Non small cell lung cancer CT: Difference between revisions

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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 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 [[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==


Computed tomography is the method of choice for the diagnosis of 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>
*In some cases, non-small cell lung cancers require further evaluation with  [[MRI]]
*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]]
:*Assessment of the main [[bronchi]]
** Evaluation of the entire [[Chest|thorax]]
:*Evaluation of the entire thorax
** Detection of [[Thoracic cavity|chest wall invasion]]
:*Detection of chest wall invasion
** Assessment of [[Hilar lymphadenopathy|hilar]] and [[Mediastinal lymph node|mediastinal invasion]]/[[Lymphadenopathy|adenopathy]]
:*Assessment of [[Hilar lymphadenopathy|hilar]] and mediastinal invasion/adenopathy
** Determination of non-small cell lung cancer [[Lung cancer staging|staging]]
:*Determination of non-small cell lung cancer staging  
** Precise determination of size and [[tumor]] dimensions
:*Precise determination of size and tumor dimensions  
** Detection of [[liver]], [[Bone tumors|bone]], [[Adrenal gland|adrenal]], and [[brain]] metastasis
:*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>


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'''
**[[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  


*'''Lung adenocarcinoma'''
*'''Squamous cell carcinoma of the lung'''
:*Lung adenocarcinomas are typically peripherally located
**[[Squamous cell carcinoma of the lung]] is centrally located within the [[lung]]
:*Usually measure <4 cm in diameter, very few show [[cavitation]]
**Usually measure larger than 4 cm in diameter
:*[[Hilar lymphadenopathy|Perihilar]] and [[Mediastinal mass|mediastinal]] involvement
**Frequent [[cavitation]]
:*[[Ground glass opacification on CT|Ground glass opacity]] (slow growth), usually lesions double the size within a year
**Commonly cause segmental or lobar lung collapse due to the central location


*'''Bronchoalveolar carcinoma'''
*'''Large cell carcinoma of the lung'''
:*Subtype of adenocarcinoma
**[[Large cell carcinoma of the lung]] shows rapid growth
:*Single [[pulmonary nodule]] or mass
**Early metastasizes to the [[Mediastinal mass|mediastinum]] and [[Intracerebral metastases|brain]]
:*Multicentric or diffuse disease
**Large mediastinal [[Nodule (medicine)|nodules]]/[[Mediastinal mass|masses]]
:*Localized area of parenchymal consolidation
**[[Lymph node metastases|Lymph node]] involvement (frequently [[Lymph node metastases|subcarinal)]]
:*Bubble-like areas of low attenuation within the mass are a characteristic finding
**Nodular [[pleural]] thickening
:*[[Hilar lymphadenopathy|Hilar]] and [[mediastinal lymphadenopathy]] is uncommon
**[[Pleural effusion]]
:*Persistent peripheral consolidation with associated [[Pulmonary nodule|nodules]]


*'''Squamous cell lung carcinoma'''
*'''Bronchoalveolar carcinoma of the lung'''
:*Centrally located within the lung  
**[[Bronchoalveolar carcinoma|Bronchoalveolar carcinoma of the lung]] is a subtype of adenocarcinoma
:*Usually measure larger than 4 cm in diameter
**Single [[pulmonary nodule]] or [[mass]]
:*Frequent [[cavitation]]
**Multicentric or diffuse disease
:*Commonly cause segmental or lobar lung collapse due to central location
**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]]


*'''Large cell lung carcinoma'''
*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>
:*Rapid growth
** '''Finger in glove sign''': The [[Bronchiectasis|bronchial dilation]], distal to the [[Airway obstruction|obstruction]].  
:*Early metastasizes to the [[mediastinum]] and brain
** '''Crazy-paving sign''':  Appearance of [[Ground glass opacification on CT|ground-glass opacity]] with superimposed [[Lung#Anatomy|interlobular septal]] thickening and intralobular reticular thickening.
:*Large mediastinal nodules/[[Mediastinal mass|masses]]
:*Lymph node involvement (frequently subcarinal)
:*Nodular [[pleural]] thickening
:*[[Pleural effusion]]
 
*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==

Latest revision as of 19:04, 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]

On CT, characteristic findings of non-small cell lung cancer include:[3]

  • Squamous cell carcinoma of the lung

References

  1. 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. 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. 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.


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