Non small cell lung cancer diagnostic study of choice: Difference between revisions
Line 8: | Line 8: | ||
=== Study of choice: === | === Study of choice: === | ||
*Computed tomography is the diagnostic study of choice for the diagnosis of non-small cell lung cancer. | *Computed tomography is the diagnostic study of choice for the diagnosis of non-small cell lung cancer. | ||
* | On 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|Lung adenocarcinoma]]''' | ||
* | :*Lung adenocarcinomas are typically peripherally located | ||
** | :*Usually measure <4 cm in diameter, very few show cavitation | ||
:*Perihilar and mediastinal involvement | |||
:*Ground glass opacity (slow growth), usually lesions double the size within a year | |||
*'''[[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 | |||
*'''[[Squamous cell carcinoma of the lung|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 central location | |||
*'''[[Large cell carcinoma of the lung|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 | |||
* The CT scan should be performed when the following is required: | |||
:*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 tumors|bone]], [[Adrenal gland|adrenal]] , and [[brain]] metastasis | |||
** A positive [test] is detected in the patient. | ** A positive [test] is detected in the patient. | ||
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name]. | * [Name of the investigation] is the gold standard test for the diagnosis of [disease name]. |
Revision as of 21:55, 23 February 2018
Non Small Cell Lung Cancer Microchapters |
Differentiating Non Small Cell Lung Cancer from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Non small cell lung cancer diagnostic study of choice On the Web |
American Roentgen Ray Society Images of Non small cell lung cancer diagnostic study of choice |
FDA on Non small cell lung cancer diagnostic study of choice |
CDC on Non small cell lung cancer diagnostic study of choice |
Non small cell lung cancer diagnostic study of choice in the news |
Blogs on Non small cell lung cancer diagnostic study of choice |
Directions to Hospitals Treating Non small cell carcinoma of the lung |
Risk calculators and risk factors for Non small cell lung cancer diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Diagnostic Study of Choice
Study of choice:
- Computed tomography is the diagnostic study of choice for the diagnosis of non-small cell lung cancer.
On CT, characteristic findings of non-small cell lung cancer include:[1]
- Lung adenocarcinomas are typically peripherally located
- Usually measure <4 cm in diameter, very few show cavitation
- Perihilar and mediastinal involvement
- Ground glass opacity (slow growth), usually lesions double the size within a year
- 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
- Centrally located within the lung
- Usually measure larger than 4 cm in diameter
- Frequent cavitation
- Commonly cause segmental or lobar lung collapse due to central location
- Rapid growth
- Early metastasizes to the mediastinum and brain
- Large mediastinal nodules/masses
- Lymph node involvement (frequently subcarinal)
- Nodular pleural thickening
- Pleural effusion
- The CT scan should be performed when the following is required:
- 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
- A positive [test] is detected in the patient.
- [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
- The diagnostic study of choice for [disease name] is [name of the investigation].
- There is no single diagnostic study of choice for the diagnosis of [disease name].
- There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
- [Disease name] is mainly diagnosed based on clinical presentation.
- Investigations:
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
The comparison table for diagnostic studies of choice for [disease name]
Sensitivity | Specificity | |
---|---|---|
Test 1 | ✔ | ...% |
Test 2 | ...% | ✔ |
✔= The best test based on the feature
Diagnostic results
The following result of [investigation name] is confirmatory of [disease name]:
- Result 1
- Result 2
Sequence of Diagnostic Studies
The [name of investigation] should be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
Diagnostic Criteria
- Here you should describe the details of the diagnostic criteria.
- Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
- Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
- Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
- Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
- To view an example (endocarditis diagnostic criteria), click here
- If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
- You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
- [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
- There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
- The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
- [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
IF there are clear, established diagnostic criteria:
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
- The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
- The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria:
- There are no established criteria for the diagnosis of [disease name].
References
- ↑ 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.