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Lung Cancer

History:  55-year-old female was incidentally found to have a 10-mm mass at the right lung apex with mediastinal suspicious lymphadenopathy.
 

Impression:

  1. The findings compatible with lung carcinoma at the right lung apex. Metastasis in the mediastinal, right supra and infraclavicular lymph nodes. Similarly a highly suspicious metastatic lymph node in the left supraclavicular region.
  2. No evidence for distant metastatic disease or metastasis within the abdomen or pelvis.
  3. Cholelithiasis. Mild to moderate dilatation of the intra and extrahepatic bile ducts as before. The findings could suggest changes of chronic pancreatitis.
  4. Extensive uncomplicated colonic diverticulosis.
  5. A midline abdominal hernia in the infraumbilical regions containing small bowel loops.
 Clinical Utility:  PET scanning has much better sensitivity and specificity than chest CT scanning for staging lung cancer in the mediastinum, and distant metastatic disease can be detected by PET scanning (Chest 2007 Sep;132(3 Suppl):178S-201S).