Sandbox:foreverlungs

Lung Mass Detected

Step 1: Assess likelihood of cancer ❑ Request enhanced CT scan

Step 2: What are the imaging features?

Hyperdense pulmonary mass ❑ Internal calcification

Cavitating pulmonary mass ❑ Gas-filled area ❑ Thick wall (must be greater than 2-5 mm)

Imaging approach ❑ Suspected lung cancer

Chest X Ray normal?

No

Yes

Enhanced Computed Tomography (ECT), includes: ❑ Thorax ❑ Upper Abdomen ❑ Low Neck

Manage and observe

Imaging evaluation

Location ❑ Central ❑ Peripheral ❑ Pleural lesion Size Lesion characteristics ❑ Margins (irregular/regular) ❑ Shape (spiculated/rounded) Presence of cavitation ❑ Yes ❑ No Type of adenopathy ❑ Hiliar ❑ Mediastinal

Diagnosis and Staging Assessment

Other Imaging or Diagnostic Modalities ❑ Endobronchial/endoscopic ultrasound ❑ Bronchoscopy ❑ Mediastinoscopy ❑ PET/CT

Biopsy

Diagnostic Evaluation Algorithm for Suspected Non-Small Cell Lung Cancer

Imaging approach ❑ Suspected lung cancer

Chest X Ray normal?

No

Yes

Enhanced Computed Tomography (ECT) ❑ Thorax ❑ Upper Abdomen ❑ Low Neck

Manage and observe

Peripheral ❑ Adenocarcinoma

Peripheral with enlarged nodes

Central ❑ Squamous cell lung cancer

Pleural lesion ❑ Adenocarcinoma

Diagnosis and Staging Assessment

Other Imaging or Diagnostic Modalities ❑ Endobronchial/endoscopic ultrasound ❑ Bronchoscopy ❑ Mediastinoscopy ❑ PET/CT

Biopsy