Standard imaging of non–small cell lung cancer

Standard imaging of non–small cell lung cancer
bronchogenic carcinoma is typically 1st imaged, and sometimes
1st detected, by chest radiography. chest radiography is that the
preferred initial imaging modality due to its availability,
low cost, low-radiation dose, and high sensitivity. one computed
tomography ( ct ) and often magnetic resonance ( mr )
imaging of the chest and higher abdomen are used to stage a
known or suspected lung cancer.
morphologic appearances of
lung cancer
lung cancer morphology depends, to a precise extent, on cell
type. though prediction of cell type from morphology is far
from 100% correct, the following generalizations are often
correct two :
one. adenocarcinoma sometimes presents as a solitary pulmonary
nodule ( spn ), and most malignant spns are adenocarcinomas
( fig. twenty six. one ). squamous cell may be also a common spn
( fig. twenty six. two ), whereas spn is that the typical manifestation of
alveolar cell carcinoma.
two. giant central masses frequently represent squamous cell carcinoma
or tiny cell carcinoma ; tiny cell cancers especially
involve mediastinal and hilar lymph nodes, sometimes
while not a recognizable parenchymal lesion, whereas squamous
cell cancer is typically centered at or adjacent to the
hilum ( fig. twenty six. three ).
three. an outsized peripheral mass most commonly represents large
cell carcinoma or squamous cell carcinoma ; adenocarcinoma
often manifests this means. giant cell carcinoma
is sometimes an outsized peripheral mass, however an outsized central mass is
its next most common manifestation.
four. multiple nodules typically occur with bronchioloalveolar
cell carcinoma ( bac ) ( fig. twenty six. four ) ; adenocarcinoma conjointly occasionally
manifests this means. three with bac, multiple nodules
are a late manifestation, sometimes reflecting aerogenous, or
less commonly hematogenous, dissemination.
five. airspace disease may be another late manifestation of bac. it
could be focal, lobar, or additional diffuse ( fig. twenty six. five ).
vi. bac still as alternative sorts of adenocarcinoma could present
as ground glass attenuation nodules, semisolid attenuation,
containing solid and ground glass components, or irregular
solid nodules. four