Pancoast tumor CT: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pancoast tumor}} | {{Pancoast tumor}} | ||
{{CMG}}{{AE}}{{Mazia}} | {{CMG}}; {{AE}} {{Mazia}} | ||
==Overview== | ==Overview== | ||
CT scan is diagnostic of Pancoast tumor. CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan. Findings on CT scan of the chest suggestive of Pancoast tumor include invasion of brachial plexus, invasion of the chest wall and/or mediastinum, the extension of the tumor into vena cava, trachea and esophagus, subclavian-vessel involvement is assessed by contrast CT scanning. | [[CT scan]] is [[diagnostic]] of Pancoast tumor. [[CT scan]] has a limited ability to determine the extent of [[invasion]] of the [[primary tumor]] into adjoining structures when compared to [[MRI scan]]. Findings on [[CT scan]] of the [[chest]] suggestive of Pancoast tumor include [[invasion]] of [[brachial plexus]], [[invasion]] of the [[chest wall]] and/or [[mediastinum]], the [[extension]] of the [[tumor]] into [[vena cava]], [[trachea]] and [[esophagus]], [[subclavian]]-[[vessel]] involvement is assessed by [[contrast]] [[CT scanning]]. | ||
==CT Scan== | ==CT Scan== | ||
*CT scan is diagnostic of Pancoast tumor, a subtype of lung cancer located at the lung apex. | *[[CT scan]] is [[diagnostic]] of Pancoast tumor, a subtype of [[lung cancer]] located at the [[lung]] [[apex]]. | ||
*CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan. | *[[CT scan]] has a limited ability to determine the extent of [[invasion]] of the [[primary tumor]] into adjoining structures when compared to [[MRI scan]]. | ||
*Chest CT scan is the modality of choice in the diagnosis of lung cancer. Findings on CT scan of the chest suggestive of Pancoast tumor include: | *[[Chest]] [[CT scan]] is the modality of choice in the [[diagnosis]] of [[lung cancer]]. Findings on [[CT scan]] of the [[chest]] suggestive of Pancoast tumor include:<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> | ||
**Invasion of brachial plexus | **[[Opacity]] at the [[apex]] of the [[lung]] or in the superior sulcus area. | ||
**Invasion of chest wall and/or mediastinum | **Spread of the [[tumor]] can result in [[rib]] [[invasion]] that is observed as [[bone]] destruction of [[posterior]] [[ribs]]. | ||
**Extension of the tumor into vena cava, trachea and esophagus. | **[[Vertebral body]] [[Infiltration (medical)|infiltration]] | ||
**Subclavian vessel involvement is assessed by contrast CT scanning. | **[[Mediastinum|Enlargement of the mediastinum]]. | ||
[[File:Pancoast-tumour-with-cystic-cerebral-metastasis (1).jpg|left|thumb|350px|Irregular shaped ill defined right apical lung mass is seen invading the right aspect of D2 vertebral body with its transverse process, costovertebral junction and adjacent rib. superiorly it extends to the root of the neck. | **[[Invasion]] of [[brachial plexus]] | ||
**[[Invasion]] of [[chest wall]] and/or [[mediastinum]] | |||
[[File:Pancoast-tumour-7.jpg|left|thumb|350px|The chest CT scan confirms that the tumor involves the superior sulcus. | **[[Extension]] of the [[tumor]] into [[vena cava]], [[trachea]] and [[esophagus]]. | ||
**[[Subclavian]] [[vessel]] involvement is assessed by [[CT-scans|contrast CT scanning]]. | |||
[[File:Pancoast-tumour-with-cystic-cerebral-metastasis (1).jpg|left|thumb|350px|Irregular shaped ill defined right apical lung mass is seen invading the right aspect of D2 vertebral body with its transverse process, costovertebral junction and adjacent rib. superiorly it extends to the root of the neck.Case courtesy of Dr Ahmed Abd Rabou, rID: 27303]] | |||
[[File:Pancoast-tumour-7.jpg|left|thumb|350px|The chest CT scan confirms that the tumor involves the superior sulcus.Case courtesy of Dr David Cuete, rID: 23281]] | |||
<br clear="left" /> | <br clear="left" /> | ||
== Spiral CT perfusion imaging == | |||
*Spiral CT perfusion study can be used as a diagnostic method for peripheral pulmonary nodules. | |||
*Spiral CT perfusion study provides non-invasive method of quantitative assessment about the blood flow patterns of peripheral pulmonary nodules. | |||
*Spiral CT perfusion imaging is analyzed and evaluated for:<ref name="MaLe2008">{{cite journal|last1=Ma|first1=Shu-Hua|last2=Le|first2=Hong-Bo|last3=Jia|first3=Bao-hui|last4=Wang|first4=Zhao-Xin|last5=Xiao|first5=Zhuang-Wei|last6=Cheng|first6=Xiao-Ling|last7=Mei|first7=Wei|last8=Wu|first8=Min|last9=Hu|first9=Zhi-Guo|last10=Li|first10=Yu-Guang|title=Peripheral pulmonary nodules: Relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and VEGF expression|journal=BMC Cancer|volume=8|issue=1|year=2008|issn=1471-2407|doi=10.1186/1471-2407-8-186}}</ref> | |||
**TDC (time density curve) | |||
**Perfusion parametric maps | |||
**The respective perfusion parameters. | |||
**Immunohistochemical findings of microvessel density (MVD) measurement | |||
**[[VEGF]] expression | |||
{| class="wikitable" | |||
|[[Image:Peripheral pulmonary nodules1.jpg|thumb|300px|(A-H) Poorly differentiated adenocarcinoma found in the apicoposterior segment of superior lobe of the left lung of a 56 year-old male. (A) Time density curve. (B-F) (original image, BF, BV, MTT, PS) typeI parametric maps, PS value is higher (30.883). (G) CD34 staining shows many immature tumor microvessels (× 200). (H) VEGF expression is strong positive (× 400) via, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474637/figure/F6/.<ref name="MaLe2008">{{cite journal|last1=Ma|first1=Shu-Hua|last2=Le|first2=Hong-Bo|last3=Jia|first3=Bao-hui|last4=Wang|first4=Zhao-Xin|last5=Xiao|first5=Zhuang-Wei|last6=Cheng|first6=Xiao-Ling|last7=Mei|first7=Wei|last8=Wu|first8=Min|last9=Hu|first9=Zhi-Guo|last10=Li|first10=Yu-Guang|title=Peripheral pulmonary nodules: Relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and VEGF expression|journal=BMC Cancer|volume=8|issue=1|year=2008|issn=1471-2407|doi=10.1186/1471-2407-8-186}}</ref>]] | |||
|} | |||
==References== | ==References== | ||
Latest revision as of 14:32, 16 March 2018
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Pancoast tumor Microchapters |
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Pancoast tumor CT On the Web |
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American Roentgen Ray Society Images of Pancoast tumor CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
CT scan is diagnostic of Pancoast tumor. CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan. Findings on CT scan of the chest suggestive of Pancoast tumor include invasion of brachial plexus, invasion of the chest wall and/or mediastinum, the extension of the tumor into vena cava, trachea and esophagus, subclavian-vessel involvement is assessed by contrast CT scanning.
CT Scan
- CT scan is diagnostic of Pancoast tumor, a subtype of lung cancer located at the lung apex.
- CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan.
- Chest CT scan is the modality of choice in the diagnosis of lung cancer. Findings on CT scan of the chest suggestive of Pancoast tumor include:[1]
- Opacity at the apex of the lung or in the superior sulcus area.
- Spread of the tumor can result in rib invasion that is observed as bone destruction of posterior ribs.
- Vertebral body infiltration
- Enlargement of the mediastinum.
- Invasion of brachial plexus
- Invasion of chest wall and/or mediastinum
- Extension of the tumor into vena cava, trachea and esophagus.
- Subclavian vessel involvement is assessed by contrast CT scanning.
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Spiral CT perfusion imaging
- Spiral CT perfusion study can be used as a diagnostic method for peripheral pulmonary nodules.
- Spiral CT perfusion study provides non-invasive method of quantitative assessment about the blood flow patterns of peripheral pulmonary nodules.
- Spiral CT perfusion imaging is analyzed and evaluated for:[2]
- TDC (time density curve)
- Perfusion parametric maps
- The respective perfusion parameters.
- Immunohistochemical findings of microvessel density (MVD) measurement
- VEGF expression
 |
References
- ↑ 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.
- ↑ 2.0 2.1 Ma, Shu-Hua; Le, Hong-Bo; Jia, Bao-hui; Wang, Zhao-Xin; Xiao, Zhuang-Wei; Cheng, Xiao-Ling; Mei, Wei; Wu, Min; Hu, Zhi-Guo; Li, Yu-Guang (2008). "Peripheral pulmonary nodules: Relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and VEGF expression". BMC Cancer. 8 (1). doi:10.1186/1471-2407-8-186. ISSN 1471-2407.