Non small cell lung cancer CT: Difference between revisions
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Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer. On CT, characteristic findings of non-small cell lung cancer include [[Ground glass opacification on CT|ground-glass opacity]], rounded or spiculated mass, local nodal involvement, intraluminal obstruction, and lobar collapse. | Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer. On CT, characteristic findings of non-small cell lung cancer include [[Ground glass opacification on CT|ground-glass opacity]], rounded or spiculated mass, local nodal involvement, intraluminal obstruction, and lobar collapse. | ||
==CT== | ==CT scan== | ||
After chest X-ray, computed tomography is the best next step in diagnosing non-small cell lung cancer.<ref name="pmid8190965">{{cite journal |vauthors=Rosado-de-Christenson ML, Templeton PA, Moran CA |title=Bronchogenic carcinoma: radiologic-pathologic correlation |journal=Radiographics |volume=14 |issue=2 |pages=429–46; quiz 447–8 |year=1994 |pmid=8190965 |doi=10.1148/radiographics.14.2.8190965 |url=}}</ref><ref name="pmid19234288">{{cite journal |vauthors=Parker MS, Chasen MH, Paul N |title=Radiologic signs in thoracic imaging: case-based review and self-assessment module |journal=AJR Am J Roentgenol |volume=192 |issue=3 Suppl |pages=S34–48 |year=2009 |pmid=19234288 |doi=10.2214/AJR.07.7081 |url=}}</ref><ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref> | After chest X-ray, computed tomography is the best next step in diagnosing non-small cell lung cancer.<ref name="pmid8190965">{{cite journal |vauthors=Rosado-de-Christenson ML, Templeton PA, Moran CA |title=Bronchogenic carcinoma: radiologic-pathologic correlation |journal=Radiographics |volume=14 |issue=2 |pages=429–46; quiz 447–8 |year=1994 |pmid=8190965 |doi=10.1148/radiographics.14.2.8190965 |url=}}</ref><ref name="pmid19234288">{{cite journal |vauthors=Parker MS, Chasen MH, Paul N |title=Radiologic signs in thoracic imaging: case-based review and self-assessment module |journal=AJR Am J Roentgenol |volume=192 |issue=3 Suppl |pages=S34–48 |year=2009 |pmid=19234288 |doi=10.2214/AJR.07.7081 |url=}}</ref><ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref> | ||
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*'''Lung adenocarcinoma''' | *'''Lung adenocarcinoma''' | ||
*Lung adenocarcinomas are typically peripherally located | |||
*Usually measure <4 cm in diameter, very few shows [[cavitation]] | |||
*[[Hilar lymphadenopathy|Perihilar]] and [[Mediastinal mass|mediastinal]] involvement | |||
*[[Ground glass opacification on CT|Ground glass opacity]] (slow growth), usually lesions double the size within a year | |||
*'''Squamous cell lung carcinoma''' | *'''Squamous cell lung carcinoma''' | ||
*Centrally located within the lung | |||
*Usually measure larger than 4 cm in diameter | |||
*Frequent [[cavitation]] | |||
*Commonly cause segmental or lobar lung collapse due to the central location | |||
*'''Large cell lung carcinoma''' | *'''Large cell lung carcinoma''' | ||
*Rapid growth | |||
*Early metastasizes to the [[mediastinum]] and brain | |||
*Large mediastinal nodules/[[Mediastinal mass|masses]] | |||
*Lymph node involvement (frequently subcarinal) | |||
*Nodular [[pleural]] thickening | |||
*[[Pleural effusion]] | |||
*'''Bronchoalveolar carcinoma''' | *'''Bronchoalveolar carcinoma''' | ||
*Subtype of adenocarcinoma | |||
*Single [[pulmonary nodule]] or mass | |||
*Multicentric or diffuse disease | |||
*Localized area of parenchymal consolidation | |||
*Bubble-like areas of low attenuation within the mass are a characteristic finding | |||
*[[Hilar lymphadenopathy|Hilar]] and [[mediastinal lymphadenopathy]] is uncommon | |||
*Persistent peripheral consolidation with associated [[Pulmonary nodule|nodules]] | |||
*On CT, signs of non-small cell lung cancer may include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref><ref name="pmid19234288">{{cite journal |vauthors=Parker MS, Chasen MH, Paul N |title=Radiologic signs in thoracic imaging: case-based review and self-assessment module |journal=AJR Am J Roentgenol |volume=192 |issue=3 Suppl |pages=S34–48 |year=2009 |pmid=19234288 |doi=10.2214/AJR.07.7081 |url=}}</ref> | *On CT, signs of non-small cell lung cancer may include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref><ref name="pmid19234288">{{cite journal |vauthors=Parker MS, Chasen MH, Paul N |title=Radiologic signs in thoracic imaging: case-based review and self-assessment module |journal=AJR Am J Roentgenol |volume=192 |issue=3 Suppl |pages=S34–48 |year=2009 |pmid=19234288 |doi=10.2214/AJR.07.7081 |url=}}</ref> | ||
* '''Finger in glove sign''': The bronchus distal to the obstruction is dilated. | |||
* '''Crazy-paving sign''': Appearance of [[Ground glass opacification on CT|ground-glass opacity]] with superimposed interlobular septal thickening and intralobular reticular thickening. | |||
==References== | ==References== |
Revision as of 16:44, 9 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer. On CT, characteristic findings of non-small cell lung cancer include ground-glass opacity, rounded or spiculated mass, local nodal involvement, intraluminal obstruction, and lobar collapse.
CT scan
After chest X-ray, computed tomography is the best next step in diagnosing non-small cell lung cancer.[1][2][3]
- Common features of CT scan for the diagnosis of non-small cell lung cancer include:
- Assessment of the main bronchi
- Evaluation of the entire thorax
- Detection of chest wall invasion
- Assessment of hilar and mediastinal invasion/adenopathy
- Determination of non-small cell lung cancer staging
- Precise determination of size and tumor dimensions
- Detection of liver, bone, adrenal , and brain metastasis
On CT, characteristic findings of non-small cell lung cancer include:[3]
- Lung adenocarcinoma
- Lung adenocarcinomas are typically peripherally located
- Usually measure <4 cm in diameter, very few shows cavitation
- Perihilar and mediastinal involvement
- Ground glass opacity (slow growth), usually lesions double the size within a year
- Squamous cell lung carcinoma
- Centrally located within the lung
- Usually measure larger than 4 cm in diameter
- Frequent cavitation
- Commonly cause segmental or lobar lung collapse due to the central location
- Large cell lung carcinoma
- Rapid growth
- Early metastasizes to the mediastinum and brain
- Large mediastinal nodules/masses
- Lymph node involvement (frequently subcarinal)
- Nodular pleural thickening
- Pleural effusion
- Bronchoalveolar carcinoma
- Subtype of adenocarcinoma
- Single pulmonary nodule or mass
- Multicentric or diffuse disease
- Localized area of parenchymal consolidation
- Bubble-like areas of low attenuation within the mass are a characteristic finding
- Hilar and mediastinal lymphadenopathy is uncommon
- Persistent peripheral consolidation with associated nodules
- On CT, signs of non-small cell lung cancer may include:[3][2]
- Finger in glove sign: The bronchus distal to the obstruction is dilated.
- Crazy-paving sign: Appearance of ground-glass opacity with superimposed interlobular septal thickening and intralobular reticular thickening.
References
- ↑ Rosado-de-Christenson ML, Templeton PA, Moran CA (1994). "Bronchogenic carcinoma: radiologic-pathologic correlation". Radiographics. 14 (2): 429–46, quiz 447–8. doi:10.1148/radiographics.14.2.8190965. PMID 8190965.
- ↑ 2.0 2.1 Parker MS, Chasen MH, Paul N (2009). "Radiologic signs in thoracic imaging: case-based review and self-assessment module". AJR Am J Roentgenol. 192 (3 Suppl): S34–48. doi:10.2214/AJR.07.7081. PMID 19234288.
- ↑ 3.0 3.1 3.2 Kundel HL (1981). "Predictive value and threshold detectability of lung tumors". Radiology. 139 (1): 25–9. doi:10.1148/radiology.139.1.7208937. PMID 7208937.