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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Lung nodules are a common finding on CT chest imaging. The mixed ground glass nodule is a significant finding due to the high malignancy rate associated with them. A study published in the June 2018 Clinical Radiology journal by X-W Wang et al. considered features which may be useful in predicting invasive adenocarcinoma (ICA) compared to adenocarcinoma in-situ (AIS) and minimally invasive adenocarcinoma (MIA). There is emerging evidence to suggest that AIS and MIA may be able to undergo sublobar resection instead of lobectomy (an important consideration in the elderly or those with bilateral ground glass nodules), whereas IAC requires lobectomy. Thus presurgical assessment of the nodule is required. This study reports that the most powerful predictor of IAC over AIS or MIA is nodule mass. Mass can be calculated using computer-aided measurement, which considers nodule volume as well as CT attenuation value. Nodule volume and diameter were also found to be statistically significant predictor of IAC; however less powerful than mass, as they do not consider internal attenuation. Nodule location and multiplicity were not found to be significant predictors of IACs.
Germ-Cell Cancer of the Testis and Related Neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Staging CT includes the chest, abdomen, and pelvis. Significant lymphadenopathy is defined as nodal size of 10 mm or greater in the retroperitoneum. CT has a 70–80% sensitivity of detecting metastatic disease in the abdomen.43 The abdominal lymphatic spread in both tumor types occurs in characteristic sites (the so-called “landing zones”); these are the para-aortic area for left-sided primary tumors and the inter-aorto-caval and para-caval area for right-sided tumors. All scans of new patients should be reviewed by the specialist center in a multidisciplinary meeting to ensure accurate staging at the outset. In cases where the nodal distribution is atypical or the size of the nodal lesions is borderline (approximately 10 mm), it is often reasonable to perform an interval scan to help clarify the staging before therapy. Thoracic CT has a higher sensitivity, but a lower specificity compared to chest radiography in detecting pulmonary nodules.44 Lung nodules of uncertain significance can also be followed up with interval scanning.
How Deep Learning Is Changing the Landscape of Lung Cancer Diagnosis
Published in Ayman El-Baz, Jasjit S. Suri, Lung Imaging and CADx, 2019
Consider M and N be two Riemannian manifolds such that a mapping remains conformal (local angles are preserved). A spherical parameterization of the surface can be obtained by mapping this simple surface to a unit sphere . For genus zero closed surfaces, conformal mapping remains equivalent to a harmonic mapping and satisfies the Laplace equation, . Here, it is important to note that lung nodules are spherical in shape with limited local variations. In this regard, the spherical mapping of lung nodules to a unit sphere remains a natural option. The variations in the shapes of nodules can be modeled by conformal mapping to a unit sphere. In order to discriminate the differences of mapping to a unit sphere, SH are used. SH map to real space .
Physical Therapy Interventions in a Patient with Nontraumatic Incomplete Spinal Cord Injury Secondary to Metastatic Lung Cancer: A Case Report
Published in Physiotherapy Theory and Practice, 2022
Refer to Table 1 for the patient’s medical history and list of medications. Subjective history revealed that the patient lived in a two-story home with two steps to enter with her terminally ill husband and adult son with unspecified cognitive deficits. She worked full-time and was the sole financial provider for her household. Prior to this cancer diagnosis, she was independent for mobility and all basic and instrumental activities of daily living (ADL) without an assistive device. She reported no functional limitations from her rheumatoid arthritis (RA) diagnosis beyond mild symptoms of joint pain and intermittent fatigue. In the months leading up to her NT-SCI and cancer diagnosis she had several trips to the emergency department for various complaints. During one visit imaging revealed multiple lung nodules. The patient did not seek additional medical evaluation or treatment for these lung nodules due to being uninsured at the time. This case report was approved by the IPR Institutional Review Board and the patient provided her written informed consent to participate.
Endometriotic lung cyst causing catamenial hemoptysis; a case report and review of literature
Published in Acta Chirurgica Belgica, 2022
Evelyne Verhulst, Celine Bafort, Carla Tomassetti, Albert Wolthuis, Didier Bielen, Johan Coolen, Birgit Weynand, Lieven Platteeuw, Christel Meuleman, Dirk Van Raemdonck
Symptoms are largely correlated to the anatomic location of the lesions. The typical presentation of pleural TES is catamenial pneumothorax and chest or shoulder pain. This catamenial pneumothorax is recurrent, starting typically within 72 h after the onset of menstruation. Patients complain of chest pain, cough and shortness of breath. Diaphragmatic irritation can cause referred pain to the peri-scapular region or the neck [2,12]. In 92% of the cases, the right hemithorax is involved, in 5% the left hemithorax and 3% of patients have bilateral involvement. Catamenial hemothorax is less common for pleural TES with symptoms similar to a pneumothorax: cough, shortness of breath and pleuritic chest pain in addition to a bloody pleural effusion. Mild to moderate catamenial hemoptysis can also be caused by broncho-pulmonary TES, identified on imaging as pulmonary nodules varying in size from 0.5 to 3 cm. These lung nodules can occur in symptomatic patients, but they can also be an incidental finding [13]. Rarely, isolated diaphragmatic endometriosis can cause irritation of the phrenic nerve, producing cyclic neck, shoulder, right upper quadrant or epigastric pain.
Invasive modalities for the diagnosis of peripheral lung nodules
Published in Expert Review of Respiratory Medicine, 2021
Satish Kalanjeri, Anna Abbasi, Munish Luthra, Jeremy C. Johnson
Lung cancer is the leading cause of cancer-related death in both men and women[1]. The National lung Cancer Screening Trial (NLST) demonstrated the utility of annual low-dose chest CT scans for lung cancer screening reduction in mortality by 20%[2]. The NSLT revealed lung nodules in at least 24% of the study subjects, of which 72% required further work-up [2]. With widespread application of lung cancer screening with chest CT scans, pulmonologists are encountering more early-stage lung cancer than before. Therefore, the need to diagnose lung cancer safely and accurately poses a diagnostic challenge. Conventional bronchoscopy and transbronchial biopsies have a poor diagnostic yield in the diagnosis of lung cancer (14–63% sensitivity) [3,4]. The advent of radial probe ultrasound and curvilinear ultrasound heralded a paradigm shift in the diagnosis of peripheral lung nodules and nodal staging, respectively. However, these tools are not perfect and the pursuit of better tools for lung cancer diagnosis continues. This review will touch upon various invasive modalities for the diagnosis of peripheral lung nodules.