Chapter 11

Question 1

Masses in the anterior mediastinum include

Answer 1

substernal thyroid goiters, lymphoma, thymoma, and teratoma.

Question 2

The middle mediastinum is home primarily to lymphadenopathy from

Answer 2

lymphoma and metastatic disease, such as from small cell carcinoma of the lung.

Question 3

The posterior mediastinum is the location of neurogenic tumors that originate either from

Answer 3

the nerve sheath (mostly benign) or tissues other than the sheath (mostly malignant).

Question 4

Incidental solitary pulmonary nodules (SPNs) less than 4 mm in size are rarely malignant; in those in whom clinical or imaging findings suggest malignancy, …

Answer 4

50% over the age of 50 are malignant. The key question is to determine whether a nodule is most likely benign or most likely malignant in any given individua

Question 5

Criteria on which an evaluation of benignity can be made include (3) THINGS?

Answer 5

absolute size of the nodule upon discovery, presence of calcification within it, the margin of the nodule, and change in the size of the nodule over time.

Question 6

Bronchogenic carcinomas present in one of three ways:

Answer 6

visualization of the tumor itself; recognition of the effects of bronchial obstruction, such as pneumonitis and/or atelectasis; or by identification of either their direct extension or metastatic spread to the chest or to distant organs.

Question 7

Bronchogenic carcinomas presenting as a solitary nodule/mass in the lung are most often

Answer 7

adenocarcinomas; adenocarcinomas of the lung may sometimes present with multiple nodules, mimicking metastatic disease.

Question 8

• Bronchogenic carcinoma presenting with bronchial obstruction is most often caused by

Answer 8

squamous cell carcinoma , which is the cell type most likely to cavitate.

Question 9

• Small cell carcinomas are highly aggressive, centrally located, peribronchial tumors, the majority of which have already metastasized at the time of initial presentation; they can be associated with

Answer 9

paraneoplastic syndromes such as inappropriate secretion of anti-diuretic hormone and Cushing’s syndrome.

Question 10

• Multiple nodules in the lung are most often metastatic lesions that have traveled through the bloodstream from a distant primary tumor ( hematogenous spread ); common sites of primaries for such metastases include

Answer 10

colorectal, breast, renal cell, head and neck, bladder, uterine and cervical carcinomas, soft-tissue sarcomas, and melanoma.

Question 11

• In lymphangitic carcinomatosis, a tumor grows in and obstructs lymphatics in the lung, producing a pattern that is radiologically similar to

Answer 11

pulmonary interstitial edema; primaries that metastasize to the lung in this fashion include breast, lung, and pancreatic cancer.

Question 12

• Conventional radiography has a high false–negative rate in pulmonary thromboembolic disease because demonstration of “classical” findings such as a

Answer 12

Hampton hump, Westermark sign, and knuckle sign is infrequent.

Question 13

• CT-pulmonary angiography is now widely used for the diagnosis of __ ___ producing images of the pulmonary arteries with little or no motion artifact.

Answer 13

pulmonary embolism

Question 14

• Chronic obstructive pulmonary disease consists of

Answer 14

emphysema and chronic bronchitis; of the two, chronic bronchitis is a clinical diagnosis, whereas emphysema is defined pathologically and has findings that can be seen on both conventional radiographs and CT scans.

Question 15

• Although bronchiectasis may be seen on conventional radiographs, ___ is the study of choice; ___ demonstrates the (4 signs)

Answer 15

CT;

signet-ring sign, tram-tracks, cystic lesions, or tubular densities.