• 55-year-old male heavy smoker with history of
  • squamous cell carcinoma of the right lung with
  • invasion of the right mainstem bronchus and
  • encasement of the right pulmonary artery and
  • SVC
  • Requiring stents
  • Stage IIIC cT1bN3M0
  • is status post chemotherapy and
  • radiation therapy

Normal  CXR 7 years ago

 

4 years Later Presents with a Cough

Primary Lesion in the Right Main Stem Bronchus

CT Shows a Large Central Mass Likely a Nodal Metasasis with Invasion into Right Upper Lobe Pulmonary Artery

55 year old male with central squamous cell carcinoma of the lung presents 3 years later with a cough CT shows a large mediastinal mass in the azygous region with compression and encasement of the right upper lobe pulmonary artery
Ashley Davidoff MD TheCommonVein.net squamous cell carcinoma 55-003

PET scan

 

 

The dominant right lower paratracheal mass encases the right main
pulmonary artery demonstrates intense FDG uptake, corresponding withnodal metastasis. Right upper paratracheal and prevascular nodalconglomerates with mild and moderate FDG uptake also likely representnodal metastatic disease. Uptake in bilateral infraclavicular lymph nodes (left greater than right) most worrisome for metastatic disease.

1 Month Later with Progressive Symptoms

 

Progressive Subtotal Occlusion of the Right Main Stem Bronchus 

 

 

Progressive Encasement  of the Right Upper Lobe Pulmonary Artery

 

Stents in SVC and Brachiocephalic Vein and XRT and Chemotherapy Initiated

Resolution of Primary Mass

Functioning  Stents

 

Improved Patency of the Right Upper Lobe Artery