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Lung Cancer

Lung Cancer is the number 1 cause of cancer related deaths
- In 2011 (the most recent year numbers are available from the CDC)
- 207,339 people in the United States were diagnosed with lung cancer, including 110,322 men and 97,017 women.
- 156,953 people in the United States died from lung cancer, including 86,736 men and 70,217 women.
Lung Cancer and Smoking
(NCI database)
- Cigarette smoking causes an estimated 443,000 deaths each year, including approximately 49,000 deaths due to exposure to secondhand smoke.
- Lung cancer is the leading cause of cancer death among both men and women in the United States, and 90 percent of lung cancer deaths among men and approximately 80 percent of lung cancer deaths among women are due to smoking.
Lung Cancer and Smoking
(NCI database)
- Smoking causes many other types of cancer, including cancers of the throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, and cervix, and acute myeloid leukemia.
- People who smoke are up to six times more likely to suffer a heart attack than nonsmokers, and the risk increases with the number of cigarettes smoked. Smoking also causes most cases of chronic lung disease.
- People who quit smoking, regardless of their age, are less likely than those who continue to smoke to die from smoking-related illness:
- Quitting at age 30: Studies have shown that smokers who quit at about age 30 reduce their chance of dying prematurely from smoking-related diseases by more than 90 percent
- Quitting at age 50: People who quit at about age 50 reduce their risk of dying prematurely by 50 percent compared with those who continue to smoke
- Quitting at age 60: Even people who quit at about age 60 or older live longer than those who continue to smoke
Lymphangitic Carcinoma: Differential Diagnosis
- Pulmonary edema
- Idiopathic pulmonary fibrosis
- Scleroderma
- Lymphoma
- Drug reaction
- Asbestosis
- Hypersensitivity pneumonitis
Lymphangitic Carcinoma: Source of Tumor
- Breast cancer
- Gastric cancer
- Pancreatic cancer
- Lung cancer
- Prostate cancer
Lymphangitic Carcinoma: facts
- Spread may be via lymphatics as in lymphoma or hematogenous spread from small pulmonary artery branches to the lymphatics
- Lymphangitic spread means stage IV disease
- Pathology is interstitial thickening of interlobular septa due to tumor spread, desmoplastic response and dilated lymphatics
“ Perfusion CT can depict therapy induced changes in patients with lung adenocarcinoma and can identify response to treatment on the whole tumor mass.”
Whole Tumor Perfusion CT in Patients with Advanced Lung Adenocarcinoma Treated with Conventional and Antiangiogenetic Chemotherapy: Initial Experience
Fraioli F et al.
Radiology 2011; 259:574-582
“ Perfusion CT imaging may allow evaluation of lung cancer angiogenesis demonstrating alterations in vascularity following treatment.”
Whole Tumor Perfusion CT in Patients with Advanced Lung Adenocarcinoma Treated with Conventional and Antiangiogenetic Chemotherapy: Initial Experience
Fraioli F et al.
Radiology 2011; 259:574-582
Bronchioalveolar Carcinoma (BAC): CT Appearance
- Ground glass nodule
- Single mass
- Diffuse consolidation
- Multinodular forms
Bronchioalveolar Carcinoma (BAC): Facts
- Up to 6% of all primary lung cancers
- Male to female ratio is 1:1
- Subtype of well differentiated adenocarcinoma
- Presents with cough, hemoptysis or as an incidental finding

"In 2009 a new TNM staging system was published by the International Union Against Cancer and the American Joint Committee on Cancer. The new edition will encompass no-small cell lung cancer, small cell lung cancer, and bronchopulmonary carcinoids."

A Radiologic Review of the New TNM Classification for Lung Cancer
Kligermn S, Abbott G
AJR 2010; 194:562-573

 

"Non-small cell lung cancer with higher perfusion is more sensitive to chemoradiation therapy than that with lower perfusion. After chemoradiation therapy, findings at perfusion CT are a significant predictor of early tumor response and overall survival among patients with non-small cell lung cancer."

Tumor Response in Patients With Advanced Non-Small Cell Lung Cancer: Perfusion CT Evaluation of Chemotherapy and Radiation Therapy
Wang J et al.
AJR 2009; 193:1090-1096

How can you measure tumor response to therapy?
- RECIST criteria (size)
- Tumor volume
- Perfusion CT imaging
- PET/CT activity
“ In 2009 a new TNM staging system was published by the International Union Against Cancer and the American Joint Committee on Cancer. The new edition will encompass no-small cell lung cancer, small cell lung cancer, and bronchopulmonary carcinoids.”

A Radiologic Review of the New TNM Classification for Lung Cancer
Kligermn S, Abbott G
AJR 2010; 194:562-573