Answer
Answer
CT scanning of the thorax plays multiple roles in evaluation of patients with bronchogenic carcinoma. These include lung cancer screening, evaluation of a solitary pulmonary nodule, and staging. CT scans are used extensively for staging NSCLC; however, CT staging leads to either overestimated or underestimated staging in approximately 40% of patients.
Low-dose helical CT has been used in some trials to screen patients at risk for lung cancer. CT has depicted noncalcified nodules, although a small number have been found to be malignant.
On contrast-enhanced CT scans, increased attenuation of 20 HU or more has been shown to be 98% sensitive and 73% specific for lung cancer. [21]
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Media Gallery
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Non–small cell lung cancer. Bronchoscopy. A large central lesion was diagnosed as non–small cell carcinoma.
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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.
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Non–small cell lung cancer. Left upper collapse is almost always secondary to endobronchial bronchogenic carcinoma.
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Non–small cell lung cancer. Complete left lung collapse secondary to bronchogenic carcinoma of left mainstem bronchus.
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Non–small cell lung cancer. A cavitating right lower lobe squamous cell carcinoma.
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Non–small cell lung cancer. CT scan shows cavitation and air-fluid level.
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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.
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Non–small cell lung cancer. Right upper lobe lesion diagnosed as adenocarcinoma on percutaneous biopsy.
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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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Non–small cell lung cancer. Comparative characteristics of the primary tumor are shown in the vertical columns. Horizontal columns refer to lymph node involvement. The different stages are color coded and can be found at the intersection of appropriately matched horizontal and vertical columns. Stages with unique characteristics, such as stages 0 and IV, are defined in separate boxes. Courtesy of Lababede et al (Chest 1999; 115(1): 233-5).
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