Which findings on chest radiography are characteristic of non-small cell lung cancer (NSCLC)?

Updated: Aug 27, 2019
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

On chest radiography, the findings of non–small cell lung carcinomas are varied and considered in the differential diagnosis of many disorders. The most common findings are bronchial stenosis, regional hyperlucency, hilar mass, solitary pulmonary nodule, nonresolving pneumonia, contiguous structure involvement, and mediastinal lymph node involvement (see below for more information). 

Percutaneous transthoracic needle biopsy (PTNA) is used for the diagnosis of lung cancer. Chest radiographs are recommended at 1- and 4-hour intervals after the biopsy is performed, unless the patient appears to be hypoxemic or unstable, in which case chest radiography should be performed immediately.

A small or asymptomatic pneumothorax may be followed at an interval of 2-4 hours with repeat chest radiography. If the pneumothorax remains stable and patient is asymptomatic, chest tube drainage is not required. In an enlarging pneumothorax (15-30% pneumothorax) or a symptomatic patient, a pneumothorax drainage catheter should be placed and connected to a Heimlich valve or Pleurovac system.

(Radiographic images of non-small cell lung cancer and associated morbidity are provided below.)

Non–small cell lung cancer. Bronchoscopy. A large Non–small cell lung cancer. Bronchoscopy. A large central lesion was diagnosed as non–small cell carcinoma.
Non–small cell lung cancer. Left pleural effusion Non–small cell lung cancer. Left pleural effusion and volume loss secondary to non–small cell carcinoma of the left lower lobe. The pleural effusion was sampled and found to be malignant; therefore, the lesion is inoperable.
Non–small cell lung cancer. Left upper collapse is Non–small cell lung cancer. Left upper collapse is almost always secondary to endobronchial bronchogenic carcinoma.
Non–small cell lung cancer. Complete left lung col Non–small cell lung cancer. Complete left lung collapse secondary to bronchogenic carcinoma of left mainstem bronchus.
Non–small cell lung cancer. A cavitating right low Non–small cell lung cancer. A cavitating right lower lobe squamous cell carcinoma.
Non–small cell lung cancer. Patient has right lowe Non–small cell lung cancer. Patient has right lower lobe opacity. This is not well circumscribed and was found to be a squamous cell carcinoma.
Non–small cell lung cancer. Right upper lobe lesio Non–small cell lung cancer. Right upper lobe lesion diagnosed as adenocarcinoma on percutaneous biopsy.
Non–small cell lung cancer. Right upper lobe colla Non–small cell lung cancer. Right upper lobe collapse with the S sign of Golden secondary to underlying non–small cell carcinoma of the bronchus.

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