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==Overview== | ==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, | Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer. On [[Computed tomography|CT]], characteristic findings of non-small cell lung cancer include [[Ground glass opacification on CT|ground-glass opacity]], rounded or spiculated mass, [[Lymph node metastases|local nodal involvement]], [[Airway obstruction|intraluminal obstruction]], and [[Atelactasis|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> | |||
*Common features of [[Computed tomography|CT scan]] for the diagnosis of non-small cell lung cancer include: | |||
*Common features of CT scan for the diagnosis of non-small cell lung cancer include: | **Assessment of the main [[bronchi]] | ||
** Evaluation of the entire [[Chest|thorax]] | |||
** Detection of [[Thoracic cavity|chest wall invasion]] | |||
** Assessment of [[Hilar lymphadenopathy|hilar]] and [[Mediastinal lymph node|mediastinal invasion]]/[[Lymphadenopathy|adenopathy]] | |||
** Determination of non-small cell lung cancer [[Lung cancer staging|staging]] | |||
** Precise determination of size and [[tumor]] dimensions | |||
** Detection of [[liver]], [[Bone tumors|bone]], [[Adrenal gland|adrenal]], and [[brain]] metastasis | |||
On [[Computed tomography|CT,]] characteristic findings of non-small cell lung cancer 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> | |||
*'''Adenocarcinoma of the lung''' | |||
**[[Adenocarcinoma of the lung|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 carcinoma of the lung''' | ||
**[[Squamous cell carcinoma of the lung]] is 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 carcinoma of the lung''' | ||
**[[Large cell carcinoma of the lung]] shows rapid growth | |||
**Early metastasizes to the [[Mediastinal mass|mediastinum]] and [[Intracerebral metastases|brain]] | |||
**Large mediastinal [[Nodule (medicine)|nodules]]/[[Mediastinal mass|masses]] | |||
**[[Lymph node metastases|Lymph node]] involvement (frequently [[Lymph node metastases|subcarinal)]] | |||
**Nodular [[pleural]] thickening | |||
**[[Pleural effusion]] | |||
*''' | *'''Bronchoalveolar carcinoma of the lung''' | ||
**[[Bronchoalveolar carcinoma|Bronchoalveolar carcinoma of the lung]] is a subtype of adenocarcinoma | |||
**Single [[pulmonary nodule]] or [[mass]] | |||
**Multicentric or diffuse disease | |||
**Localized area of [[X Ray#Parenchymal consolidation|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 [[Computed tomography|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 [[Bronchiectasis|bronchial dilation]], distal to the [[Airway obstruction|obstruction]]. | |||
** '''Crazy-paving sign''': Appearance of [[Ground glass opacification on CT|ground-glass opacity]] with superimposed [[Lung#Anatomy|interlobular septal]] thickening and intralobular reticular thickening. | |||
==References== | ==References== | ||
Latest revision as of 19:04, 9 January 2019
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Differentiating Non Small Cell Lung Cancer from other Diseases |
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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]
- Adenocarcinoma of the lung
- 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 carcinoma of the lung
- Squamous cell carcinoma of the lung is 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 carcinoma of the lung
- Large cell carcinoma of the lung shows 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 of the lung
- Bronchoalveolar carcinoma of the lung is a 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 bronchial dilation, distal to the obstruction.
- 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.