Radiology of Lung Cancer and Staging Flashcards
What can an opacity of a chest X-ray indicate?
Pulmonary nodule
Mass
What should you note about the mediastinal area?
Hilar vascular structures well defined
No widening of mediastinum
Central Trachea
What should you look for when examaning the lungs?
Compare zones
Between ribs for lung detail
Behind heart
In a chest X ray, what are the systematic review areas?
Hila
Lung apices
Behind heart
Behind diaphragm
What clinical history might be indicative of lung cancer?
- Increasing SOB
- Smoker
- History of pulmonary fibrosis
- Recent haemoptysis
What is the next step in diagnosis after a chest X ray?
CT
What does a CT tell you about a mass/nodule?
- Size
- shape
- border
- atelectasis
- density
- solid vs non-solid
(atelectasis - partial collapse/incomplete lung inflation)
What is a pulmonary mass?
Lung opacity over 3 cm
No mediastinal adenopathy (enlargement lymph nodes) or atelectasis
What is a pulmonasry nodule?
Lung opacity up to 3cm with no mediastinal adenopathy or atelectasis.
What can a solitary pulmonary nodule be indicative of?
Lung cancer - (likely if patient smokes, old age)
Metastasis - (from breast cancer, renal cancer, seminoma, sarcoma)
Benign lung neoplasm, carcinoid, hamartoma
Infection bacterial, tb or fungal
Vascular haematoma, AVM (arteriovenous malformation)
What does TIA stand for?
Transient ischaemic attack
Reults in lack of blood and oxygen to brain (mini-stroke)
Symptoms are short and temporary
What do the letters TNM stand for?
T - Size and position of tumour
N- nodal involvement
M - Metastasis (yes/no?)
What are the testing techniques to determine the T? (size and position)
CT
PETCT
Bronchoscopy - (uses fibre optic endosope)
How is N determined?
PET-CT
Mediatinoscopy
CT
EBUS/EUS
How is M determined?
PETCT
CT
bone scan