Pulmonary neoplasms and neoplastic-like conditions Flashcards
(131 cards)
an opacity completely stable in size for than 2 years is considered
benign
in patient under the age of 35, particularly a nonsmoker without a history of malignancy, an SPN is invariably a
granuloma, hamartoma or an inflammatory lesion
SPNs in a patient over 35 years of age should never be followed radiographically without tissue confirmation unless benign patterns are seen such as
calcification or the presence of intralesional fat or there has been radiographically documented lack of growth over a minimum of 2 years
An SPN that arises more than 2 years after the diagnosis of an extrathoracic malignancy and proves to be malignant is almost always a
primary lung tumor rather than a metastasis
exceptions to the rule in which SPNs of more than 2 years after an extrathoracic malignancy diagnosis has been made is almost alwats a primary lung tumor except for what extrathoracic malignancies
breast and melanoma
lung cancer presenting as a solid SPN has a doubling time of approximately
180 days
some benign lesions that may exhibit a growth rate similar to that of malignant lesions
hamartomas and histoplasmosis
malignant SPNs that may have a doubling time of greater than 2 years
well-differentiated adenocarcinoma and carcinoid tumors
Altho size does not reliably discriminate benign from malignant SPNs, the larger the lesion, the greater the likelihood its
Malignant
Masses exceeding __ cm in diameter are usually malignant
4 cm
Malignancies that may have a perfectly smooth margin
Carcinoid tumor, adenocarcinoma, solitary metastasis
Benign lesions that have a spiculated border include
Lipoid pneumonia, organizing pneumonia, tuberculomas, mass lesions of progressive massive fibrosis in complicated silicosis
Presence of small “satellite” nodules around the periphery of a dominant nodule is strongly suggestive of
Benign disease such as granulomatous infection
Presence of a halo of ggo encircling an SPN in an immunocompromised, neutropenic patient should suggest diagnosis of
Invasive fungal disease
An area of pleural thickening with a “comet” tail of bronchi and vessels entering the hilar aspect of mass and associated lobar volume loss is characteristic of
Rounded atelectasis
Probably the single most important factor in characterizing the lesion as benign or indeterminate
Density
Complete, central or peripheral rim-like calcification within an SPN is specific for a
Healed granuloma from tuberculosis or histoplasmosis
Concentric or laminated calcification indicates a
Granuloma
a bronchogenic carcinoma that arises in an area of previous granulomatous infection may engulf a preexisting calcified granuloma as it enlarges. In thi situation, the calcification will be
eccentric
Identification of fat within an SPN is diagnostic of a
pulmonary hamartoma
majority of subsolid nodules that persist beyond 3 months reflect
adenocarcinoma
majority of pure ground glass nodules are
benign
ground glass nodules <6mm in diameter almost invariably reflect
atypical adenomatous hyperplasia or focal fibrosis
pure ground glass nodules >6mm may reflect malignancy, the minority that are malignant represent
indolent lepidic-predominant adenocarcinoma