Bronchial Carcinoma,Pneumothorax & Pulmonary Edema
DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Bronchial Carcinoma,Pneumothorax & Pulmonary Edema CRT04211 · Image Pattern Recognition START READING NOTES Study Bronchial Carcinoma,Pneumothorax & Pulmonary Edema using the sections below. Use the topic navigation to continue through Image Pattern Recognition. Contents of This Topic OVERVIEW Introduction to Bronchial carcinoma Bronchial Carcinoma,Pneumothorax & Pulmonary Edema Causes and risk factors CXR FINDINGS OF BRONCHIAL CARCINOMA. Pleural effusion: Fluids accumulation in the pleural spaces , often seen in the advanced cases/stages. TUMOR WILL HIDE. Below the horizon of each dome of the diaphragm. Golden’s S sign Pulmonary metastases Atypical features include consolidation, cavitation, cystic change, calcification, ossification, haemorrhage, and Introduction to pneumothorax 1. Spontaneous Pneumothorax Caused by the chest injuries such as PATHOLOGIC Open / sucking pneumothorax Tension pneumothorax. CLINICALS FEATURES. SYMPTOMS RADIOLOGICAL FINDINGS OF PNEUMOTHORAX 3: Increase in radiolucency 4: Flattened Diaphragm 6. Deep sulcus sign Note these radiographic features: PULMONARY EDEMA Causes/Etiology non-cardiogenic pulmonary edema Phases/types of pulmonary edema Radiographic features Features of pulmonary interstitial oedema: Features of pulmonary alveolar edema: General radiographic features of pulmonary edema BRONCHIAL CARCINOMA. OVERVIEW Introduction to bronchial carcinoma Types of bronchial carcinoma Radiographic features/findings Introduction to Bronchial carcinoma Also known as bronchogenic carcinoma,refers to the lung cancer originating from the bronchi (the large airways of the lungs). The most common types of lung cancer can be classified into two main categories histologically as follows: Bronchial Carcinoma,Pneumothorax & Pulmonary Edema 1: Non–small cell lung cancer(NSCLC): The most common type of lung cancer, accounting for approximately 85% of all lung cancers. It's characterized by abnormal cells in the lungs reproducing rapidly and uncontrollably. Include 3 types Adenocarcinoma Squamous cell carcinoma Large cell 2: Small cell lung carcinoma(SCLC) Oat cell carcinoma is a faster-growing cancer that often spreads early. Histological types Causes and risk factors Smoking( primary causes) Exposure to random gas Air pollution and harzadous chemicals. Genetic predisposition Symptoms Persistent cough Chest pain Coughing up blood Unexplained weight loss CXR FINDINGS OF BRONCHIAL CARCINOMA. Irregular mass (tumour): A solitary or multiple lung masses, often with edges. (lung consolidation) Hilar enlargement: Due to the tumour growth near the bronchi. Lung collapse ( Atelectasis): If the tumour obstructs a bronchus, leading to segmental or lobar collapse. Golden S sign Cavitations: 15% of peripheral primary carcinomas cavitate. Most of these are squamous cell carcinomas that may show central necrosis with cavitation. Pleural effusion: Fluids accumulation in the pleural spaces , often seen in the advanced cases/stages. Note: Most cancers ( more than 70%) occurs in the upper lobes. Many bronchial carcinomas are easy to detect usually as conspicous mass. BRONCHOGENIC CARCINOMA. Lung cancer. Left hilum bronchogenic carcinoma TUMOR WILL HIDE. Some of carcinomas are difficult to detect because of their position or because they are overlapped by normal structures. To locate a hidden mass you need to inspect four areas very carefully. Superimposed on the heart. Make sure that the density on the heart on both side of the supine is equal. Bronchial Carcinoma,Pneumothorax & Pulmonary Edema The lung apices. Some tumor begin as flat lesion and the CXR appearance may be dismissed as simple pleural thickness ,A flat apices carcinoma can mimic a apical pleural cap Below the horizon of each dome of the diaphragm. A large part of each lower lobe lies below the horizon of each dome of the diaphragm ,even so if a lung mass is surrounded by air it is usually detectable on frontal CXR. Bronchial Carcinoma,Pneumothorax & Pulmonary Edema Around the hila: This does not refer to hilar enlargement. It refers to the lung parenchyma around, behind and in front of a hilum. Overlap by vessels entering or leaving the hilum can cause a nearby lung lesion to be overlooked. Golden’s S sign A collapsed right upper lobe with a mass at the hilum results in a reverse S configuration. The reversed S is made up of an elevated horizontal fissure and a bulky tumour at the hilum. Golden S sign Pulmonary metastases Refer to distant tumour spread from a variety of primary tumours to the lungs via the blood or lymphatics. Radiographic features Pulmonary metastases typically appear as multiple, peripheral, rounded nodules scattered throughout both lungs. Larger nodules and masses may be termed cannonball metastases. Atypical features include consolidation, cavitation, cystic change, calcification, ossification, haemorrhage, and secondary pneumothorax(post–primary). Cannonball PNEUMOTHORAX OVERVIEW Introduction to Pneumothorax. Clinical types. Radiological findings. Introduction to pneumothorax Pneumothorax refers to the presence of air in the pleural spaces/ refers to the presence of gas in the pleural space which allows the parietal and visceral pleura to separate and the lung to collapse. Occurs when the air enter in the pleural spaces( the area between the lung and the chest wall), causing the lungs to collapse partially or completely. There are several types of the pneumothorax,classified based on their causes and severity: 1. Spontaneous Pneumothorax Occurs without trauma and is further divided into: Primary spontaneous pneumothorax : happens in young healthy individuals without underlying lung disease. often due to ruptured lung blebs(sub pleural blebs). Secondary spontaneous pneumothorax: occurs in people with underlying lung diseases like COPD, asthma or cyst fibrosis. Caused by the chest injuries such as Blunt trauma: Ribs fractures puncturing the lung the lung. Penetrating trauma: stab wound, gunshot injuries or medical procedures like lung biopsies. Traumatic pneumothorax Bronchial Carcinoma,Pneumothorax & Pulmonary Edema Occurs when the air enter in the pleural spaces but can not escape and increasing pressure in the chest and progressive lungs collapse, this can compress the heart and the major blood vessels cause cardiovascular instability. Iatrogenic pneumothorax Occurs due to the medical procedures such as; Mechanical ventilation ,Excessive pressure causing lung rupture. Tension pneumothorax: PATHOLOGIC Simple/ closed pneumothorax: The opening in lung is very small and hence ,it heals rapidly. There is no continuous communication between the lung and pleural cavity. This means that pleural pressure is less than atmospheric pressure. Open / sucking pneumothorax The rupture site remains open and there is a communication between the pleural cavity and the