Module 7 - Cancer Flashcards
What is the size criteria for a lung nodule?
Nodule: lesion <3cm in size
What is the size criteria for a lung nodule?
Nodule: lesion <3cm in size
Differentials for ground glass appearance of lung parenchyma on CT?
○ Consolidation/air (vessels can be seen passing through it)
○ Acutely: infection, oedema, haemorrhage
○ Chronic: fibrosis, tumour
What is atypical adenomatous hyperplasia? How does it usually appear on Chest CT?
Precursor lesion to adenocarcinoma: also known as adenocarcinoma in situ
○ Round/lobular GGN
○ Usually <5mm
○ Slow growth (volume doubling time >800 days)
Differentiate between N1 and N2 disease in lung adenoacarcinoma
N1 nodes are within the confines of the pleural reflection and are therefore intrapulmonary.
N2 nodes are outside the pleural reflection and are therefore mediastinal.
N1 disease are considered surgically resectable in the absence of mediastinal invasion by tumor, a malignant pleural effusion, satellite nodules, or metastases
Which has the highest risk of malignancy?
Solid
Mixed solid and ground glass
Ground Glass
mixed > ground glass > solid
if solid part of mixed is >10mm, need PET or biopsy
T stage of pleural involvement
T stage of chest wall involvement
when do they become unresectable
T2: pleural involvement or bronchus involvement
T3: chest wall involvement
T3a remains resectable
Indications for PET in workup of a lung nodule (2)
- staging
- evaluation of nodule without ability to biopsy
Typical appearance of hepatic metastases
- Hypovascular: minimal arterial enhancement, often solid and les well-defined than cysts
- Hypervascular: arterial enhancement, hypodense in portal venous phase with small washout
- Often from neuroendocrine tumours, RCC
don’t take up HPB specific contrast
HCC appearance on CT
Arterial enhancement
Washout to hypodense
Enhancing capsule
Utility of the 4 phases of CT pancreas
early arterial: for arterial structures
late arterial: pancreas enhances, adenoca will be hypodense
portal venous: increasing enhancement
pre-contrast: assess for LN enhancement
Characteristics of unresectable pancreatic cancer (4)
- Distant mets
- SMV or portal vein occlusion unresectable
- Coeliac axis/SMA encasement >180 degrees
- aortic invasion or encasement
Characteristics of borderline resectable pancreatic cancer (4)
- No distant mets
- SMV or portal vein involvement with safe reconstruction possible
- Hepatic artery short segment involvement, no extension into coeliac axis
- SMA abutment, not >180 degrees
Determine superior vs inferior and medial vs lateral on standard mammography
Lower on a C-C is medial, upper on a C-C is lateral
Upper of MLO is upper, lower is inferior (in reference to nipple)
Right breast is left image
U/S features of breast cancer (6)
○ Spiculated ○ Hypoechoic ○ Ill-defined margins ○ Interrupted tissue plans ○ Posterior shadowing ○ taller rather than wide
