CT findings of small cell lung carcinoma: Can recognizable features be found?

The purpose of this study was to clarify the recognizable computed tomography (CT) features of small cell lung carcinoma (SCLC).Contrast enhanced CT scans were reviewed retrospectively for mass location, mediastinal extension, and other concomitant findings in 142 patients with pathologically proven...

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Bibliographic Details
Published in:Medicine (Baltimore) 2016-11, Vol.95 (47), p.e5426-e5426
Main Authors: Lee, Dongjun, Rho, Ji Young, Kang, Seunghun, Yoo, Koun Joy, Choi, Hye Jeong
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biopsy
Contrast Media
Female
Humans
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - pathology
Lymphatic Metastasis
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Invasiveness - diagnostic imaging
Neoplasm Invasiveness - pathology
Observational Study
Positron-Emission Tomography
Retrospective Studies
Small Cell Lung Carcinoma - diagnostic imaging
Small Cell Lung Carcinoma - pathology
Tomography, X-Ray Computed
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Summary:The purpose of this study was to clarify the recognizable computed tomography (CT) features of small cell lung carcinoma (SCLC).Contrast enhanced CT scans were reviewed retrospectively for mass location, mediastinal extension, and other concomitant findings in 142 patients with pathologically proven SCLC. SCLC was classified into hilar mass only (type I), hilar mass with ipsilateral mediastinal extension (type II), hilar mass with bilateral mediastinal extension (type III), and peripheral mass (type IV). When mediastinal lymphadenopathy (m-LAP) was indistinguishable from a hilar mass, we defined it as a mediastinal conglomerate mass (m-CM). Type IIa or IIIa had ipsilateral or bilateral m-LAP and type IIb, IIIb or IIIc had ipsilateral or bilateral m-CM.Type I (n = 8, 5.6%), type II (n = 58, 40.8%), type III (n = 55, 38.8%), and type IV (n = 21, 14.8%) were manifested. The combination of a hilar mass and m-CM was found in 68 patients (47.9%). Type IV masses showed lobulation in 11, microlobulation in 4, both lobulated and irregular margins in 4, and spiculation in 2. A total of 120 patients (84.5%) had a bronchial stenosis/obstruction; single (n = 52) and 2 or more (n = 68). Ninety-five patients (67.0%) had vascular invasion including main/lobar pulmonary artery and superior vena cava, and 55 (38.7%) had pleural effusion and/or pleural nodules. Concomitant parenchymal findings (n = 92, 64.8%) were noted: contiguous consolidation/nodule (n = 45), hematogeneous spread (n = 32), lymphangitic spread (n = 21), obstructive pneumonia (n = 22), and obstructive atelectasis (n = 14).In conclusion, the recognizable CT features of SCLC were a hilar mass with m-CM. Most of the hilar masses showed 2 or more bronchial stenoses/obstructions. Most cases of peripheral SCLC manifested as a lobulated mass rather than a spiculated mass. Vascular invasion and concomitant parenchymal findings were observed commonly.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000005426