Faces of Small Cell Carcinoma of the Lung

Stage IV Small Cell Lung Carcinoma – Hilum Overlay Sign

Stage IV Small Cell Lung Carcinoma – Hilum Overlay Sign
65 year old male presents with a history of chest pain, back pain, myalgias, and night sweats
Frontal CXR shows a left sided mass that silhouettes the aortic knob and the main pulmonary artery (white arrowhead, b) indicating that the mass arises from middle mediastinal tumors, or hilar adenopathy. The mass also compresses and displaces the left mainstem bronchus (teal arrowhead b).
The axial CT (c) shows the extent of the mass and the coronal CT scan (d) confirms the presence of a large mediastinal mass that extends beyond the aortic knob (white arrowhead)
A diagnosis of a large mediastinal small cell carcinoma of the lung was diagnosed
Ashley Davidoff MD TheCommonVein.net 297Lu 136691cL

Compression and Encasement

Stage IV Small Cell Lung Carcinoma – Mediastinal Mass Extending from the Left Hilum with Encasement
65 year old male presents with a history of chest pain, back pain, myalgias, and night sweats
CT scan in multiple planes shows a left sided mass that extends from the left hilum to the mediastinum and to the ight hilum. The mass compresses the SVC, (blue arrowhead a), narrows the left mainstem bronchus (teal arrowhead, a) and encases the left pulmonary artery., the left mainstem bronchus (teal arrowhead b).
A diagnosis of a large mediastinal small cell carcinoma of the lung was diagnosed
Ashley Davidoff MD TheCommonVein.net 297Lu 136692cL

Extensive Regional Spread

Stage IV Small Cell Lung Carcinoma – Metastases to the Cervical Chain and Left Axilla
65 year old male presents with a history of chest pain, back pain, myalgias, and night sweats
PET CT scan in multiple planes shows extensive hypermetabolic activity throughout the mediastinum and extending into the right cervical chain, subpectoral region and axilla on the left.
A diagnosis of a large mediastinal small cell carcinoma of the lung with extensive regional metastases was diagnosed
Ashley Davidoff MD TheCommonVein.net 297Lu 136696

Responsive to Treatment

Stage IV Small Cell Lung Carcinoma – Pre and 7Months Post Treatment
Coronal CT of the chest through the mediastinum at the level of the carina before (a) and 7months following chemotherapy, shows significant reduction of the extensive mediastinal and hilar tumor
Ashley Davidoff MD TheCommonVein.net 297Lu 136698

 

Endobronchial Spread of Poorly Differentiated Small Cell Carcinoma with Encasement

This CT collage represents the radiological findings of the endobronchial spread of poorly differentiated small cell carcinoma with extensive tubular obstruction. Images 1, 2, and 3 (and corresponding green overlay) show a significantly narrowed lumen starting at the right mainstem and extending down into bronchus intermedius and segmental branches. These findings were confirmed at bronchoscopy. Aspirated contrast or calcified bronchioles to the RML and RLL outline the tumor filled bronchi with surprisingly little volume loss.
Courtesy Ashley Davidoff MD.
TheCommonVein.net
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Structural Consequences of Central Disease
The CT scan of the centrally positioned small cell carcinoma has structural implication as a result of its central location close to large arteries, veins, airways and lymphatics. In this case the centrally placed tumor (dark green in image b) is pushing on the right mainstem bronchus (shown with white arrow) and the lymphatics with peribronchial thickening (image d light green) and extension into the interlobular septa (bright green in d) Subcarinal nodal involvement and left hilar involvement (light green in b)together with small right effusion (a,b) are also noted suggesting advanced disease.
Ashley Davidoff
TheCommonVein.net
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Central Carcinoma
An axial and a sagittal view of a centrally placed carcinoma that lies on the major fissure of the right lung code lung mass fissure likely carcinoma central probability of it being a squamous cell carcinoma or a small carcinoma is high because of its central location.
keywords lung mass nodule major fissure cancer carcinoma central CTscan
Ashley Davidoff
TheCommonVein.net
75675c01.8s
Central Carcinoma
The anatomical specimen shows a 2cms central lesion near the hilum of the left lung causing extrinsic impression on the central bronchovascular bundle. The relatively small size and central location suggests a squamous cell carcinoma though a non small cell carcinoma is also possible
Ashley Davidoff
TheCommonVein.net
32323c02.8s

Small Cell Lung Carcinoma  with Early Atelectasis

CT scan of a small cell lung carcinoma showing narrowing of the left main stem bronchus and upper lobe bronchus of the left lung  caused by a large hilar mass.
Diagnosis Small Cell Lung Carcinoma  with Early Atelectasis
Ashley Davidoff MD TheCommonVein.net
CT scan of a small cell lung carcinoma showing narrowing of the left main stem bronchus and upper lobe bronchus of the left lung  caused by a large hilar mass.
Diagnosis Small Cell Lung Carcinoma  with Early Atelectasis
Ashley Davidoff MD TheCommonVein.net

1 Week Later  Almost Complete White Out with Near Total Left Lung Collapse

1 Week Later  Almost Complete White Out with Near Total Left Lung Collapse
Diagnosis Small Cell Lung Carcinoma  
CXR  shows almost complete “white out” of the left lung  caused by a large hilar mas       Diagnosis Small Cell Lung Carcinoma  
Ashley Davidoff MD TheCommonVein.net