Bronchogenic Carcinoma Quiz
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Questions and Answers

What characteristic appearance on radiology may indicate infiltration into the bronchus in the case of lung cancer?

  • Necrotic lesions
  • Presence of air bronchogram
  • Enlarged hilum
  • Absence of air bronchogram (correct)

What initial diagnostic tool is typically used for diagnosing bronchogenic carcinoma?

  • Gallium scans
  • PET scan
  • Lung X-Ray (correct)
  • MRI

Which of the following is NOT a common site to which primary lung cancer metastasizes?

  • Heart (correct)
  • Liver
  • Bone
  • Brain

What is a notable effect associated with bronchogenic carcinoma as observed on a radiological scan?

<p>Enlarged hilum (D)</p> Signup and view all the answers

What method may best demonstrate the spread of lung cancer to other organs in a less invasive manner?

<p>PET scan (D)</p> Signup and view all the answers

Which route is NOT involved in the hematogenous spread of lung malignancy?

<p>Lymphatic vessels (B)</p> Signup and view all the answers

What is a common secondary effect of bronchogenic carcinoma visible on imaging studies?

<p>Pleural effusion (C)</p> Signup and view all the answers

Which technique is most likely to provide a tissue sample for diagnosing a nodule in suspected bronchogenic carcinoma?

<p>Bronchoscopy with biopsy (C)</p> Signup and view all the answers

What is the most common site of occlusions in pulmonary embolism?

<p>Lower lobes of the lungs (C)</p> Signup and view all the answers

Which of the following is NOT a potential cause of pulmonary embolism?

<p>Regular exercise (C)</p> Signup and view all the answers

What symptom is commonly associated with pulmonary embolism?

<p>Chest pain (C)</p> Signup and view all the answers

Which imaging modality is the first choice for diagnosing pulmonary embolism?

<p>CT scan (D)</p> Signup and view all the answers

What is the primary treatment method for managing recurrent thrombi in pulmonary embolism?

<p>Anticoagulant therapy (C)</p> Signup and view all the answers

What radiographic appearance would indicate a pulmonary embolism?

<p>Increased radiolucency distal to embolus (B)</p> Signup and view all the answers

Which condition is characterized by a stationary blood clot that forms in a blood vessel?

<p>Thrombus (B)</p> Signup and view all the answers

What could lead to ischemia in lung tissue due to pulmonary embolism?

<p>Obstruction of blood supply (A)</p> Signup and view all the answers

Which of the following does NOT represent a preventive measure for pulmonary embolism?

<p>Drinking carbonated drinks (C)</p> Signup and view all the answers

What does a filling defect within the pulmonary artery indicate on a CT scan?

<p>Pulmonary embolism (C)</p> Signup and view all the answers

Which type of lung cancer typically arises in the periphery of the lung?

<p>Adenocarcinoma (D)</p> Signup and view all the answers

What factor is associated with an increased incidence of bronchogenic carcinoma?

<p>Heavy cigarette smoking (A)</p> Signup and view all the answers

Which of these describes the term 'Embolus'?

<p>Clot that breaks free and moves (C)</p> Signup and view all the answers

Which symptom might indicate a significant pulmonary embolism complication?

<p>Unable to lie flat (D)</p> Signup and view all the answers

What is primarily affected in patients with cystic fibrosis?

<p>Exocrine glands (D)</p> Signup and view all the answers

What type of disease is Hyaline Membrane Disease primarily associated with?

<p>Acute respiratory distress (A)</p> Signup and view all the answers

Which radiographic appearance is characteristic of cystic fibrosis?

<p>Irregular thickening of linear markings (D)</p> Signup and view all the answers

What is the main cause of pulmonary metastases leading to lung cancer?

<p>Spread from other cancers (A)</p> Signup and view all the answers

What is the purpose of using prophylactic antibiotics in cystic fibrosis patients?

<p>Decrease the risk of lung infections (C)</p> Signup and view all the answers

What prominent effect is seen in lung imaging for Thyroid cancer metastasis?

<p>Snowstorm effect (A)</p> Signup and view all the answers

Which symptom is commonly associated with Hyaline Membrane Disease in newborns?

<p>Cyanosis (A)</p> Signup and view all the answers

What is a common consequence of thick mucus in patients with cystic fibrosis?

<p>Atelectasis (C)</p> Signup and view all the answers

What type of glands secrete substances directly into the bloodstream?

<p>Endocrine glands (C)</p> Signup and view all the answers

What is the primary reason for hyperinflation seen in cystic fibrosis radiographs?

<p>Obstruction by thick mucus (B)</p> Signup and view all the answers

What is a common radiological appearance associated with bronchogenic carcinoma that differentiates it from pneumonia?

<p>Absence of air bronchogram (C)</p> Signup and view all the answers

Which of the following is the most common route for malignancy to spread to the lungs?

<p>Haematogenous spread through the bloodstream (A)</p> Signup and view all the answers

What does a raised left hemi diaphragm on imaging potentially indicate?

<p>Malignancy in the left lung region (D)</p> Signup and view all the answers

What type of scan best identifies where bronchogenic carcinoma may have deposited in the body?

<p>PET scan (B)</p> Signup and view all the answers

What is a potential secondary effect of bronchogenic carcinoma as observed on imaging studies?

<p>Atelectasis (C)</p> Signup and view all the answers

Which of the following methods is NOT typically used for diagnosing bronchogenic carcinoma?

<p>CT Angiography (B)</p> Signup and view all the answers

Which organ system is commonly affected by metastases from bronchogenic carcinoma?

<p>Nervous system (A)</p> Signup and view all the answers

What is the most common cause of pulmonary embolism?

<p>Heart disease (A)</p> Signup and view all the answers

Which symptom is most characteristic of pulmonary embolism?

<p>Chest pain (D)</p> Signup and view all the answers

How does a pulmonary embolism primarily affect the lung tissue?

<p>Causes ischemia (A)</p> Signup and view all the answers

Which imaging modality is considered the preferred choice for diagnosing pulmonary embolism?

<p>CT scan (C)</p> Signup and view all the answers

What is the primary role of anticoagulant therapy in managing pulmonary embolism?

<p>Prevent new clot formation (A)</p> Signup and view all the answers

Which of the following best describes the radiographic appearance associated with pulmonary embolism?

<p>Wedge-shaped infiltrate (B)</p> Signup and view all the answers

What does 'IVC filter placement' aim to achieve in the context of recurrent pulmonary embolism?

<p>Prevent blood clots from reaching the lungs (A)</p> Signup and view all the answers

In which region of the lungs do most pulmonary embolisms occlude blood flow?

<p>Lower lobes (B)</p> Signup and view all the answers

Which of the following is NOT a method of preventing pulmonary embolism?

<p>Prolonged immobility (A)</p> Signup and view all the answers

What characteristic appearance would one expect to find on CT indicating a pulmonary embolism?

<p>Filling defect in a pulmonary artery (A)</p> Signup and view all the answers

Which of these factors is a potential risk for developing a pulmonary embolism?

<p>Long flights (C)</p> Signup and view all the answers

Which type of embolism involves fat or air bubbles that can travel through the bloodstream?

<p>Embolus (C)</p> Signup and view all the answers

What exclusive characteristic distinguishes a thrombus from an embolus?

<p>Location of formation (C)</p> Signup and view all the answers

Which condition would most likely lead to a pulmonary infarct?

<p>Pulmonary embolism (D)</p> Signup and view all the answers

What is the respiratory complication commonly associated with cystic fibrosis in children under 10 years old?

<p>Lung abscesses (C)</p> Signup and view all the answers

Which radiographic feature is characteristic of Hyaline Membrane Disease in newborns?

<p>Air bronchogram sign (D)</p> Signup and view all the answers

What primary treatment is recommended for cystic fibrosis to reduce the risk of lung infections?

<p>Prophylactic antibiotics (D)</p> Signup and view all the answers

In which demographic is Hyaline Membrane Disease most commonly observed?

<p>Premature infants (A)</p> Signup and view all the answers

What physiological process is impaired in cystic fibrosis due to thick mucus production?

<p>Gas exchange in the alveoli (B)</p> Signup and view all the answers

What is a common symptom of Hyaline Membrane Disease in newborns?

<p>Cyanosis (A)</p> Signup and view all the answers

Which of the following is a complication of cystic fibrosis affecting the pancreas?

<p>Cyst formation (D)</p> Signup and view all the answers

What type of lesions can pulmonary metastases present as on imaging?

<p>Multiple well-circumscribed nodules (C)</p> Signup and view all the answers

Which genetic abnormality is associated with cystic fibrosis?

<p>Defective gene on chromosome 7 (A)</p> Signup and view all the answers

How does the appearance of thyroid cancer metastases differ on radiological scans?

<p>A 'snowstorm effect' (C)</p> Signup and view all the answers

Flashcards

Bronchogenic Carcinoma

Lung cancer originating in the bronchi.

Pulmonary Metastasis

Cancer that spreads from another part of the body to the lungs.

Primary Lung Cancer

Cancer that starts in the lungs.

Lung Cancer Metastasis

Spread of lung cancer cells to other parts of the body.

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Radiographic Appearance of Bronchogenic Carcinoma

Lung cancer's varied visible characteristics on X-rays, depending on its location and if it's obstructing airways.

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Diagnosis of Bronchogenic Carcinoma

Methods used to confirm if a person has lung cancer from bronchi, including X-rays, scans (PET, Gallium), tests of samples from the lungs, and biopsies.

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Pulmonary Metastases Routes

Ways cancer spreads to the lungs, including the bloodstream, lymphatic system, and direct extension from other cancers, or directly into the lung.

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Secondary Effects of Bronchogenic Carcinoma

Conditions like pneumonia, atelectasis, and pleural effusions that may result from lung cancer.

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Pulmonary Embolism (PE)

A blockage in a lung artery by a dislodged blood clot (thrombus), or other material such as air or fat.

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Deep Venous Thrombosis (DVT)

A blood clot (thrombus) that forms in a deep vein, often in the legs.

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PE Risk Factors

Conditions and lifestyles increasing PE chances, like prolonged immobility, heart disease, cancer, surgery, and smoking.

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PE Symptoms

Symptoms of PE, including chest pain, shortness of breath (dyspnea), cough, rapid heartbeat (tachycardia), leg pain, lightheadedness.

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PE Treatment

PE treatment involves blood thinners (anticoagulants), clot-busting drugs (thrombolytics), or filters in the inferior vena cava (IVC filter).

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PE Prevention

Strategies to lessen PE risk, like compression stockings, movement during travel, and hydration.

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PE Radiographic Appearance

CT scans often reveal pulmonary emboli, showing a filling defect or a cut-off within the pulmonary artery.

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Pulmonary Infarct

Lung tissue damage due to reduced blood supply (ischemia) caused by a blocked artery.

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Bronchogenic Carcinoma Types

Lung cancer types including adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, differentiated by location and aggressiveness.

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Risk Factors for Lung Cancer

Exposure to carcinogens, smoking, and other toxins increase the chance of developing lung cancer.

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Malignant vs. Benign

Discriminating between Cancerous (malignant) and non-cancerous (benign) growths often requires visual or other medical assessment.

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Thrombus

A stationary blood clot within a blood vessel.

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Embolus

A foreign material, often a blood clot (thrombus), that travels through the bloodstream and lodges in a vessel.

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Metastatic Spread Sources

Cancer can metastasize to the lungs from various origins like breast, GI tract, melanoma, etc.

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Radiological Appearance (Metastases)

Multiple, well-defined round or oval nodules in X-rays, varying in size and vascularity.

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Cystic Fibrosis

Genetic disease causing thick mucus secretion, affecting organs like lungs and pancreas.

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Cystic Fibrosis Cause

Faulty gene on chromosome 7 causing excessive secretions of thick mucus.

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Cystic Fibrosis Lung Issues

Thick mucus obstructs airways causing lung collapse (atelectasis) and recurrent infections.

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Hyaline Membrane Disease

Respiratory disorder in newborns, often premature, due to lack of surfactant (lung substance).

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Hyaline Membrane Disease Symptoms

Difficulty breathing, cyanosis, grunting, flaring nostrils, chest retractions.

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Hyaline Membrane Disease X-ray

Widespread tiny spots (granular opacities) in X-rays due to alveolar collapse.

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Cystic Fibrosis X-ray Appearance

Thickening of lung markings, hyperinflation, and similar to adult chronic conditions.

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Lung Metastases Appearance

Multiple, well-defined round or oval nodules seen on imaging, often with a clear space between them. Can be small or large, dense or less dense.

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What is the 'snowstorm effect' in lung imaging?

A characteristic pattern seen on imaging where numerous small, bright spots appear in the lungs, often associated with thyroid cancer spreading to the lungs.

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How does Cystic Fibrosis affect the lungs?

Thick mucus blocks the airways, trapping bacteria and causing infections, leading to lung collapse (atelectasis) and potentially bronchiectasis (widening of the airways).

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What is Hyaline Membrane Disease?

A respiratory disorder in newborns, primarily premature infants, caused by a lack of surfactant, which helps keep the alveoli (tiny air sacs) open.

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How does Hyaline Membrane Disease appear on imaging?

Imaging shows widespread tiny spots (granular opacities), giving a 'ground-glass' appearance, due to collapsed alveoli.

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Cystic Fibrosis Imaging Appearance

Imaging shows thickened lung markings, hyperinflation (over-expanded lungs), and may resemble adult chronic lung conditions.

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What are some treatment options for Cystic Fibrosis?

Treatment includes prophylactic antibiotics to prevent infections, chest physiotherapy (percussions) to clear mucus, and newer gene therapy techniques to replace the faulty gene.

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What are the 5 ways cancer spreads to the lungs?

Cancer can spread to the lungs via five routes: the bloodstream (hematogenous), lymphatic vessels, direct extension from nearby cancer, direct implantation during procedures, and seeding through body cavities (transcoelemic).

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What's a telltale sign of lung cancer on X-rays?

The absence of an air bronchogram (airways visible within lung tissue) can indicate lung cancer, as it suggests the cancer has infiltrated the bronchus. It helps differentiate pneumonia from cancer.

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What are the secondary effects of lung cancer?

Lung cancer can cause complications like pneumonia, atelectasis (collapsed lung), and pleural effusion (fluid buildup around the lung).

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What makes lung cancer so challenging to detect?

Lung cancer can be difficult to detect early because it can present with a wide range of radiographic abnormalities, and a discreet mass might be undetectable until secondary changes arise from airway obstruction or compression.

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What are the diagnostic tools for lung cancer?

Diagnosing lung cancer involves a combination of methods: initial chest X-ray, Gallium scans (showing 'hot spots'), PET scans (best and most accessible), sputum analysis, transthoracic needle aspiration biopsy (TTNA), and bronchoscopy with biopsy.

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What distinguishes pulmonary metastases from a primary lung tumor?

Pulmonary metastases are tumors that have spread to the lungs from another part of the body, whereas primary lung tumors originate in the lungs. Metastases often appear as multiple nodules on X-rays.

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What is the significance of an enlarged hilum on lung X-rays?

An enlarged hilum on a chest X-ray can suggest either a primary lung tumor arising in the hilar region or a metastasis from enlarged lymph nodes.

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What are the typical radiographic characteristics of pulmonary metastases?

Pulmonary metastases often appear as multiple, well-defined round or oval nodules in a variety of sizes and with different degrees of vascularity.

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What is Pulmonary Embolism?

A blood clot that travels from the legs or heart and lodges in a pulmonary artery, blocking blood flow to the lungs.

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Why are lower lobes affected more?

Lower lobes receive more blood flow, making them more likely to be affected by a traveling clot.

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Major Cause of PE?

Deep vein thrombosis (DVT), where a blood clot forms in a deep vein, often in the legs.

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Risk factors for PE?

Conditions like prolonged immobility, heart disease, cancer, and surgery increase the risk of PE.

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What is a thrombus?

A stationary blood clot that forms inside a blood vessel.

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What is an embolus?

A clot that travels through the bloodstream and gets stuck in a blood vessel, such as a pulmonary embolism.

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What happens to lung tissue in PE?

The lung tissue becomes ischemic (lacks blood flow) due to the blocked artery, which can cause a pulmonary infarct (tissue death).

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CT scan for PE?

CT scan is the preferred imaging technique for diagnosing PE, showing filling defects or cut-offs in the pulmonary artery.

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Radiographic Features of PE?

CT scans reveal filling defects within the pulmonary artery, a cut-off indicating complete obstruction, and a wedge-shaped infiltrate.

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What is bronchogenic carcinoma?

A type of lung cancer that originates in the bronchi, the airways of the lungs.

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What are the 4 main types of lung cancer?

There are 4 main types: adenocarcinoma, squamous cell carcinoma, bronchiolar alveolar carcinoma, and small cell carcinoma.

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What is adenocarcinoma?

Most common type of lung cancer, typically found in the periphery of the lung.

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What is squamous cell carcinoma?

Most common type of lung cancer, usually found closer to the center of the lung.

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What is small cell carcinoma?

A very aggressive type of lung cancer, often associated with smoking.

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Study Notes

Pulmonary Embolism

  • Pulmonary embolism (PE) is a potentially fatal condition.
  • A dislodged thrombus from the deep venous system (most common) or veins in the arms (less common) travels to the heart and is deposited in a pulmonary artery.
  • Most emboli occur in the lower lung lobes due to blood flow patterns.
  • PE is a common cause of death in hospitalized patients.
  • Less blood flow occurs in the lower lungs than the upper lungs.
  • A dislodged thrombus can be from the legs (most common), or arms (less common).

Causes of Pulmonary Embolism

  • Heart disease
  • Cancer
  • Post-surgery
  • Prolonged immobility
  • Fat embolism from trauma
  • Smoking
  • Overweight
  • Estrogen replacement therapy
  • Pregnancy

Symptoms of Pulmonary Embolism

  • Chest pain
  • Shortness of breath (dyspnea)
  • Cough
  • Rapid heartbeat (tachycardia)
  • Inability to lie flat
  • Leg pain
  • Lightheadedness and dizziness

Treatment of Pulmonary Embolism

  • Anticoagulant therapy
  • Thrombolytic therapy for recurrent emboli
  • IVC filter placement for recurrent emboli or trauma

Prevention of Pulmonary Embolism

  • Compression stockings
  • Movement and frequent changes in posture
  • Staying hydrated
  • Regular breaks from sitting

Radiographic Appearance of Pulmonary Embolism

  • Increased radiolucency distal to the embolus
  • Absence of lung markings distally
  • Characteristic wedge-shaped infiltrate reaching out to the pleura
  • Associated with pleural effusion
  • CT scan is the preferred modality for diagnosis
  • Chest X-rays may sometimes be negative
  • Sometimes, findings on chest X-rays may be negative or inconclusive. CT scans are often needed

Results of Pulmonary Embolism

  • Lung tissue beyond the embolus no longer receives blood.
  • Causes ischemia (lack of blood supply), leading to pulmonary infarct (death of lung tissue).

Bronchogenic Carcinoma (Lung Cancer)

  • Arises from the mucosa of the bronchial tree.
  • Increased incidence in heavy smokers and those exposed to pollutants and carcinogens.
  • A broad term used to describe various types of lung cancer resulting from inhalation of carcinogens

Types of Bronchogenic Carcinoma

  • Adenocarcinoma: Typically arises in the lung periphery
  • Squamous Cell Carcinoma: Most common type
  • Bronchiolar Alveolar Carcinoma: Large cell
  • Small Cell Oat Cell Carcinoma: Most aggressive

Benign vs Malignant Lesions

  • Well-circumscribed lesions on imaging are often benign
  • The presence of hair-like linear streaks radiating from a lesion on imaging suggests malignancy

Primary Malignant Lung Tumor - Radiological Appearance

  • Wide spectrum of radiographic abnormalities
  • Dependent on the tumor's location and relation to the bronchial tree
  • A discreet mass may not be apparent, but inferred from secondary changes due to obstruction or compression of the bronchus
  • Airway obstruction on imaging often indicates a tumor.

Bronchogenic Carcinoma - Metastasis

  • Lung cancer cells can break off and spread to other body sites.
  • Common metastatic sites include lymph nodes, liver, adrenal glands, bone, and brain.

Pulmonary Metastases

  • Lung lesions developed from primary cancer elsewhere in the body,
  • One-third of cancer patients develop pulmonary metastases.
  • They are much more common than primary lung neoplasms
  • Metastasis may appear as nodules or more diffuse, vascular patterns.

Pulmonary Metastases - Routes of Malignancy Spread

  • Haematogenous (bloodstream)
  • Lymphatic
  • Direct extension by invasion from the primary lung neoplasm
  • Direct implantation from biopsy or surgery
  • Transcoelemic (seeding of cells through body cavities (ex: esophagus, stomach, bronchus, breast, or diaphragm))

Pulmonary Metastases - Cancer Origin Sites

  • Breast cancer
  • Gastrointestinal Cancer
  • Melanoma
  • Gynecological cancers
  • Prostate cancer
  • Musculoskeletal sarcomas
  • Thyroid cancer

Pulmonary Metastases - Radiological Appearance

  • Multiple well-circumscribed round or oval nodules are common
  • Appearance ranges from fine nodules to highly vascular tumors (ex: Thyroid cancer with a snowstorm effect).
  • The appearance depends on the origin of the metastasis.
  • Imaging may show multiple, more diffuse, radiolucent areas between the nodules.

Lung Metastases - Radiographic appearance

  • Multiple radiolucent areas between solid lesions in the lung

Congenital Neonatal

  • Cystic fibrosis: A genetic disease characterized by increased viscosity of mucus produced by exocrine glands
  • Hyaline membrane disease (newborn respiratory distress syndrome): A condition that results from a deficiency in surfactant (substance in lungs keeping air sacs open) which prevents lung expansion

Cystic Fibrosis - Causes

  • Defective gene on chromosome 7
  • Affects the pancreas and digestive system
  • 90% morbidity due to respiratory involvement

Cystic Fibrosis - Symptoms

  • Thick mucus secreted by the trachea and bronchial passages
  • Mucus plugs block air passages
  • Recurrent lung infections
  • Development of bronchiectasis (large cysts and abscesses) in young patients
  • Impeded pancreatic enzyme production, leading to poor digestion of fats and malnutrition
  • Large quantities of foul-smelling stools

Cystic Fibrosis - Radiographic Appearance

  • Irregular thickening of linear markings throughout the lungs with hyperinflation
  • Looks similar to adult chronic disease
  • Radiographs may show hyperinflation and irregular markings throughout the lung fields. CT scans are often necessary to fully assess the disease

Cystic Fibrosis - Treatment

  • Prophylactic antibiotics to reduce risk of lung infections
  • Chest physiotherapy for mucus removal.
  • Life expectancy has increased since the 1950's
  • Treatment focuses on managing symptoms and complications

Hyaline Membrane Disease - Causes

  • Occurs primarily in prematurely born infants
  • Result from a lack of surfactant in the lungs

Hyaline Membrane Disease - Symptoms

  • Respiratory difficulty within first hour after birth
  • Cyanosis
  • Grunting sounds
  • Flaring nostrils
  • Retraction of the chest wall.

Hyaline Membrane Disease - Radiographic Appearance

  • Widespread minute pulmonary granular opacities
  • Ground-glass appearance
  • Air filled bronchial tree/Bronchogram sign
  • The bronchi are surrounded by non-aerated alveoli
  • Radiographic appearance may show a "ground-glass" appearance and air bronchograms.

Congenital Disorders – Overview

  • Agenesis: Complete absence of an organ due to absence of primordial tissue
  • Aplasia: Failure of an organ to develop or function normally
  • Hypoplasia: Underdevelopment or incomplete development of an organ
  • Atresia: Absence or closure of a normal body orifice or passage (eg., esophageal atresia, which can cause aspiration pneumonia)

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Description

Test your knowledge on bronchogenic carcinoma with this informative quiz. Explore radiological signs, diagnostic tools, and metastasis patterns associated with lung cancer. Perfect for medical students and healthcare professionals looking to assess their understanding.

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