Pancoast tumor diagnostic study of choice: Difference between revisions
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{{CMG}}; {{AE}}{{Mazia}} | {{CMG}}; {{AE}}{{Mazia}} | ||
== Overview == | == Overview == | ||
[[CT scan]] is the gold standard test for the [[diagnosis]] of Pancoast tumor. [[MRI]] imaging should be performed for evaluation of [[chest wall]] [[invasion]], [[examination]] of [[vascular]] structures and [[brachial plexus]] involvement, evaluation of resectability of the [[tumor]]. | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
* CT scan is the gold standard test for the diagnosis of Pancoast tumor. | ===CT scan=== | ||
* CT scan is the gold standard test for the [[diagnosis]] of Pancoast tumor. | |||
* The following result of CT scan is confirmatory of Pancoast tumor:<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> | * The following result of CT scan is confirmatory of Pancoast tumor:<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> | ||
**[[Opacity]] at the [[apex]] of the [[lung]] or in the superior sulcus area. | **[[Opacity]] at the [[apex]] of the [[lung]] or in the superior sulcus area. | ||
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**[[Invasion]] of [[brachial plexus]] | **[[Invasion]] of [[brachial plexus]] | ||
**[[Invasion]] of [[chest wall]] and/or [[mediastinum]] | **[[Invasion]] of [[chest wall]] and/or [[mediastinum]] | ||
**[[Extension]] of the [[tumor]] into [[vena cava]], [[trachea]] and [[esophagus]]. | **[[Extension]] of the [[tumor]] into [[vena cava]], [[trachea]], and [[esophagus]]. | ||
**[[Subclavian]] [[vessel]] involvement is assessed by [[CT-scans|contrast CT scanning]]. | **[[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. | |||
[[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, | |||
[[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" /> | ||
===MRI=== | |||
*[[MRI]] imaging should be performed for: | *[[MRI]] imaging should be performed for: | ||
**Evaluation of [[chest wall]] [[invasion]] | **Evaluation of [[chest wall]] [[invasion]] | ||
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**Evaluation of resectability of the [[tumor]]. | **Evaluation of resectability of the [[tumor]]. | ||
=== Diagnostic Criteria === | === Diagnostic Criteria === | ||
* Pancoast tumor may be diagnosed at any time if | * Pancoast tumor may be diagnosed at any time if the following criteria are met: | ||
** | **Tumor localized to the superior sulcus of the lung | ||
==References== | ==References== |
Latest revision as of 18:15, 15 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
CT scan is the gold standard test for the diagnosis of Pancoast tumor. MRI imaging should be performed for evaluation of chest wall invasion, examination of vascular structures and brachial plexus involvement, evaluation of resectability of the tumor.
Diagnostic Study of Choice
CT scan
- CT scan is the gold standard test for the diagnosis of Pancoast tumor.
- The following result of CT scan is confirmatory of Pancoast tumor:[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.
![](/images/2/26/Pancoast-tumour-with-cystic-cerebral-metastasis_%281%29.jpg)
![](/images/5/5e/Pancoast-tumour-7.jpg)
MRI
- MRI imaging should be performed for:
- Evaluation of chest wall invasion
- Examination of vascular structures and brachial plexus involvement
- Evaluation of resectability of the tumor.
Diagnostic Criteria
- Pancoast tumor may be diagnosed at any time if the following criteria are met:
- Tumor localized to the superior sulcus of the lung
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.