Diagnosis and Staging of Lung Cancer Flashcards
What is the systematic review of chest x-ray?
Lines/metal work, heart, mediastinum, lungs (zones),, bones, diaphragm and soft tissues
What do we need to look for in the mediastinum?
Hilar vascular structures should be crisply defined
No widening of the mediastinum
Trachea should be central
How should you look at lungs on chest x-ray?
\compare upper, mid and lower zones
Look between the ribs for lung detail
Remember to look ‘behind’ the heart
What is the sign of right upper lobe collapse in chest x-ray?
Horizontal fissure is pulled up along with hila and hemi-diaphragm
There is also reduced volume on the right
Why should we be aware of lobar collapse in smokers?
Can fail to resolve in smoker of age of above 45
Where can abnormalities hide in chest x-rays?
Can hide in apices, behind the heart, hemidiaphragm and hila
Compare with previous films and always look in review areas
What are the review areas in CXR?
Hila, lung apices, behind the heart and behind the diaphragm
What is included in the clinical history of lung cancer/
Increasing shortness of breath in smoker, history of pulmonary fibrosis and recent haemoptysis
What does the CT evaluate?
Size, shape atelectasis, border, density, solid or not solid, dynamic contrast enhancement and growth
What is a pulmonary mass?
Is an opacity in the lung over 3cm with no mediastinal adenopathy or atelectasis
What does atelectasis mean?
Lung collapse
What is a pulmonary nodule?
Is an opacity in the lung up to 3cm with no mediastinal adenopathy or atelectasis
What can be a pulmonary mass or nodule?
Lung cancer, metastasis, benign lung neoplasm, infection bacterial, TB or fungal and vascular haematoma, AVM
What is a hamartoma?
Benign lung tumour
Can show signs of calcification
What is pulmonary AVM?
Abnormal connections between a pulmonary artery and a pulmonary vein
Can cause paradoxical emboli that can lead to strokes or TIAs (transient ischaemic attack)
