Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Histologically, NSCLC is divided into adenocarcinoma, squamous cell carcinoma (SCC) (see the image below), and large cell carcinoma. Small cell lung cancer (SCLC), previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics.
Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Histologically, NSCLC is divided into adenocarcinoma, squamous cell carcinoma (SCC) (see the image below), and large cell carcinoma. Small cell lung cancer (SCLC), previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics.
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
Etiology of Leprosy:
A chronic infection caused by Mycobacterium leprae
Acid-fast, rod shaped
Main route of infection:
nasal droplets,
Eating armadillos (south america)
Not very contagious, but close relatives are at high risk of infection
In this presentation our agenda is
Brief introduction
Radiological Modalities
Radiological Features
Radiological Imaging Of Complications of lung cancer.
I followed Dahnert and try to describe all findings in lung cancer.
Hope it will prove an atlas in Lung cancer imaging.
Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
2024.06.01 Introducing a competency framework for languag learning materials ...
Lung cancer
1. Dr. ASHISH K GUPTA
PG II YEAR
RADIODIAGNOSIS
SLIMS
2. Lung cancer, or frequently, if somewhat
incorrectly, known as bronchogenic
carcinoma,
The most common cause of cancer in men,
and the 6th most frequent cancer in women
worldwide.
It is the leading cause of cancer mortality
worldwide in both men and women and
accounts for approximately 20% of all cancer
deaths
3. Epidemiology
Lung cancer is the most common fatal malignancy
worldwide both in male and female.
The major risk factor is CIGARETTE SMOKING
which is implicated in 90% of cases and increase
the risk of lung cancer 20-30 times.
Other risk factors:
asbestos: 5x increased risk
occupational exposure: uranium, radon, arsenic,
chromium
diffuse lung fibrosis: 10x increased risk
chronic obstructive pulmonary disease
4. Clinical presentation
Patients with lung cancer may be asymptomatic in up
to 50% of cases.
Cough and dypnoea are rather non-specific
symptoms that are common amongst those with lung
cancer.
Central tumours may result in haemoptysis and
peripheral lesions with pleuritic chest pain.
Pneumonia, pleural effusion, wheeze,
lymphadenopathy are not uncommon. Other
symptoms may be secondary to metastases (brain,
liver, bone) or to paraneoplastic syndromes.
5. Pathology
The term bronchogenic carcinoma is
somewhat loosely used to refer to primary
malignancies of the lung
associated with inhaled carcinogens and
includes four main histological subtypes.
These are broadly divided into non small-
cell carcinoma and small cell carcinoma as
they are differ clinically in terms of
presentation, treatment and prognosis:
6. NON SMALL-CELL LUNG
CANCER (NSCLC) (80%)
Adenocarcinoma (35%)
Most common cell type overall
Most common in women
Most common cell type in non-smokers but still most patients
are smokers
Peripheral
Squamous cell carcinoma (30%)
Strongly associated with smoking
Most common carcinoma to cavitate
Poor prognosis
Large-cell carcinoma (15%)
Peripherally located
Very large, usually more than 4 cm
7. SMALL CELL
CARCINOMA (20%)
Almost always in smokers
Metastasises early
Most common primary lung malignancy
to cause paraneoplastic
syndromesand SVC obstruction
Worst prognosis
Other malignant pulmonary neoplasms
include lymphoma and sarcoma (rare)
8. Non-small cell lung cancer
(NSCLC) staging
Non-small cell lung cancer (NSCLC)
staging can be accomplished both by
the TNM system, or by the AJCC
staging system.
9. TNM system
Primary tumour (T)
Tx: malignant cells on cytology but no
tumour found on bronchoscopy or imaging.
Tis: carcinoma in situ
T1
tumour size equal or less than 3cm
not involving the main bronchus
○ T1a: smaller than 2 cm in longest dimension
○ T1b: larger than 2 cm but smaller or equal to 3
cm
10. Stage T1 tumors. (a) Chest CT scan shows a left lower lobe nodule (arrow)
measuring less than 2 cm in size, a finding that is consistent with a stage
T1a tumor (≤2 cm). (b) Chest CT scan obtained in a different patient shows
a right upper lobe nodule (arrow) measuring 2.9 cm in size, a finding that
is consistent with a stage T1b tumor (>2 cm but ≤3 cm).
11. T2:
Tumour size more than 3cm but
less/equal to 7cm or
Involving the main bronchus but >2 cm
from carina
Visceral pleural involvement
Lobar atelectasis extending to the hilum
but not collapse of the entire lung
T2a: larger than 3 cm but smaller than 5 cm
T2b: larger than 5 cm but smaller than 7 cm
12. Stage T2 tumors. (a) Chest CT scan shows a centrally located lung nodule (arrow)
causing airway obstruction, with atelectasis or postobstructive pneumonia that
does not, however, involve the entire lung. (b) Chest CT scan obtained in a
different patient shows a mass in the right lung (arrow) measuring 4.8 cm, a
finding that is consistent with a stage T2a tumor (>3 cm but ≤5 cm). (c) Coronal
chest CT scan obtained in a third patient shows a nodule in the bronchus
intermedius (arrow). The nodule is 4 cm from the carina (an endobronchial lesion
> 2 cm from the carina is considered stage T2
13. T3
Tumour size more than 7 cm or
tumour <2 cm from carina but not involving
trachea or carina
Involvement of the chest wall, including
pancoast tumour, diaphragm, phrenic
nerve, mediastinal pleura or parietal
pericardium
Separate tumour nodule(s) in the same
lobe
Atelectasis or post obstructive pneumonitis
of entire lung
14. Stage T3 tumors.
(a) Chest CT scan shows an irregular mass in the left upper lobe with
suspicious local extension to the mediastinal pleura (arrow).
(b) Chest CT scan obtained in a different patient shows an endobronchial
mass (arrow) less than 2 cm from the carina.
(c) Chest CT scan obtained in a third patient shows a left lower lobe mass
over 7 cm in diameter (arrow).
15. Stage T3 tumors. Chest CT scan shows a primary mass
(arrow) with satellite nodules (arrowheads) in the right
lower lobe.
16. T4
any size tumour with:
involvement of the trachea, oesophagus,
recurrent laryngeal nerve vertebra, great
vessels or heart
separate tumour nodules in the same
lung but not in the same lobe
17. Stage T4 tumors. Chest CT scan shows a primary lung
tumor in the right upper lobe (long arrow) with a smaller
separate nodule in the right lower lobe (short arrow).
18. Stage T4 tumors. Chest CT scan shows a right upper
lobe mass (arrow) with mediastinal and carinal
invasion, ipsilateral loculated pleural effusion, and
thickening and enhancement of the pleura.
19. Nodal status (N)
Nx: regional nodes cannot be assessed
N0: no regional nodal metastases
N1: ipsilateral peribronchial, hilar or
intrapulmonary nodes, including direct
invasion
N2: ipsilateral mediastinal or subcarinal
nodes
N3: contralateral nodal involvement ;
ipsilateral or contralateral scalene or
supraclavicular nodal involvement
20. Stage N1 lymph nodes.
(a) Chest CT scan shows an enlarged right hilar lymph node (level 10) (arrow)
measuring 15 mm in the short axis.
(b) Chest CT scan shows a left lower lobe mass and an ipsilateral enlarged
interlobar lymph node (level 11) (arrow) measuring 11 mm in the short axis
21. Stage N2 lymph nodes. (a) Chest CT scan shows an enlarged (1.6-cm) right upper
paratracheal lymph node (level 2) (arrowhead). (b) Chest CT scan obtained in a
different patient shows an enlarged (1.5-cm) right lower paratracheal lymph node
(level 4) (arrowhead). (c) Chest CT scan obtained in a third patient shows a right
lower lobe mass (white arrow) with an enlarged (1.6-cm) subcarinal lymph node
(level 7) (black arrow )
22. Stage N3 lymph nodes. (a) Axial PET/CT image of the chest shows a primary
mass in the left lung (arrow) and a right lower paratracheal lymph node
(arrowhead), both of which demonstrate intense radiotracer uptake.
Metastatic involvement of the lymph node was confirmed at
mediastinoscopic resection. (b) Chest CT scan obtained at the lung apex in
a different patient shows enlarged bilateral supraclavicular lymph nodes
(arrows).
23. Distant metastasis (M)
Mx: distant metastases cannot be
assessed
M0: no distant metastases
M1: distant metastases present
M1a: presence of a malignant pleural or
pericardial effusion, pleural dissemination, or
pericardial disease, and metastasis in
opposite lung
M1b: extrathoracic metastases
24. Metastatic disease as seen at
conventional imaging. (a) Axial contrast
material–enhanced T1-weighted MR
image of the brain obtained in a
patient with known primary lung
cancer shows a ring-enhancing lesion
with surrounding edema in the right
occipital pole (arrow), a finding that is
consistent with metastasis. (b)
Abdominal CT scan obtained in a
different patient shows multiple
enhancing hepatic masses (arrows)
and a right adrenal mass (arrowhead),
findings that are consistent with
metastatic disease. (c) Technetium-
99m methylene diphosphonate nuclear
bone scintigrams obtained in a third
patient with lung cancer show
multifocal areas of abnormal
radiotracer uptake in the axial and
appendicular skeleton, findings that
are consistent with metastases
25. Types of bone metastases in lung cancer. (a)
Blastic; (b) Lytic; (c)
Mixed; (d) Bone marrow.
26. AJCC staging system
stage 0
TNM equivalent: carcinoma in stiu
resectable: yes
stage I
TNM equivalent: T1 or T2, N0, M0
resectable: yes
5 year survival: 47%
stage IIa
TNM equivalent: T1, N1, M0
resectable: yes
stage IIb
TNM equivalent: T2, N1, M0 or T3, N0, M0
resectable: yes
5 year survival: 26%
stage IIIa
TNM equivalent: T1 or 2, N2, M0 or T3, N1 or 2, M0
resectable: yes
--------------- accepted cut off between resectable and non resectable ----------
stage IIIb
TNM equivalent: T1, 2 or 3, N3, M0 or T4, N0, 1, 2 or 3, M0
resectable: no
5 year survival: 8%
stage IV
TNM equivalent: any T, any N with M1
resectable: no
5 year survival: 2%
27. PET/CT
PET/CT is a hybrid imaging technique that
provides anatomical information of the CT
and metabolic information of the PET,
allowing to visualize both individually or
fused in 3D or bidimensional slices.
The most commonly used radiotracer is
F18-FDG,
which allows detecting primary tumors as
well as metastasis that consume glucose,
corresponding to the majority of the
malignant pulmonary lesions.
28. Partially necrotic left pulmonary tumor with rib involvement. Transthoracic
needle biopsy has to be directed to periphery of tumor for viable sample.
There are two metastases in infraclavicular node and muscular location
(arrows),both of them negative in CT.
29. As each subtype has a different
radiographic appearance, demographic,
and prognosis:
squamous cell carcinoma of the lung
adenocarcinoma of the lung
large cell carcinoma of the lung
small cell carcinoma of the lung
30. Squamous cell
carcinoma (SCC)
Squamous cell carcinoma (SCC) is
one of the non-small cell carcinomas of
the lung, overtaken by adenocarinoma
of the lung as the most
commonly encountered lung cancer.
31. Epidemiology
Squamous cell carcinoma accounts for ~30-35%
of all lung cancers and in most instances are due
to HEAVY SMOKING .
In general, squamous carcinomas are
encountered more frequently in male smokers,
and adenocarcinoma in female smokers.
32. Clinical presentation
depends on the location of the tumour
A chronic cough and haemoptysis may be
present.
More peripheral tumours, (e.g. Pancoast tumour)
Metastatic disease may be the first sign of
malignancy (e.g. cerebral metastasis,pathological
fracture, etc).
33. Pathology
known to arise centrally (66-90%), the incidence of
peripherally located SCC is increasing .
Macroscopically these tumours tend to be off-white in
colour, arising from, and extending into a bronchus.
They invade the surrounding lung parenchyma and can
extend into the chest wall.
Larger tumours have a tendency to undergo central
necrosis.
Four subtypes are recognised :
papillary
clear cell
small cell (not to be confused with small cell lung cancer)
basaloid
34. Metastases
Most common sites of metastatic disease
are :
Regional lymph nodes
Adrenal glands (see adrenal gland
tumours)
Brain (see cerebral metastases)
Bone (see skeletal metastases)
Liver (see liver metastases)
35. Radiographic features
Chest radiograph
The appearance depends on the location of the
lesion.
When the right upper lobe is collapsed and a hilar
mass is present, this is known as the Golden S
sign.
A more peripheral location may appear as a
rounded or spiculated mass. Cavitation may be
seen as an air-fluid level.
A pleural effusion may also be seen, and although
it is associated with a poor prognosis,
36. (a) and bronchogram (b) show the characteristic growth pattern of these tumors
in a patient with a squamous cell carcinoma of the night main stem bronchus.
Note the irregular narrowing (arrow) of to bronchial lumen, which may result in
postobstructive pneumonia or atelcısis
37. Squamous cell carcinoma in a 57-year-old man.
PA (a) and lateral (b) chest radiographs demonstrate a complete consolidation
of the right upper lobe. At bronchoscopy, an endobronchial tumor of the r ı t
main stem bronchus was identified.
38. Squamous cell carcinoma in a 63-year-old woman with dysphagia and weight
loss. (a) Frontal chest radiograph demonstrates opacification of the left
hemithorax and ipsilateral mediastinal shift consistent with complete atelectasis of
the left lung. Lack of visualization of the left main stem bronchus suggests central
occlusion. (b) Contrast-enhanced chest CT scan (mediastinal window)
demonstrates a softtissue mass (in), which narrowed and obstructed the left main
stem bronchus, left lung atebectasis, and left pleural effusion. At bronchoscopy, a
circumferential, friable obstructing endobronchial lesion was found.
39. Squamous cell carcinoma in a 62-year-old man with left shoulder pain. (a, b) Thin-
section chest CT scans (lung window) show an endobronchial nodule (arrow in a) within
the right lower lobe bronchus.
There is involvement of the adjacent lung parenchyma with associated volume loss of
the night lower lobe.
Note the bobulated mass (arrowhead in b) that displaces the major fissure. (C) Gross
specimen of the resected right lower lobe shows the endobronchial component of the
tumor
40. Squamous cell carcinoma in a 72-year-old man
with left arm pain, chest pain, and increasing dyspnea.
(a) PA chest radiograph demonstrates a large rounded cavitary
mass with an air-fluid level in the superior segment of the left lower lobe. Note the
nodular, irregular contour of the inner wall of the cavity. (b) Contrast-enhanced chest CT
scan (mediastinal window) demonstrates the air-fluid level within the lesion and the
irregular aspect of its inner wall.
41. CT
Cavitation is a frequent finding in primary lung
SCC but can also be encountered in metastatic
SCC.
Cavitation is secondary to tumoral necrosis.
SCC can have a central scar with peripheral
growth of tumor.
42. Differential diagnosis
The differential diagnosis depends on
the location and appearance of the
mass.
hilar mass (unilateral): differential for a
hilar mass
solitary pulmonary nodule: differential for
a solitary pulmonary nodule
pleural effusion: differential for a pleural
effusion
43. Adenocarcinoma of the
lung
one of the non-small cell carcinomas of
the lung
a malignant tumour with glandular
differentiation or mucin production.
Tumour exhibits various patterns and
degrees of differentiation, including
lepidic, acinar, papillary, micropapillary
and solid with mucin formation
44. Epidemiology
It is now considered the most common
histological subtype in terms of
prevalence.
Clinical presentation
Early symptoms are fatigue with mild
dyspnoea followed by chronic cough
and haemoptysis at a later stage.
45. Radiographic features
A lung nodule is a rounded or irregular
region of increased attenuation
measuring less than 3 cm.
The amount of attenuation can further
classify the nodules as either ground
glass, sub-solid or solid.
46. Adenocancinoma in an asymptomatic 58-year-old male smoker with a radiographic
abnormalitfound incidentally on a preoperativeradiograph obtained before cataract
surgery.
(a) Posteroantenior (PA) chest radiograph shows alobulated 1.5-cm solitary nodule
(arrow) in theright upper lobe overlying the first anterior rib
47. (b) Chest computed tomographic (CT) scan (lungwindow) shows large bullae
surrounding a wellmarginated,lobulated soft-tissue nodule.
48. Adenocarcinoma in a 41-year-old man with right shoulder pain for several
months. (a) Apical brdotic
chest radiograph demonstrates a right apical mass with poorly marginated
borders. (b) Chest CT scan
(lung window) shows a homogeneous peripheral right upper lobe mass with
irregular borders. There is tumon
involvement of a posterior rib (arrow).
50. Large cell carcinoma of the
lung
Large cell carcinoma of the
lung is one of the histological type
of non-small cell carcinomas of the lung.
Epidemiology
It is thought to account for approximately
10% of bronchogenic carcinoma .
Clinical presentation
Patient presents with dyspnea, chronic
cough and haemoptysis.
51. Radiographic features
Large cell carcinoma of the lung typically
presents as a large peripheral mass of
solid attenuation and irregular margin.
Focal necrosis can be present.
Other characteristics include rapid
growth and early metastasis.
52. large cell carcinoma in a 61-year-old woman with blood-streaked
sputum and weight loss. (a) PA chest radiograph demonstrates a large
peripheral mass of the left upper lobe,
which abuts the pleural surface and has a bobubated contour.
53. large cell carcinoma in a
57-year-old man with weight loss, orthopnea, and a painful palpable mass of the
anterior chest wall on the
left side. (a) Contrast-enhanced chest CT scan (mediastinal window) demonstrates
a large mass of heterogeneoUs
attenuation, which produces mass effect on the mediastinal structures.
54. Small cell lung cancer
(SCLC)
Also known as oat cell lung cancer is a subtype of
bronchogenic carcinoma .
Rapidly grow,
Are highly malignant,
Widely metastasise and show initial response to
chemotherapy and radiotherapy.
Sclcs have a very poor prognosis and are usually
unresectable.
Epidemiology
Small cell lung cancers represent 15-20% of lung
cancers and is strongly associated with cigarette
smoking.
55. Clinical presentation
Clinical presentation can significanctly vary and can present in the
following ways.
constitutional
fever
weight loss
malaise
primary tumour
cough
haemoptysis
dyspnoea
local invasion
dysphagia (oesophageal compression)
hoarseness (recurrent laryngeal nerve palsy)
stridor (airway compression)
SVC obstruction
rib erosion
metastatic spread (affecting ~70% of patients are presentation)
bone pain (bone metastases)
focal neurological deficit (CNS involvement)
right upper quadrant pain (liver metastases)
paraneoplastic syndromes
56. Pathology
It arises from the bronchial mucosa.
Local invasion occurs in the submucosa with subsequent
invasion of peribronchial connective tissue.
Cells are small, oval, with scant cytoplasm and a high
mitotic count.
It is the most common lung cancer subtype to produce
necrosis, superior vena cava (SVC) infiltration/SVC
obstruction, and paraneoplastic syndromes.
Location
Approximately 90-95% of SCLCs occur centrally, and
usually arising in a lobar or main bronchus .
57. Radiographic features
located centrally in the vast majority of cases
(90%). They arise from main-stem of lobar
bronchi, and thus appear as hilar or perihilar
masses .
They frequently have mediastinal lymph node
involvement at presentation.
Plain film
seen as a hilar/perihilar mass usually with
mediastinal widening due to lymph node
enlargement.
58. CT
On CT mediastinal involvement may appear
similar to lymphoma, with numerous enlarged
nodes.
Direct infiltration of adjacent structures is more
common.
Small cell carcinoma of the lung is the most
common cause of SVC obstruction, due to both
compression/thrombosis and/or direct infiltration .
Necrosis and haemorrhage are both common.
CT is able to stage small cell cell lung cancer.
59. Small cell carcinoma in a 41-year-old woman with persistent cough and weight
loss.
(a) PA chest radiograph shows a lobulated right hilar mass. (b) Frontal linear
chest tomogram shows smooth
narrowing of the bronchus intermedius due to extrinsic compression by the hilar
mass, which represented
lymph node metastases from small cell carcinoma.
60. Small cell carcinoma in a 72-year-old man with a history of dyspnea.
(a) Chest CT scan demonstrates a spiculated nodule in the right upper lobe.
(b) Contrast enhanced chest CT scan (mediastinal window) shows massive
mediastinal lymphadenopathy secondary to lymph node metastases.
61. Differential diagnosis
Imaging imaging differential considerations
include
non small-cell lung cancer
squamous cell carcinoma of the lung
adenocarcinoma of the lung
undifferentiated large-cell carcinoma of the lung
lymphoma
pulmonary sarcoma (rare)
pulmonary metastases
benign lung lesions
62. Paraneoplastic
Syndromes
Various paraneoplastic syndromes can
arise in the setting of lung cancer:
ENDOCRINE
SIADH causing hyponatraemia: small-cell sub
type
ACTH secretion (Cushing syndrome): carcinoid
and small-cell sub type
PTHrp causing hypercalcaemia: squamous cell
carcinoma
Carcinoid syndrome
Gynaecomastia
65. case
Pt came to orthopedics department with
trauma , and was referred for PAC and
consequently chest radiograph was
taken
Pt gave history of smoking last 10-15
years but was asymptomatic.
66. Chest radiograph
Findings reveals :-
9999 Left upper lobe
homogeneous opacity
with minimal hilar
enlargement measuring
approx 3 x 3.4 cm
Another nodular
homogeneous opacity
noted in the right upper
lobe measuring 1.5 cm.
67. CT findings reveals :-
A central cavitary mass lesion measuring 3.1 x 3.4 cm with thin
walls measuring 0.4 -0.5 cm and spiculated margins and chunky
calcification in the inferior wall of cavity with CT densitometric
value of 110 - 140 HU in left upper lobe posterior segment.
68.
69. Another solitary lesion measuring 2.5 cm with central
hyperdense focal calcification noted in the right upper
lobe .