Non small cell lung cancer CT

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, intraluminal obstruction, and lobar collapse.

After chest X-ray, computed tomography is the best next step in diagnosing non-small cell lung cancer.^[1][2][3]

• 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]

• Adenocarcinoma of the lung
  • Lung adenocarcinomas are typically peripherally located
  • Usually measure <4 cm in diameter, very few shows cavitation
  • Perihilar and mediastinal involvement
  • Ground glass opacity (slow growth), usually lesions double the size within a year

• Squamous cell carcinoma of the lung
  • Squamous cell carcinoma of the lung is centrally located within the lung
  • Usually measure larger than 4 cm in diameter
  • Frequent cavitation
  • Commonly cause segmental or lobar lung collapse due to the central location

• Large cell carcinoma of the lung
  • Large cell carcinoma of the lung shows rapid growth
  • Early metastasizes to the mediastinum and brain
  • Large mediastinal nodules/masses
  • Lymph node involvement (frequently subcarinal)
  • Nodular pleural thickening
  • Pleural effusion

• Bronchoalveolar carcinoma of the lung
  • Bronchoalveolar carcinoma of the lung is a 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

• On CT, signs of non-small cell lung cancer may include:^[3][2]
  • Finger in glove sign: The bronchial dilation, distal to the obstruction.
  • Crazy-paving sign: Appearance of ground-glass opacity with superimposed interlobular septal thickening and intralobular reticular thickening.

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