Non small cell lung cancer CT
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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
Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer. On CT, characteristic findings of non-small cell lung cancer include ground-glass opacity, rounded or spiculated mass, local nodal involvement, intraluminar obstruction, and lobar collapse.
CT
Computed tomography is the method of choice for the diagnosis of non-small cell lung cancer.[1][2][3]
- In some cases, non-small cell lung cancers require further evaluation with MRI
- Common features of CT scan for the diagnosis of non-small cell lung cancer include:
- Assessment of the main bronchi
- Evaluation of the entire thorax
- Detection of chest wall invasion
- Assessment of hilar and mediastinal invasion/adenopathy
- Determination of non-small cell lung cancer staging
- Precise determination of size and tumor dimensions
- Detection of liver, bone, adrenal , and brain metastasis
On CT, characteristic findings of non-small cell lung cancer include:[3]
- Lung adenocarcinomas are typically peripherally located
- Usually measure <4 cm in diameter, very few show cavitation
- Perihilar and mediastinal involvement
- Ground glass opacity (slow growth), usually lesions double the size within a year
- Subtype of adenocarcinoma
- Single pulmonary nodule or mass
- Multicentric or diffuse disease
- Localized area of parenchymal consolidation
- Bubble-like areas of low attenuation within the mass are a characteristic finding
- Hilar and mediastinal lymphadenopathy is uncommon
- Persistent peripheral consolidation with associated nodules
- Centrally located within the lung
- Usually measure larger than 4 cm in diameter
- Frequent cavitation
- Commonly cause segmental or lobar lung collapse due to central location
- Rapid growth
- Early metastasizes to the mediastinum and brain
- Large mediastinal nodules/masses
- Lymph node involvement (frequently subcarinal)
- Nodular pleural thickening
- Pleural effusion
- Finger in glove sign: The bronchus distal to the obstruction is dilated.
- Crazy-paving sign: Appearance of ground-glass opacity with superimposed interlobular septal thickening and intralobular reticular thickening.
Gallery
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Bronchogenic lung carcincoma: upper lobe collapse -
Bronchogenic lung carcincoma: upper lobe with lymphangitic spread -
Adenocarcinoma of the lung: ground-glass attenuation corresponds to a lepidic growth pattern and the solid component correspond to invasive patterns. -
Squamous cell lung carcinoma: Peripheral squamous cell lung carcinoma may be seen as a solid nodule/mass with or without an irregular border. The irregular margin can be attributed to a desmoplastic reaction or infiltrative growth
References
- ↑ 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.
- ↑ 2.0 2.1 Parker MS, Chasen MH, Paul N (2009). "Radiologic signs in thoracic imaging: case-based review and self-assessment module". AJR Am J Roentgenol. 192 (3 Suppl): S34–48. doi:10.2214/AJR.07.7081. PMID 19234288.
- ↑ 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.