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D.D of Unilaterally Opacified Lung. Massive Pleural Effusion. Massive Collapse. Pneumonectomy . Massive Consolidation. 1. 2. 3. 4. Lung Masses. Benign, malignant. Chest Malignancy. Central or Peripheral
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D.D of Unilaterally Opacified Lung • Massive Pleural Effusion. • Massive Collapse. • Pneumonectomy. • Massive Consolidation.
1 2 3 4
Lung Masses Benign, malignant
Chest Malignancy • Central or Peripheral • Central tumours may be associated with atelectasis or obstructive pneumonitis. • Squamous & Small-cell more commonly central • Adeno & Large-cell commonly peripheral • All types may be assoc. with: pleural effusion, destruction of ribs or vertebrae, elevation of a hemidiaphragm (phrenic nerve involvement), or mediastinal widening due to lymphadenopathy.
Adenocarcinoma • Represents 35-40% of all lung cancers . • usually occurs in a peripheral location within the lung and measure <4 cm in diameter. • Only 4% show cavitation • Hilar or hilar and mediastinal involvement is seen in 51% of cases on chest radiography
Squamous cell carcinoma • Accounts for 25-30% of all lung cancers. • Strong association with cigarette smoking. • Often centrally located within the lung . • Cavitation is seen in up to 82%. • Commonly causes lung collapse due to their central location.
Small Cell Lung Cancer • Strong association with smoking. • Rapid growth. • Early spread to distant sites. • Exquisite sensitivity to chemo and radiotherapy. • Frequent association with distinct paraneoplastic syndromes. • Surgery usually plays no role in its management, except in rare situations (<5% of patients) in which it presents at a very early stage as a solitary pulmonary nodule
Small cell lung cancer • 18% of all lung cancers. • Often present with bulky hila and mediastinal lymph node masses. • TNM system does not provide important prognostic information; only useful in <5%.