THORACIC Section 5: LUNG CANCER Flashcards
A solitary pulmonary nodule (SPN) is defined as?
- Oval lesion
- < 3 cm
- Needs to be surrounded by lung parenchyma
- No associated adenopathy or pleural effusion
What are the 4 classic “benign calcification” patterns?
What calcification pattern is considered the most suspicious?
“eccentric pattern”
Popcorn and central calcifications are benign except in the setting of what disease?
GI cancer
Solid calcifications are benign except in what disease?
Osteosarcoma
Benign or Malignant?
Air Bronchogram through the nodules
Malignant.
usually Adenocarcinoma in situ
Benign or Malignant?
Spiculated Margins “Corona Radiata Sign”
Malignant
Benign or Malignant?
Partially solid lesions with ground-glass component
Malignant
Benign or Malignant?
Presence of Fat
Benign
Benign or Malignant?
Rapid Doubling Time (less than 1 month)
Benign
Slow Doubling Time (longer than 16 months) *Stable at two years
Benign
Describe ground glass vs Consolidative
Ground Glass (GG) opacity is defined by preserved bronchial and vascular markings.
Consolidative (C) opacities will obscure the bronchial and vascular markings.
What is the moist suspicious morphology that you can have in a Solitary pulmonary nodule?
A part solid with a ground glass component
PET for SPN: Cancer vs Not Cancer
Solid Nodule (>1cm in size):
Hot = ?, COLD = ?
Ground Glass Nodules:
Hot = ?
COLD = ?
PET for SPN: Cancer vs Not Cancer
Solid Nodule (>1cm in size):
Hot = Cancer , COLD = Not Cancer
Ground Glass Nodules:
Hot = infectionn
COLD = CANCER
Solid noduel = HOT
GGO = COLD
70% of Lung CA is in the ___ Lobes
upper
Peripheral basilar cancer is more common in what condition?
Pulmonary fibrosis
SPN in the stting of head and neck CA is more likely to be a ?
Primary bronchogenic CA
Screening CT minimum size thickness
2.5 mm
The most commonly encounter “risk” of lung CA
False positive
Growth is considdered __ mm or more in 1 year
1.5 mm
LUNG RADS Category
Negative, < 1% chance of CA. Either no nodules or granulomas
Follow up in?
Category 1, 1 year follow up
LUNG RADS Category
Benign < 1 % change of CA.
Baseline exam - Nodules smaller thant 6 mm.
Subsequent exam - No new nodules larger than 4 mm.
Ground glass nodule smaller thant 30 mm.
Perifissural nodules < 10 mm
Ff up in?
Category 2
Follow up in 1 year
Probably Benign, 1-2%. chance of CA.
Baseline nodule 6-8 mm.
Subsequent exam new nodule >4mm.
Ground glass >30 mm
Category 3
6 month follow-up
LUNG RADS Category
Suspicious, 5-15% chance of CA
Baseline 8-15 mm
New nodule 6-8 mm
Follow-up?
Category 4a
3 months follow up vs PET
