Bronchial Neoplasm

Question 1

What features point towards a pneumonia caused by bronchial CA?

Answer 1

Fissure may show bulge (golden s sign), no improvement in consolidation after 2 to 3 weeks, visible mass, hilarious adenopathy, mucus filled bronchi in collapsed lobe

Question 2

Define in detail the tnm staging of lung CA.

Answer 2

Tx - histo proven but no x-ray features
T0 - no evidence
T1 - 3cm or less, no evidence of invasion of bronchus
T2 - more than 3cm or invades visceral pleura, atelectasis/obstructive pneumonitis
T3 - within 2cm of carina, invading chest wall, diaphragm, mediastinum, pericardium
T4 - invading heart, vessels, trachea, oesophagus, VB, Carina. Malignant pleural effusion. Satellite tumour nodules

N1 - ipsilateral hilar nodes/peribronchial. No invasion
N2 - ipsi mediastinal and subcarinal
N3 - contralateral

M1 - distant meta present

T1nomo 0, t2nomo1a, t1n1m0 11a, t2n1mo t3nomo 11b, 111 a t3n1mo t1n2mo t2n2mo t3n2mo, 111b t4nomo t4n1mo t4n2mo t1n3mo t2n3mo t3n3mo t4n3mo, 4 m1

Question 3

When is Mri used in lung ca?

Answer 3

Superior sulcus tumour, mediastinal invasion, root of neck invasion involvement of vascular and neural structures

Question 4

Name other causes for ln besides lung cancer.

Answer 4

Tb, histo, pneumoconiosis, sarcoidosis, reactive hyperplasia to tumour, pneumonia/atelectesis

Question 5

Radiology features of lymphoma.

Answer 5

Resembling pneumonia, military nodulation resembling lymphangitis carcinomatosis, pulmonary modules multiple

Question 6

Causes of a solitary pulmonary nodule

Answer 6

Bronchial ca, bronchial carcinoid, granuloma, hamartoma, mets, chronic pneumonia/abscess, hydatid cyst, haematoma, bronchocoele, fungus ball, massive fibrosis, bronchogenic cyst, sequestration, AV malform, infarcts, round atelectesis

Question 7

What factors do you use to determine if a nodule is benign or malignant?

Answer 7

Rate of growth, attenuation, size, margins