Faces of Squamous Cancer of the Lung

Parts
Size

Small
Cancer Squamous Cell carcinoma 001 5 months prior mucoid impaction
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 001
Cancer Squamous Cell carcinoma 5 months prior Note bronchiole alongside the nodule
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 002

Large

Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net


Shape
Wedge Peripheral

Peripheral Squamous Cell Carcinoma that
Looked Like and Infiltrate

 

Triangular Shaped

CT scan performed prior to biopsy performed 2 months later shows rapid growth  of soft tissue component  within the pseudocavitation lesion.   
Final diagnosis Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

 

Wedge Post Obstructive

CT – Right Upper Lobe Collapse Central Squamous Cell Carcinoma
55-year-old male presenting with dyspnea
Axial CT at the level of the carina shows atelectasis of the RUL caused by a central obstructing lesion in the right upper lobe bronchus resulting in atelectasis of the RUL characterized by a wedge-shaped consolidation of the anteriorly positioned right upper lobe. The major fissure is displaced anteriorly. There is extensive filling of the distal bronchiectatic segmental and subsegmental airways of the RUL. Final diagnosis was a central RUL proximal squamous cell carcinoma.
Ashley Davidoff TheCommonVein.net 212Lu 136432

Position

Central

60M central scc obstrx
PET scan shows endobronchial mass within the
right mainstem bronchus with intense FDG uptake, corresponding to
biopsy-proven squamous cell carcinoma.
Ashley Davidoff MD TheCommonVein.net


Character

Cavitating 

Pseudocavitation

Cavitating Squamous Cell Carcinoma
65 year male with peripheral lung nodule characterized by cavitation that was not present 2 years earlier . Pathology revealed squamous cell carcinoma
Ashley Davidoff
TheCommonVein.net
CT scan of a 78 year old male with history of nicotine shows growth of the complex cystic lesion in the left upper lobe .  The lesion shows finding consistent with pseudocavitation.
Final diagnosis Squamous Cell Carcinoma 
Ashley Davidoff MD TheCommonVein.net

Heterogeneous Liquefaction

Squamous cell carcinoma with liquefaction, rib destruction and lymphangitis carcinomatosa
Ashley Davidoff MD TheCommonVein.net
Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

 

Necrotic Squamous Cell Carcinoma

Necrotic Squamous Cell Carcinoma
52 year old male with known squamous cell carcinoma of the lung
CT scan in the axial projection shows a large low density mass in the right upper lobe with invasion into the neural foramen of the abutting vertebral body. Antero-laterally, the mass is low density and postero-medially it is slightly higher density. PET CT shows a rind of intense activity surround the necrotic center and invading the vertebra. Findings are consistent with a squamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 136490
Necrotic Squamous Cell Carcinoma
52 year old male with known squamous cell carcinoma of the lung
CT scan in the axial projection shows a large low density mass in the right upper lobe with invasion into the neural forman of the abutting vertebral body. Antero-laterally, the mass is low density (11 HU) and postero-medially it is slightly higher density ( 39HU). PET CT shows a rind of intense activity surround ythe necrotic center and invading the vertebra. Eindings are consistent with a aquamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 136489


Time

Starting
6 Months Prior left Upper Lobe Complex Cystic Lesion Pseudocavitation

CT scan of a 78 year old male with history of nicotine shows a complex cystic lesion in the left upper lobe 
Final diagnosis Squamous Cell Carcinoma 
Ashley Davidoff MD TheCommonVein.net

Growth of Cystic Lesion Over 6months

CT scan of a 78 year old male with history of nicotine shows growth of the complex cystic lesion in the left upper lobe .  The lesion shows finding consistent with pseudocavitation.
Final diagnosis Squamous Cell Carcinoma 
Ashley Davidoff MD TheCommonVein.net

PET CT shows Hyperintense Lesion
Despite Lack of Soft Tissue Component

PET CT scan of a 78 year old male with history of nicotine use shows a hyperintense lesion in the left upper lobe of the lung, despite the paucity of soft tissue .  
Final diagnosis Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

Significant Progression of Soft Tissue Growth
2 Months Later
Prior to Biopsy

CT scan performed prior to biopsy performed 2 months later shows rapid growth  of soft tissue component  within the pseudocavitation lesion.   
Final diagnosis Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

Associated Findings

Bronchiectasis and Bronchial Invasion
CT – Right Upper Lobe Collapse Central Squamous Cell Carcinoma
55-year-old male presenting with dyspnea
Coronal CT at the level of the trachea and mainstem bronchi, shows atelectasis of the RUL caused by a central obstructing lesion in the right upper lobe bronchus (b, white arrowhead) resulting in atelectasis of the RUL characterized by a wedge-shaped consolidation of the right upper lobe with superiorly displaced major fissure (a, pink arrowhead). There is extensive filling of the distal bronchiectatic segmental and subsegmental airways of the RUL (b, yellow arrowheads). Final diagnosis was a central RUL proximal squamous cell carcinoma.
Ashley Davidoff TheCommonVein.net 212Lu 136433cL

Squamous Cell Carcinoma Masquerading as ABPA

Squamous Cell Carcinoma Masquerading as ABPA
56-year-old male presents with chronic cough dyspnea and weight loss. CT scan in coronal projection shows an appearance reminiscent of finger in glove in the right lower lobe. There s segmental and subsegmental thickening of the airways in the upper lobes, and paraseptal emphysema. Micronodules in the upper lobes suggest smoker’s bronchiolitis. The subcarinal esophageal mass was diagnosed as a leiomyoma, Pathology of the right lower process was a squamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 267Lu 136219
Squamous Cell Carcinoma Masquerading as ABPA
56-year-old male presents with chronic cough dyspnea and weight loss. CT scan in axial projection shows an appearance reminiscent of finger in glove in the right lower lobe. There s a para-fissural soft tissue mass that seems “soft” since it does not displace nor deform the fissure.. Pathology of the right lower process was a squamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 267Lu 136221

Lymphangitis Carcinomatosa

Squamous cell carcinoma with liquefaction, rib destruction and lymphangitis carcinomatosa
Ashley Davidoff MD TheCommonVein.net

Occluded Veins

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net occluded-pulm-vein-001

Squamous Cell Carcinoma


Central

60M central scc obstrx
PET scan shows endobronchial mass within the
right mainstem bronchus with intense FDG uptake, corresponding to
biopsy-proven squamous cell carcinoma.
Ashley Davidoff MD TheCommonVein.net

CXR

Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net
Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net
Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net
Squamous Cancer with Extensive Necrosis at Pathology
Ashley Davidoff MD TheCommonVein.net
Squamous Cancer with Extensive Necrosis at Pathology
Ashley Davidoff MD TheCommonVein.net

Cavitating 

Lower Lobe
Ashley Davidoff MD TheCommonVein.net squamous cell carcinoma cavitating 002

Poorly Differentiated

Poorly Differentiated Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

Central with Post Obstructive Atelectasis

CT – Right Upper Lobe Collapse Central Squamous Cell Carcinoma
55-year-old male presenting with dyspnea
Axial CT at the level of the carina shows atelectasis of the RUL caused by a central obstructing lesion in the right upper lobe bronchus (b, white arrowhead) resulting in atelectasis of the RUL characterized by a wedge-shaped consolidation of the anteriorly positioned right upper lobe. The major fissure is displaced anteriorly (a, pink arrowhead). There is extensive filling of the distal bronchiectatic segmental and subsegmental airways of the RUL (b, yellow arrowheads). Final diagnosis was a central RUL proximal squamous cell carcinoma.
Ashley Davidoff TheCommonVein.net 212Lu 136432cL
CT – Right Upper Lobe Collapse Central Squamous Cell Carcinoma
55-year-old male presenting with dyspnea
Coronal CT at the level of the trachea and mainstem bronchi, shows atelectasis of the RUL caused by a central obstructing lesion in the right upper lobe bronchus resulting in atelectasis of the RUL characterized by a wedge-shaped consolidation of the right upper lobe with superiorly displaced major fissure. There is extensive filling of the distal bronchiectatic segmental and subsegmental airways of the RUL. Final diagnosis was a central RUL proximal squamous cell carcinoma.
Ashley Davidoff TheCommonVein.net 212Lu 136433
Endoscopy Central Obstructing Mass in the Right Upper Lobe Bronchus
Endoscopic image of a central squamous cell carcinoma (SCC) with extensive
Ashley Davidoff TheCommonVein.net 212Lu 136434

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net occluded-pulm-vein-005

Occluded Pulmonary Vein

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net occluded-pulm-vein-001

Encased Pulmonary Artery

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net occluded-pulm-vein-003

Encased Pulmonary Artery

Large Central Mass with Obstruction of the Pulmonary Vein and Encasement of the Arteries – Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net occluded-pulm-vein-001

Peripheral with Cavitation

Peripheral Large Upper Lobe Mass with Cavitation
The collage of images reflects a patient with stage IV, cavitating, primary, squamous carcinoma of the right upper lobe (RUL) (a, b, c, d – white arrows) with COPD. A metastatic lesion to the right femur was complicated by a pathological fracture. (e, f black arrows).
Courtesy Ashley Davidoff, M.D. TheCommonVein.net Lung cancer P 018
Non Small Carcinoma
This is a case of poorly differentiated non small cell carcinoma presenting as a large necrotic mass, with a percutaneous biopsy (2) treated with radiation therapy (3), with associated small nodes (4) overlaid in green, (5) with a response as seen by shrinkage of the tumor 4 months later (6) as well shrinkage of the nodes (7, 8).
Ashley Davidoff, M.D. TheCommonVein.net Lung cancer P 037b

Peripheral Squamous Cell Carcinoma

Peripheral Squamous Cell Carcinoma presenting as a small well circumscribed lung nodule
Ashley Davidoff TheCommonVein.net

Small Peripheral Growth Over  5 Months

5 Months Prior

Cancer Squamous Cell carcinoma 001 5 months prior mucoid impaction
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 001
Cancer Squamous Cell carcinoma 5 months prior Note bronchiole alongside the nodule
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 002
Cancer Squamous Cell carcinoma 5 months prior PET CT positive
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 004
Cancer Squamous Cell carcinoma 4 months prior Biopsy with hemorrhage
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 005
Cancer Squamous Cell carcinoma 3 months prior
Ashley Davidoff MD TheCommonVein.net Squamous Cell carcinoma 006

 

Peripheral Squamous Cell Carcinoma that Looked Like and Infiltrate

PET Scan Positive
PET Positive Peripheral Parenchymal infiltrate in the lung
Biopsy confirmed  the presence of a squamous cell carcinoma.
Ashley Davidoff MD TheCommonVein.net
Squamous Cancer with Extensive Necrosis at Pathology
Ashley Davidoff MD TheCommonVein.net
Squamous Cancer with Extensive Necrosis at Pathology
Ashley Davidoff MD TheCommonVein.net

peripheral Mass with Lymphangitis Carcinomatosa

Squamous cell carcinoma with liquefaction, rib destruction and lymphangitis carcinomatosa
Ashley Davidoff MD TheCommonVein.net
Squamous cell carcinoma with liquefaction, rib destruction and lymphangitis carcinomatosa
Ashley Davidoff MD TheCommonVein.net

Cavitating Masses

Squamous cell carcinoma with liquefaction, rib destruction and lymphangitis carcinomatosa
Ashley Davidoff MD TheCommonVein.net

Necrotic Squamous Cell Carcinoma

Necrotic Squamous Cell Carcinoma
52 year old male with known squamous cell carcinoma of the lung
CT scan in the axial projection shows a large low density mass in the right upper lobe with invasion into the neural foramen of the abutting vertebral body. Antero-laterally, the mass is low density and postero-medially it is slightly higher density. PET CT shows a rind of intense activity surround the necrotic center and invading the vertebra. Findings are consistent with a squamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 136490
Necrotic Squamous Cell Carcinoma
52 year old male with known squamous cell carcinoma of the lung
CT scan in the axial projection shows a large low density mass in the right upper lobe with invasion into the neural forman of the abutting vertebral body. Antero-laterally, the mass is low density (11 HU) and postero-medially it is slightly higher density ( 39HU). PET CT shows a rind of intense activity surround ythe necrotic center and invading the vertebra. Eindings are consistent with a aquamous cell carcinoma
Ashley Davidoff MD TheCommonVein.net 136489

Cavitating and Spiculated

Lung Cancer
Spiculated and Cavitating Nodule
Ashley Davidoff
TheCommonVein.net

Cavitating Squamous Cell Carcinoma
65 year male with peripheral lung nodule characterized by cavitation that was not present 2 years earlier . Pathology revealed squamous cell carcinoma
Ashley Davidoff
TheCommonVein.net

 

Pseudocavitation

6 Months Prior left Upper Lobe Complex Cystic Lesion

CT scan of a 78 year old male with history of nicotine shows a complex cystic lesion in the left upper lobe 
Final diagnosis Squamous Cell Carcinoma 
Ashley Davidoff MD TheCommonVein.net

Growth of Cystic Lesion Over 6months

CT scan of a 78 year old male with history of nicotine shows growth of the complex cystic lesion in the left upper lobe .  The lesion shows finding consistent with pseudocavitation.
Final diagnosis Squamous Cell Carcinoma 
Ashley Davidoff MD TheCommonVein.net

PET CT shows Hyperintense Lesion
Despite Lack of Soft Tissue Component

PET CT scan of a 78 year old male with history of nicotine use shows a hyperintense lesion in the left upper lobe of the lung, despite the paucity of soft tissue .  
Final diagnosis Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net

Significant Progression of Soft Tissue Growth
2 Months Later
Prior to Biopsy

CT scan performed prior to biopsy performed 2 months later shows rapid growth  of soft tissue component  within the pseudocavitation lesion.   
Final diagnosis Squamous Cell Carcinoma
Ashley Davidoff MD TheCommonVein.net