Radiology of Lung Cancer and Staging Flashcards Preview

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Flashcards in Radiology of Lung Cancer and Staging Deck (83)
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61

When are tumours classified as T3 althouh they are less than 5cm?

Invades any of:

 

Chest wall

Phrenic nerve

Parietal pericardium

 

or has seperate tumour nodules in the same lobe as primary

62

What is T4?

More than 7cm

63

When is a tumour T4 although it is less than 7cm?

Invades any of:

 

Diaphragm

Mediastinum

Heart

Great vessels

Trachea

Recurrent laryngeal nerve

Oesophagus

Vertebral body

Carina

 

or seperate tumour nodules in a different ipsilateral lobe

64

What does N staging range from?

N0 to N3

65

What is N0?

No regional lymph node involvement

66

What is N1?

Ipsilateral peribronchial, hilar or intrapulmonary nodes including by direct extension

67

What is N2?

Ipsilateral mediastinal, subcarinal

68

What is N3?

Contralateral mediastinal, contralateral hilar, scalene or supraclavicular

69

How does the number of lymph nodes change with size?

There are many small lymph nodes and few large ones

70

How does the prevalence of metastasis change with the size of lymph nodes?

Large lymph nodes are more likely to have metastasis

71

What percentage of patients present with metastasis?

33%

72

What are common metastasis?

Cerebral

Skeletal

Adrenal

Liver

73

What does M staging range from?

M0 to M1

74

What is M0?

No distant metastasis

75

What is M1?

Distant metastasis

76

What are the different classes of M1?

M1a

M1b

M1c

77

What is M1a?

Seperate tumour nodes in a contralateral lobe, tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion

78

What is M1b?

Single distant metastasis

79

What is M1c?

Multiple distant metastasis

80

What are some of the advantages of PET/CT scanning in staging?

Performs whole body staging in single study excluding cerebral disease

Discloses metastasis and other pathology no detected by other means

Excludes metastasis where structural imaging abnormal

Non invasive

81

What are some limitations of CT/PET?

All tests have false positives and false negatives

Cost

82

How does 5 year survival change with staging?

As staging increases survival decreases

83

What are some examples of tissue diagnosis methods?

Bronchoscopy with endobronchial ultrasound

Percutaneous image guided biopsy, flouroscopy/CT/US guided

Mediastinoscopy (sample mediastinal nodes)

Mediastinotomy (anterior mediastinal nodes)

Video assisted thoracoscopic surgery (VATS)

Explorative thoracotomy