Diagnosis And Staging Of Lung Cancer

Question 1

Which hilum is higher

Answer 1

Left

Question 2

Systematic review

Answer 2

Name/marker/rotation/penetration
Lines/metal work 
Heart
Mediastinum 
Lungs (upper middle lower zones)
Bones
Diaphragm
Soft tissues

Question 3

Hilum in xrays

Answer 3

Should be crisply defined with a central trachea and no widening of Mediastinum

Question 4

Review areas for chest xray

Answer 4

Hila, lung apices, behind the heart, behind the diaphragm

Question 5

Pleural effusion

Answer 5

Too much fluid in pleural cavity

Question 6

Haemoptysis

Answer 6

Coughing up blood

Question 7

After found something on an xray

Answer 7

Do a CT for size, shape, atelactasis(collapse), border, density, solidity, dynamic contrast enhancement, growth

Question 8

Nodule vs mass

Answer 8

Mass>3cm≥nodule (opacity with no mediastinal adenomatous or atelactasis)

Question 9

What cancers metastasise in lungs

Answer 9

Breast, renal, seminoma (testicular), sarcoma

Question 10

TIA

Answer 10

Almost like a stroke, mini

Question 11

TNM staging - T

what imaging is used for it

Answer 11

How big it is and how far it’s spread (size and position)
CT
PET-CT
Bronchoscopy

Question 12

TNM staging - N

Answer 12

Whether it's spread to lymph nodes or not
PET-CT 
Mediastinoscopy
CT 
EBUS (endoscopic bronchial ultrasound)

Question 13

TNM staging - M

what scans are used

Answer 13

Whether it has metastasised
PET-CT
CT
Bone scan

Question 14

Functional PET scan

Answer 14

Use 18F FDG (glucose analogue, shows tumours inflammation and infection)

Question 15

Half body time of FDG glucose

Answer 15

60mins

Question 16

Tx

Answer 16

Primary tumour cannot be assessed

Question 17

T0

Answer 17

No evidence of primary tumour

Question 18

Tis

Answer 18

Carcinoma in situ

Question 19

T1

Answer 19

≥3cm, surrounded by lung or visceral pleural, no main bronchial involvement

Question 20

T1a

Answer 20

Less than 1cm

Question 21

T1b

Answer 21

Less than 2cm

Question 22

T1c

Answer 22

Less than 3cm

Question 23

T2

Answer 23

> 3cm, with any of: involve main bronchus, but not carina, invades visceral pleura, associated with atelactasis or obstructive pneumonitis in hilar region

Question 24

T2a

Answer 24

Between 3 and 4cm

Question 25

T2b

Answer 25

Between 4 and 5cm

Question 26

T3

Answer 26

Between 5 and 7cm and invades any of: chest wall, phrenic nerve, parietal pericardium. Or has separate nodules in same lobe as primary

Question 27

T4

Answer 27

Over 7cm or invades any of: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, oesophagus, vertebral body, carina. Or has separate tumour nodules in different ipsilateral lobe

Question 28

N0

Answer 28

No regional lymph node metastasis

Question 29

N1

Answer 29

Ipsilateral peribronchial, hilar or intrapulmonary nodes

Question 30

N2

Answer 30

Ipsilateral mediastinal or subcarinal

Question 31

N3

Answer 31

Contralateral or scalene or supraclavicular

Question 32

Common sites of metastasis of lung disease

Answer 32

Cerebral, skeletal, adrenal, liver

Question 33

M0

Answer 33

No distant metastasis

Question 34

M1

Answer 34

Distant metastasis

Question 35

M1a

Answer 35

Separate tumour nodules in contralateral lobe or pleural/pericardial

Question 36

M1b

Answer 36

Single distant metastasis

Question 37

M1c

Answer 37

Multiple distant metastasis

Question 38

Tissue diagnosis

Answer 38

Bronchoscopy and EBUS, percutaneous image/CT/US guided biopsy