The

CT

Ap

pe

aran

ce o

f Sm

all C

ell

Lun

g C

ance

rD

r L

Bro

okf

ield

an

d D

r J

Ho

wel

ls

Lun

gca

nce

ris

resp

on

sib

lefo

r2

0%

of

can

cer-

rela

ted

dea

ths.

Smal

lce

lllu

ng

can

cer

(SC

LC)

acco

un

tsfo

r1

3%

of

alll

un

gca

nce

rs.

Ch

arac

teri

sed

by

anag

gres

sive

nat

ure

,ra

pid

do

ub

ling

tim

ean

dea

rly

met

asta

sis,

SCLC

carr

ies

the

wo

rst

pro

gno

sis

of

all

lun

gca

nce

rs.

(5ye

arsu

rviv

al<5

%).

The

imag

ing

app

eara

nce

of

SCLC

isn

ot

oft

end

escr

ibed

inlit

erat

ure

bu

tit

isty

pic

ally

seen

asa

larg

eh

ilar

or

per

ihila

rm

ass,

wit

hm

edia

stin

alw

iden

ing

cau

sed

by

the

pri

mar

ytu

mo

ur,

bu

lky

lym

ph

aden

op

ath

yo

rb

oth

.9

0%

of

SCLC

are

cen

tral

and

aris

ew

ith

inlo

bar

and

mai

nb

ron

chi

bu

tin

som

eca

ses

ap

erip

her

alp

rim

ary

tum

ou

rm

ayn

ot

be

visi

ble

and

wid

esp

read

lym

ph

aden

op

ath

yis

the

mai

nfi

nd

ing.

This

stu

dy

furt

her

des

crib

esth

eim

agin

gap

pea

ran

ceo

fSC

LCw

ith

par

ticu

lar

focu

so

nSC

LCo

ccu

rrin

gso

lely

wit

hin

the

med

iast

inu

m.

Intr

od

uct

ion

Aim

s

Res

ult

s

Co

ncl

usi

on

•R

etro

spec

tive

ly r

evie

wed

CT

scan

s o

f 1

51

co

nse

cuti

ve p

atie

nts

wit

h p

ure

SC

LC in

Lan

cash

ire

Teac

hin

g H

osp

ital

s Tr

ust

.

•Sc

ans

wer

e re

view

ed lo

oki

ng

at m

ass

size

, ed

gean

d lo

cati

on

⁻M

ass

edge

was

eit

her

sm

oo

th o

r sp

icu

late

d

⁻M

ass

loca

tio

n w

as e

ith

er: i

ntr

a-m

edia

stin

al (

typ

e 1

), in

tra-

med

iast

inal

an

d in

tra-

pu

lmo

nar

y (t

ype

2)

or

intr

a-p

ulm

on

ary

(typ

e 3

).

Met

ho

ds

23

84

43

0

10

20

30

40

50

60

70

80

90

Intr

a-m

ed

iast

inal

(ty

pe

1)

Intr

a-m

ed

iast

inal

an

din

tra-

pu

lmo

nar

y (t

ype

2)

Intr

a-p

ulm

on

ary

(typ

e 3

)

15

0p

atie

nts

had

avi

sib

lem

ass

on

CT

scan

wh

ich

cou

ldb

ere

view

ed.

The

med

ian

surv

ival

len

gth

was

24

3d

ays.

89

(58

.9%

)p

atie

nts

had

can

cers

aris

ing

inth

eri

ght

sid

eo

fth

ech

est

and

61

(40

.4%

)in

the

left

wh

ich

isst

atis

tica

llysi

gnif

ican

t(p

=0

.02

72

).M

ore

than

hal

fw

ere

typ

e2

.Fe

wer

occ

urr

edo

nly

wit

hin

the

lun

gti

ssu

e(t

ype

3)

and

som

eSC

LCm

asse

sw

ere

typ

e1

,o

ccu

rrin

go

nly

wit

hin

the

med

iast

inu

m(C

har

t1

).7

2(4

7.7

%)

had

asm

oo

thed

gew

hile

78

(51

.7%

)w

ere

spic

ula

ted

.Ty

pe

3m

asse

sh

adth

egr

eate

stp

rop

ort

ion

of

spic

ula

ted

mas

ses

wh

ilety

pe

1h

adn

on

e.M

ass

size

ran

ged

fro

m1

0-1

82

mm

wit

ha

med

ian

valu

eo

f5

6m

m.

•In

tra-

med

iast

inal

an

d in

tra-

pu

lmo

nar

y m

ass

mo

st c

om

mo

n

•Si

ze a

nd

ed

ge v

ary

wit

h m

ass

loca

tio

n

•R

igh

t si

ded

mas

ses

are

mo

re c

om

mo

n

Smal

l ce

ll lu

ng

can

cer

can

occ

ur

sole

ly w

ith

in t

he

me

dia

stin

um

1.

This

fin

din

g q

ues

tio

ns

the

his

tolo

gica

l ori

gin

of

thes

e tu

mo

urs

2.

This

fin

din

g co

uld

aid

rad

iolo

gica

l dia

gno

sis

1.T

o d

escr

ibe

the

imag

ing

app

eara

nce

of

smal

l cel

l lu

ng

can

cer

2.T

o a

sses

s h

ow

oft

en s

mal

l cel

l lu

ng

can

cer

may

occ

ur

sole

ly w

ith

in t

he

med

iast

inu

m

Ch

art

1:

Illu

stra

tes

the

var

iati

on

in lo

cati

on

of

the

15

0 m

asse

s in

clu

ded

in

th

e st

ud

y.

Figu

re1

:C

Tim

age

of

a6

9ye

aro

ldm

anw

ho

pre

sen

ted

wit

hb

reat

hle

ssn

ess

and

wei

ght

loss

.Th

isd

emo

nst

rate

sa

~11

2m

mle

ftsi

ded

mas

sw

hic

his

inva

din

gb

oth

the

med

iast

inu

man

dth

elu

ng

tiss

ue.

Figu

re2

:Sa

me

CT

imag

eas

figu

re1

seen

inlu

ng

win

do

wd

emo

nst

rate

sth

esp

icu

late

ded

geo

fth

em

ass.

Figu

re3

:C

Tim

age

of

a5

4ye

aro

ldw

om

anw

ho

pre

sen

ted

wit

hw

eigh

tlo

ss.

The

imag

ed

emo

nst

rate

sa

~40

mm

spic

ula

ted

mas

sin

the

left

low

erlo

be

Figu

re4

:C

Tim

age

of

a5

8ye

aro

ldw

om

anw

ho

pre

sen

ted

wit

ha

sup

racl

avic

ula

rn

eck

lum

p.

The

imag

ed

emo

nst

rate

sa

~9

0m

msm

oo

thm

ass,

con

tain

edw

ith

inth

eri

ght

sid

eo

fth

em

edia

stin

um

.

1.

Can

cerr

earc

hu

k.o

rg [

ho

mep

age

on

inte

rnet

] Lu

ng

can

cer

stat

isti

cs. A

vaila

ble

fro

m:h

ttp

://w

ww

.can

cerr

esea

rch

uk.

org

/hea

lth

-pro

fess

ion

al/c

ance

r-st

atis

tics

/sta

tist

ics-

by-

can

cer-

typ

e/lu

ng-

can

cer.

[C

ited

8 J

un

e 2

01

5].

2.

Go

vin

dan

R, P

age

N, M

org

ensz

tern

D, R

ead

W, T

iern

ey R

, Vla

hio

tis

A e

t al

. Ch

angi

ng

Epid

emio

logy

of

Smal

l-ce

ll Lu

ng

Can

cer

in t

he

Un

ited

Sta

tes

Ove

r th

e La

st 3

0 Y

ears

: An

alys

is o

f th

e Su

rvei

llan

ce, E

pid

emio

logi

c, a

nd

En

d R

esu

lts

Dat

abas

e. J

clin

on

col.

20

06

; 2

4(2

8):

45

39

-45

44

.3

.M

eerb

eeck

J, F

enn

ell D

, De

Ru

yssc

her

D. S

mal

l-ce

ll Lu

ng

Can

cer.

Lan

cet.

20

11

; 37

8:

17

41

-17

55

.4

.M

erri

ll R

, Hen

son

D, B

arn

es, M

. Co

nd

itio

nal

Su

rviv

al a

mo

ng

Pati

ents

wit

h C

arci

no

ma

of

the

Lun

g. C

hes

t. 1

99

9; 1

16

(3

): 6

97

-70

3.

5.

Krei

sman

H, W

olk

ove

N, Q

uo

ixE.

Sm

all C

ell L

un

g C

ance

r P

rese

nti

ng

as a

So

litar

y P

ulm

on

ary

No

du

le. C

hes

t. 1

99

2;

10

1 (

1):

22

5-2

31

.6

.R

osa

do

-de-

Ch

rist

enso

n M

, Tem

ple

ton

P, M

ora

n C

. Bro

nch

oge

nic

Car

cin

om

a: R

adio

logi

c-Pa

tho

logi

c C

orr

elat

ion

. Rad

iogr

aph

ics.

19

94

; 14

(2

): 4

29

-44

6.