Pancoast tumor echocardiography or ultrasound: Difference between revisions

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{{Pancoast tumor}}
{{Pancoast tumor}}
{{CMG}}{{AE}}{{Mazia}}
{{CMG}}; {{AE}} {{Mazia}}
 
 
==Overveiw==
==Overveiw==
Pancoast tumor, a subtype of [[lung cancer]] located at the [[lung]] [[apex]]. On endobronchial and endoscopic [[ultrasound]], characteristic findings of [[lung cancer]] may include: [[enlarged lymph nodes]] and local [[invasion]] to adjacent [[bronchial]] structures and [[mediastinum]]. Endobronchial [[ultrasound]] is a first-line diagnostic modality for [[mediastinal]] [[Staging (pathology)|staging]].<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>


==Ultrasound==
==Ultrasound==
Pancoast tumor, a subtype of lung cancer located at the lung apex. On endobronchial and endoscopic ultrasound, characteristic findings of lung cancer may include: enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
*Endobronchial [[ultrasound]] is a first-line [[diagnostic]] modality for [[mediastinal]] [[Cancer staging|staging]].<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
 
*Common features of endobronchial [[ultrasound]], include:<ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>  
==Ultrasound==
:*Evaluation of [[lymph nodes]] and other structures in the [[mediastinum]]
*Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref>
:*[[Mediastinum]] [[invasion]] [[Cancer staging|staging]]
*Common features of endobronchial ultrasound, include: <ref name="cancer"> Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>  
:*Evaluation of lymph nodes and other structures in the mediastinum  
:*Mediastinum invasion staging  
:*Determination of management strategy  
:*Determination of management strategy  
:*Real time evaluation of structures
:*Real time evaluation of structures
:*Sensitivity 90% and specificity of 97%
:*[[Sensitivity]] 90% and [[specificity]] of 97%
*On ultrasound (endobronchial ultrasound), findings of Pancoast tumor may include: <ref name="lung cancer">Lung cancer staging. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on February 25,2016</ref>
*On [[ultrasound]] (endobronchial [[ultrasound]]), findings of Pancoast tumor may include:<ref name="lung cancer">Lung cancer staging. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on February 25,2016</ref>
:*Enlarged lymph nodes  
:*[[Enlarged lymph nodes]]
:*Local invasion to adjacent bronchial structures and mediastinum
:*Local [[invasion]] to adjacent [[bronchial]] structures and [[mediastinum]]
* The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.  
* The table below summarizes the advantages and disadvantages of both [[ultrasound]] modalities, for the [[diagnostic]] assessment of Pancoast tumor.  


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! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Disadvantages}}
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|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|  Endobronchial ultrasound (EBUS)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  Endobronchial [[ultrasound]] (EBUS)
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Direct visualization of lymph node stations.
*Direct visualization of [[lymph node]] stations  
*Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
*Complements [[endoscopic ultrasound]]: covers [[lymph node]] stations 2R and 4R which are difficult to access by [[endoscopic ultrasound]]
*Lower false-negative rate than with blind transbronchial fine needle aspiration and fewer complications
*Lower [[false-negative]] rate than with blind transbronchial [[fine needle aspiration]] and fewer [[complications]]
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
*More [[invasive]] than [[endoscopic ultrasound]], few practitioners, but rapidly growing in popularity
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|  [[Endoscopic ultrasound]] (EUS)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  [[Endoscopic ultrasound]] (EUS)
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Least invasive modality
*Least [[invasive]] modality
*Uses the esophagus to access mediastinal lymph nodes
*Uses the [[esophagus]] to access [[mediastinal]] [[lymph nodes]]
*Excellent for staging lymph nodes
*Excellent for [[Staging (pathology)|staging]] [[lymph nodes]]
*Useful for station 2L and 4L, L adrenal, celiac lymph node
*Useful for station 2L and 4L, L [[adrenal]], [[celiac]] [[lymph node]]
|style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |
*Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R
*Cannot reliably access right sided [[Paratracheal lymph nodes|paratracheal]] [[Lymph nodes|lymph node]] stations 2 R and 4R
*Accurate discrimination of primary hilar tumors and involved lymph nodes is important
*Accurate discrimination of primary [[Hilar|hilar tumors]] and involved [[lymph nodes]] is important
|}
|}
==Gallery==
<div align="left">
<div align="left">
<gallery heights="175" widths="175">
<gallery heights="175" widths="175">
Image:Eus doppler mediastinal lymph node.JPG | Doppler endoscopic ultrasound: mediastinal lymph node  
Image:Eus doppler mediastinal lymph node.JPG | Doppler endoscopic ultrasound: mediastinal lymph node  
Image:Lul mass linear eus 1.jpg|Endoscopic ultrasound: A biopsy window is found and an fine needle aspiration advanced into the mass
Image:Lul mass linear eus 1.jpg|Endoscopic ultrasound: A biopsy window is found and an fine needle aspiration advanced into the mass
Image:Lul mass radial eus.jpg | Endoscopic ultrasound: A lung mass which is partially behind the aorta is seen with endoscopic ultrasound
Image:Lul mass radial eus.jpg | Endoscopic ultrasound: A lung mass which is partially behind the aorta is seen with endoscopic ultrasound
</gallery>
</gallery>
</div>
</div>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 18:07, 16 March 2018


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]


Overveiw

Pancoast tumor, a subtype of lung cancer located at the lung apex. On endobronchial and endoscopic ultrasound, characteristic findings of lung cancer may include: enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1]

Ultrasound

  • The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of Pancoast tumor.
Procedure Advantages Disadvantages
Endobronchial ultrasound (EBUS)
Endoscopic ultrasound (EUS)

References

  1. 1.0 1.1 Kinsey CM, Arenberg DA (2014). "Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging". Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
  2. Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016
  3. Lung cancer staging. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on February 25,2016

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