Chest II (fibrosis & tumors)

Question 1

Signs you may find in early pulmonary fibrosis

Answer 1

1. inter lobular septal thickning
2. interlobular reticulation
3. thickning in the plura (fine irregularity)

Question 2

Signs you may find in late pulmonary fibrosis

Answer 2

1. tractional bronchactisis
2. honeycombing
3. architecture distortion

Question 3

DDs of fibrosis predominant in the lower lobe

Answer 3

1. idiopathic pulmonary fibrosis
2. end stage of aspectosis (+plural plaque)
3. non specific pulmonary pneumonia (collagen vascular disease & drug reaction)

Question 4

DDs of fibrosis predominant in the upper lobe

Answer 4

1. end stage sarcoidosis
2. chronic hypersensitivity pneumonitis
3. end stage silicosis

Question 5

in case of

x-ray pulmonary fibrosis, what you should mention and what is the next step

Answer 5

1. if it’s diffuse or pridominant in one lobe
2. early or late signs of fibrosis (3+3)
3. shagy appearance of the heart and decrease lung volume
4. DDs
5. next step CT

Question 6

review

difinition of bronchactisis

Answer 6

loss of normal tapering of the air ways

Question 7

types of bronchiectasis

Answer 7

cylindrical (or tubular), varicose or cystic

Question 8

simple question

what is the different between nodule and mass

Answer 8

nodule < 3cm

Question 9

if you see nodule in the lung what it can be

Answer 9

1. benign:
   * pulmonary hamartoma
   * rheumatoid
   * arteriovenous malformation
2. malignant (lung cancer)

Question 10

Pulmonary nodule

when you think it’s benign

Answer 10

it’s so easy

Question 11

when you think it’s hamartoma

Answer 11

1. fat content
2. macro-calcification (popcorn)

if it’s lobulated or large (it can be hamartoma or malignant lesion)

Question 12

if there are calcification is it benign or malignant

Answer 12

macro-calcification
~benign
micro-calcification
~malignant

Question 13

why when we found nodule we ask for enhanced CT

Answer 13

to exclude PAVM (Pulmonary arteriovenous malformation)
and to prevent hematothorax due to biopsy
treatment – embolization

Question 14

can you classify lung cancer to two types?

Answer 14

small cell and non small cell

Question 15

the other name of small cell lung cancer, and what is the prognosis

Answer 15

neuroendocrine tumours, poor prognosis

Question 16

types of non-small cell lung cancer

Answer 16

1. squamous cell carcincarcinoma
2. adenocarcinoma
3. large cell carcinoma

Question 17

1. the most common cancer
2. in male vs female
3. 1st killer cancer

Answer 17

1. lung
2. in male (lung) n female (breast)
3. lung

Question 18

the most common type of lung cancer

Answer 18

1. squamous cell carcinoma in smokers
2. adenocarcinoma in non smokers

Question 19

in lung cancer

when the case is inoperable

Answer 19

1. encacemnet and compresiion of great vessel
2. invasion of the chest wall
3. Mets

Question 20

special name if the tumor in the apex of lung

Answer 20

Pancoast tumor
(superior sulcus tumor)

Question 21

what is the clinical presentation of Pancoast tumor

Answer 21

1. sholder pain
2. hornor syndrome

Question 22

what is the next step of Pancoast tumor

Answer 22

MRI (if invade the brachial blexus)