniaTumor obstruction; accumulation of cellular lipid in foamy macrophagesPleural effusionTumor spread into pleura iHoarsenessRecurrent laryngeal nerve invasionDysphagiaEsophageal invasionDiaphragm paralysisPhrenic nerve invasionRib destructionChest wall invasionSVC syndromeSVC compression by tumorHorner syndromeSympathetic ganglia invasionPericarditis, tamponadePericardial involvementSVC, Superior vena cava 