“ This is further sub-divided into squamous cell carcinoma (SCC) (35%), adenocarcinoma (30%) and large-cell carcinoma (15%). Plain film • ...
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This is further sub-divided into squamous cell carcinoma (SCC) (35%), adenocarcinoma (30%) and large-cell carcinoma (15%).
Plain film
• Lung mass.
• Lung/lobar collapse denoting an obstructing endobronchial mass.
• Pleural effusion.
• SCC tends to cavitate, adenocarcinoma may appear as consolidation resistant to antibiotics.
• Check for mediastinal or hilar lymph node enlargement and bone destruction.
CT
• Ill-defined, peripheral, spiculated and irregular nodules are high risk.
• Air bronchogram and focal lucency in a nodule also suggest malignancy.
• Cavitation is non-specific, but a cavity wall >15 mm thick is worrying.
• Nodules enhancing >15 HU are 98% sensitive, 73% specific for malignancy.
• Common sites for metastases include adrenal glands, liver, brain, bones and soft tissues.
Nuclear medicine
• PET is superior for staging (92% accuracy, 25% for CT) and assessing bone disease (92% vs. 87%).
• False positives may arise due to inflammatory processes.
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