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Respiratory system SA > Radiology of lung cancer and staging > Flashcards

Radiology of lung cancer and staging Flashcards

1
Q

What does your survival rate depend on in the diagnosis of lung cancer

A

Availability for surgery

Early diagnosis

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2
Q

In a chest ray what parts are visible and checked

A

Name/marker/rotation/ penetration

Lines/metal work

Heart

Mediastinum

Lungs
Zones (upper/middle/lower)

Bones

Diaphragm

Soft Tissues

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3
Q

What clinical features should you look out for in the mediastinum in a chest x ray

A

Hilar vascular structures should be crisply defined
No widening of mediastinum
Trachea should be central

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4
Q

Where is the special review areas in a chest x ray of the lungs

A

Hila
Lung apices
Behind the heart
Behind the diaphragm

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5
Q

What is a hillier mass, what does it usually indicate

A

abnormality in one or both of the hilar lymph nodes in the lungs, usually indicating bronchogenic carcinoma

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6
Q

Where is a pancost tumour located

A

a tumor of the pulmonary apex

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7
Q

What is the a similarity and difference between a pulmonary nodule and pulmonary mass

A

both have no enlargement of mediastinal lymph nodes

But a pulmonary mass is greater than 3cm, where a pulmonary nodule is up to 3cm

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8
Q

Define atelectasis

A

partial collapse or incomplete inflation of the lung

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9
Q

No all pulmonary masses or nodules can be deemed lung cancer what are the other possibilities

A

Metastasis
Benign lung neoplasm
Infection, bacterial, TB, fungal
Vascular haematoma

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10
Q

What effect do small tumour within a main area have

A

they have a dramatic effect

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11
Q

In diagnosing lung cancer with radiology what information do you need to gather

A

Clinical history

Compare with previous films

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12
Q

What diagnosis technique is particularly good in characterising lesions

A

CT

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13
Q

What does T stand for in TNM staging

A

How big it is and how far has it spread /Size and position of the tumour

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14
Q

What does N stand for in TNM staging

A

Whether cancer cells have spread into the lymph nodes

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15
Q

What does M stand for in TNM staging

A

Whether the tumour has spread anywhere else in the body ie metastases

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16
Q

What diagnostic techniques can assess T

A

CT
PET
Bronchoscopy

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17
Q

What is the diagnostic techniques to assess N

A

PET - CT
mediastinoscopy
EBUS/EUS - tissue diagnosis

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18
Q

What is the diagnostic techniques to assess M

A

PET - CT

Bone scan

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19
Q

What is a mediastinoscopy

A

procedure used to examine the mediastinum, good in examining lymph nodes

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20
Q

What is a PET scan labeled with and why is this useful

A

glucose analogue FDG
This is recognised by tumours as glucose which takes lots of it - failt to metabolise and accumulate it - shows up on PET scan where tumours are located

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21
Q

What is the disadvantage to a PET scan

A

Expensive
Limited
exclude cerebral diseases - brains absorbs to much glucose

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22
Q

What does TX stand for

A

Primary tumour cannot be assessed

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23
Q

What does T0 stand for

A

no evidence of primary tumour

24
Q

What does Tis stand for

A

carcimona in situ - group of abnormal cells with the potentially to be cancerous

25
Q

What is the tumour growth sizes for T1 staging

A

Tumour growth below 3cm
T1a- 1cm
T1b-2cm
T1c-3cm

26
Q

Does T1 evolve the main bronchus

A

No

27
Q

What is the tumour growth for T2a/b Lung cancer

A

T2a- 3-4cm

T2b - 4-5cm

28
Q

What does T2 stage of lung cancer invade

A

Involves main bronchus, but not carina

Invades visceral pleura

29
Q

At the phase of T2 Lung cancer what can occur

A
  • Atelectasis - partial collapse or incomplete inflation of the lung
  • obstructive pneumonitis that extends to the hilar region involving part or all the lung
30
Q

What is the characteristics of T3 lung cancer

A

tumour growth 5-7cm span

or separate tumor nodule(s) in the same lobe as the primary

31
Q

What structures are invaded in T3 lung cancer

A

chest wall (including superior sulcus tumors)
phrenic nerve
parietal pericardium

32
Q

What is the characteristic of T4 lung cancer

A

tumour growth above 7cm

Separate tumour nodules on different ipsilateral lobes

33
Q

Where does T4 stage of lung cancer invade

A 
Diaphragm
mediastinum
heart
great vessels
trachea
recurrent laryngeal nerve
esophagus
vertebral body
carina
34
Q

What is PET and CT scan checking for in T staging

A

assessing chest wall
and
mediastinal invasion

35
Q

What does N0 stand for in lung cancer staging

A

No regional lymph node metastases

36
Q

What does N1 stand for in lung cancer staging

A

Ipsilateral peribronchial , hilar or intrapulmonary nodes including by direct extension (same side)

37
Q

What does N2 stand for in lung cancer staging

A

Ipsilateral mediastinal, subcarinal (same side)

38
Q

What does N3 stand for in lung cancer staging

A

Contralateral mediastinal, contralateral hilar, scalene or supraclavicular (both sides)

39
Q

What has greater infect in increasing Metastases the number of lymph nodes or the size

A

The size of the lymph nodes

40
Q

Above which size will the lymph nodes give 100% metastases

A

> 4cm

41
Q

Where is lung cancer most likely to metastasis

A

Cerebral
Skeletal
Adrenal
liver

42
Q

How much patients present with metastasis

A

1/3

43
Q

What does the M0 in lung cancer staging present

A

No distant metastasis

44
Q

What does the M1 in lung cancer staging present

A

Distant metastasis

45
Q

What does the M1a in lung cancer staging present

A

Separate tumour nodule(s) in a contralateral lobe

Tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion

(to the lungs and the heart)

46
Q

What does the M1b in lung cancer staging present

A

single distant metastasis

47
Q

What does the M1c in lung cancer staging present

A

multiple distant metastases

48
Q

What is the benefit of PET-CT scan

A

non invasive
discloses metastases and other pathology not detected by other means
performs whole body staging in a single

49
Q

What is stage 1A

A

T1 N0 M0 (67% survival)

50
Q

What is stage 1B

A

T2 N0 M0 (57% survival)

51
Q

What is stage 11A

A

T1 N1 M0 (55% survival)

52
Q

What is stage 11B

A

T2 N1 MO/T3 NO MO (39% survival)

53
Q

What is stage 111A

A

T3 N1 MO/T3 N2 MO (23% survival)

54
Q

What is stage 111B

A

T4 NO-2 MO/T1-4 N3 MO (5% survival)

55
Q

What is stage IV

A

any T any N M1

56
Q

What is the survival rate at stage IV

A

1%

Respiratory system SA (37 decks)

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