Diagnosis and Staging of Lung Cancer Flashcards
What is the systematic review when examing chest x-rays?
-Name/market/rotation/penetration
-Lines/metal work
-Heart
-Mediastinum
-Lungs
(zones)
-Bones
-Diaphragm
-Soft tissue
What is TNM staging?
Tumour- Nodes- Metastasise
How is a tumour graded?
-How big it is and how far it has spread
-Size
and Position
What can be used to detect tumours in thorax?
CT
PET-CT
Bronschoscopy
What can be used to dected spread to lymph nodes?
PET-CT
mediastinoscopy
CT
EBUS/EUS
What can used to detect metastasis?
PET-CT
CT
bone scan
What does a FDG PET use?
Flurodeoxyglucose
Why is FDG good for detecting tumours?
Tumours metabolise it fast and it accumulates
What is an EBUS?
Endobronchial Ultrasound
How do you classify tumours?
TX
T0
Tis
T(1-4)
TX?
Primary tumour cannot be assesed
T0?
No evidence of primary tumour
Tis?
Carcinoma in situ
T1?
Tumour less than 3cm surrounded by visceral pleura without involvement of the main bronchus
T1a?
Minimally invasive adenocarcinoma
Tumour less than or equal to 1 cm
T1b?
<=2cm
T1c?
<=3cm
T2?
> 3cm
T2a?
- 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
T3?
5-7cm or invades
- chest wall
- phrenic nerve
- parietal pericardium
T4?
greater than 7cm or invades
- Diaphragm
- Mediastinum
- Heart
- Great vessels
- Traches
- Recurrent laryngeal nerve
- Esophagus
- Vertebral body
- Carina
N0?
No regional lymph node metastases
N1?
Ipsilateral peribronchial, hilar or intrapulmonary nodes including by direct extension
N2?
Ipsilateral mediastinal, subcarinal
N3?
Contralateral mediastinal, contralteral hilar, scalene or supraclavicular
M0?
No distant metastasis
M1?
Distant metastasis
M1a?
- Separate tumour nodule(s) in a contralateral lobe
- Tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion
M1 b?
single distant metastasis
M1 c?
Multiple distant metastases
