Diagnosis and Staging of Lung Cancer

Question 1

What is the systematic review when examing chest x-rays?

Answer 1

-Name/market/rotation/penetration
-Lines/metal work
-Heart
-Mediastinum
-Lungs
(zones)
-Bones
-Diaphragm
-Soft tissue

Question 2

What is TNM staging?

Answer 2

Tumour- Nodes- Metastasise

Question 3

How is a tumour graded?

Answer 3

-How big it is and how far it has spread
-Size
and Position

Question 4

What can be used to detect tumours in thorax?

Answer 4

CT
PET-CT
Bronschoscopy

Question 5

What can be used to dected spread to lymph nodes?

Answer 5

PET-CT
mediastinoscopy
CT
EBUS/EUS

Question 6

What can used to detect metastasis?

Answer 6

PET-CT
CT
bone scan

Question 7

What does a FDG PET use?

Answer 7

Flurodeoxyglucose

Question 8

Why is FDG good for detecting tumours?

Answer 8

Tumours metabolise it fast and it accumulates

Question 9

What is an EBUS?

Answer 9

Endobronchial Ultrasound

Question 10

How do you classify tumours?

Answer 10

TX
T0
Tis
T(1-4)

Question 11

TX?

Answer 11

Primary tumour cannot be assesed

Question 12

T0?

Answer 12

No evidence of primary tumour

Question 13

Tis?

Answer 13

Carcinoma in situ

Question 14

T1?

Answer 14

Tumour less than 3cm surrounded by visceral pleura without involvement of the main bronchus

Question 15

T1a?

Answer 15

Minimally invasive adenocarcinoma

Tumour less than or equal to 1 cm

Question 16

T1b?

Answer 16

<=2cm

Question 17

T1c?

Answer 17

<=3cm

Question 18

T2?

Answer 18

> 3cm

Question 19

T2a?

Answer 19

• Involves main bronchus, but not carina
• Invades visceral pleura
• Associated with atelectasis or obstructive pneumonitis that extends to the hilar region part of the lung

Question 20

T3?

Answer 20

5-7cm or invades

• chest wall
• phrenic nerve
• parietal pericardium

Question 21

T4?

Answer 21

greater than 7cm or invades

• Diaphragm
• Mediastinum
• Heart
• Great vessels
• Traches
• Recurrent laryngeal nerve
• Esophagus
• Vertebral body
• Carina

Question 22

N0?

Answer 22

No regional lymph node metastases

Question 23

N1?

Answer 23

Ipsilateral peribronchial, hilar or intrapulmonary nodes including by direct extension

Question 24

N2?

Answer 24

Ipsilateral mediastinal, subcarinal

Question 25

N3?

Answer 25

Contralateral mediastinal, contralteral hilar, scalene or supraclavicular

Question 26

M0?

Answer 26

No distant metastasis

Question 27

M1?

Answer 27

Distant metastasis

Question 28

M1a?

Answer 28

• Separate tumour nodule(s) in a contralateral lobe

- Tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion

Question 29

M1 b?

Answer 29

single distant metastasis

Question 30

M1 c?

Answer 30

Multiple distant metastases