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Lung Cancer

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