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==Overview==
==Overview==
Chest X-ray is the initial imaging study in a patient with suspected non-small cell lung cancer. The initial evaluation of suspected lung cancer will depend upon the results of the chest X-ray. Further evaluation of suspected lung cancer includes contrast-enhanced CT scan of the chest, neck, and abdomen.


On chest X-ray, characteristic findings of non-small cell lung cancer include rounded or spiculated mass, bulky [[hilum]] (representing the tumor and local nodal involvement) and lobar collapse.<ref name="pmid8190965">{{cite journal |vauthors=Rosado-de-Christenson ML, Templeton PA, Moran CA |title=Bronchogenic carcinoma: radiologic-pathologic correlation |journal=Radiographics |volume=14 |issue=2 |pages=429–46; quiz 447–8 |year=1994 |pmid=8190965 |doi=10.1148/radiographics.14.2.8190965 |url=}}</ref>
==X-Ray==
Conventional chest radiograph may be helpful in the diagnosis of non-small cell lung cancer.<ref name="PurandareRangarajan2015">{{cite journal|last1=Purandare|first1=NilenduC|last2=Rangarajan|first2=Venkatesh|title=Imaging of lung cancer: Implications on staging and management|journal=Indian Journal of Radiology and Imaging|volume=25|issue=2|year=2015|pages=109|issn=0971-3026|doi=10.4103/0971-3026.155831}}</ref><ref name="pmid8190965">{{cite journal |vauthors=Rosado-de-Christenson ML, Templeton PA, Moran CA |title=Bronchogenic carcinoma: radiologic-pathologic correlation |journal=Radiographics |volume=14 |issue=2 |pages=429–46; quiz 447–8 |year=1994 |pmid=8190965 |doi=10.1148/radiographics.14.2.8190965 |url=}}</ref><ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>
*The majority of non-small cell lung cancers require further evaluation with either [[Computed tomography|CT scan]] or [[MRI]].
*Chest X-ray helps to assess the involvement of lung and adjacent structures:
**Primary detection and characterization of [[Parenchyma|parenchymal]] tumor
**Assessment of [[Bronchi|main bronchi]] and tracheal involvement
**Detection of [[chest wall]] invasion
**Assessment of hilar and [[Mediastinal tumor|mediastinal invasion]]/adenopathy
**Detection of obstructive atelectasis and signs of [[pneumonitis]]
**Detection of [[pleural effusion]]


==Chest X Ray==
*On conventional radiography, characteristic findings of non-small cell lung cancer include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>
 
**Rounded or spiculated mass
*Conventional chest radiograph may be helpful in the diagnosis of non-small cell lung cancer
**Bulky hilum (representing the tumor and local nodal involvement)  
*The majority of non-small cell lung cancers require further evaluation with either CT scan or [[MRI]]
**Lobar collapse
*Common features of conventional radiography to perform the diagnosis of non-small cell lung cancer include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>
**[[Cavitation]] may be seen as an air-fluid level
:*Primary detection and characterization of [[Parenchyma|parenchymal]] tumor
**Pleural effusion  
:*Assessment of [[Bronchi|main bronchi]] and tracheal involvement
:*Detection of [[chest wall]] invasion
:*Assessment of hilar and [[Mediastinal tumor|mediastinal invasion]]/adenopathy
:*Detection of obstructive atelectasias and signs of [[pneumonitis]]
:*Detection of [[pleural effusion]]
 
*On conventional radiography, characteristic findings of non-small cell lung cancer include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>  
:*Rounded or spiculated mass
:*Bulky hilum (representing the tumor and local nodal involvement)  
:*Lobar collapse
:*[[Cavitation]] may be seen as an air-fluid level
:*Pleural effusion
 
*On conventional radiography, signs of non-small cell lung cancer include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>
:* '''Golden "S" sign''': created by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary lung cancer. Usually seen with right upper lobe collapse.
:* '''Coin lesion''': round or oval, well-circumscribed lesion
:* '''Luftsichel sign''': curvilinear opacity represents compensatory hyperinflation of the lobe
:* '''Bronchial cut off sign''': abrupt truncation of a bronchus from obstruction
 
==Gallery==
 
<div align="left">
<gallery heights="175" widths="175">
Image:Golden-s-sign marked.jpg|'''Golden "S" Sign''' (or reverse "S" sign of Golden) : right upper lobar collapse (the right upper lobe appearing dense and shifting medially and upwards, with a central mass expanding the hilum
Image:Cavitating-lung-cancer.jpg|'''Squameous cell lung cancer''': lung cavitating mass left upper lobe adjacent to the oblique fissure.  The prominent air-fluid level is best seen on the lateral radiograph
Image:Luftsichel-sign-in-lung-cancer.jpg|'''Luftsichel sign''': curvilinear opacity at the left apex represents compensatory hyperinflation of the left lower lobe
Image:Pulmonary-coin-lesion.jpg|'''Coin lesion sign''': round or oval, well-circumscribed lesion, compatible with primary lung cancer
Image:Bronchial cut off sign.jpg| '''Bronchial cut off sign''': abrupt truncation of a bronchus from obstruction
Image:Pleural-effusion-unilateral-malignant.jpg|'''Malignant pleural effusion'''
</gallery>
</div>


*On conventional radiography, signs of non-small cell lung cancer include:<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref>
** '''Golden "S" sign''': created by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary lung cancer. Usually seen with right upper lobe collapse.
** '''Coin lesion''': round or oval, well-circumscribed lesion
** '''Luftsichel sign''': curvilinear opacity represents compensatory hyperinflation of the lobe
** '''Bronchial cut off sign''': abrupt truncation of a bronchus from obstruction


==References==
==References==

Latest revision as of 19:22, 18 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Chest X-ray is the initial imaging study in a patient with suspected non-small cell lung cancer. The initial evaluation of suspected lung cancer will depend upon the results of the chest X-ray. Further evaluation of suspected lung cancer includes contrast-enhanced CT scan of the chest, neck, and abdomen.

X-Ray

Conventional chest radiograph may be helpful in the diagnosis of non-small cell lung cancer.[1][2][3]

  • The majority of non-small cell lung cancers require further evaluation with either CT scan or MRI.
  • Chest X-ray helps to assess the involvement of lung and adjacent structures:
  • On conventional radiography, characteristic findings of non-small cell lung cancer include:[3]
    • Rounded or spiculated mass
    • Bulky hilum (representing the tumor and local nodal involvement)
    • Lobar collapse
    • Cavitation may be seen as an air-fluid level
    • Pleural effusion
  • On conventional radiography, signs of non-small cell lung cancer include:[3]
    • Golden "S" sign: created by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary lung cancer. Usually seen with right upper lobe collapse.
    • Coin lesion: round or oval, well-circumscribed lesion
    • Luftsichel sign: curvilinear opacity represents compensatory hyperinflation of the lobe
    • Bronchial cut off sign: abrupt truncation of a bronchus from obstruction

References

  1. Purandare, NilenduC; Rangarajan, Venkatesh (2015). "Imaging of lung cancer: Implications on staging and management". Indian Journal of Radiology and Imaging. 25 (2): 109. doi:10.4103/0971-3026.155831. ISSN 0971-3026.
  2. Rosado-de-Christenson ML, Templeton PA, Moran CA (1994). "Bronchogenic carcinoma: radiologic-pathologic correlation". Radiographics. 14 (2): 429–46, quiz 447–8. doi:10.1148/radiographics.14.2.8190965. PMID 8190965.
  3. 3.0 3.1 3.2 Kundel HL (1981). "Predictive value and threshold detectability of lung tumors". Radiology. 139 (1): 25–9. doi:10.1148/radiology.139.1.7208937. PMID 7208937.


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