Diagnosis and Staging of Lung Cancer Flashcards
Explain how to systematically review a chest ray
- Name/ marker/rotation/penetration
- Presence of any lines/tubes/metalwork
- Airway- trachea/carina/bronchi
- Breathing- Lung fields/diaphragm/costophrenic angle
- Circulation- Heart/aortic knuckle/mediastinum
- Disability- Bones
- Everything else- Soft tissue
List the three things that could cause a complete white out on a CXR
large pleural effusion, complete collapse of the lung or pneumectomy
How can a large pleural effusion, complete collapse of the lung and a pneumectomy be differentiated from one another?
loss of volume (pneumothorax)
mediastinal shift (large effusion will push mediastinum away from that area
pneumothorax & pneumectomy will pull the mediastinal structures towards that side)
What day finding is diagnostic of lung cancer
Lobar collapse which fails to resolve in 2-3 weeks in a smoker aged >45
What should happen after a mass has been identified on CXR?
CT
How is a pulmonary mass differentiated from a pulmonary mass?
Pulmonary mass is an opacity in lung over 3cm with no mediastinal adenopathy or atelectasis
Pulmonary nodule is an opacity in lung up to 3cm with no mediastinal adenopathy or atelectasis
Describe TX (from the tumour scoring system)
Primary tumour cannot be assessed
Describe T0 (from the tumour scoring system)
No evidence of primary tumour
Describe T1 (from the tumour scoring system)
Tumour ≤3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of involvement of the main bronchus
Describe T2 (from the tumour scoring system)
Tumour >3 cm but <5 cm or
tumour with any of the following features;
- Involves main bronchus, but not carina
- Invades visceral pleura
- Associated with atelectasis or obstructive pneumonitis that extends to the hilar region involving part or all the lung
Describe T3 (from the tumour scoring system)
Tumour >5 cm but <7cm or one that directly invades any of the following: chest wall (including superior sulcus tumors) phrenic nerve parietal pericardium
or separate tumor nodule(s) in the same lobe as the primary
Describe T4 (from the tumour scoring system)
Tumour >7cm or invades any of the following:
- Diaphragm, mediastinum, heart, great vessels, trachea ,recurrent laryngeal nerve, esophagus, vertebral body, carina
- separate tumour nodule(s) in a different ipsilateral lobe
Describe N0 (from the tumour scoring system)
No regional lymph node metastases
Describe N1 (from the tumour scoring system)
Ipsilateral peribronchial , hilar or intrapulmonary nodes including by direct extension
Describe N2 (from the tumour scoring system)
Ipsilateral mediastinal, subcarinal lymph node metastases
