Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘cancer’ Category

Sites of Metastasis

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Nice graphic of where primaries metastasize: link

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Written by lmwong

October 28, 2011 at 9:54 am

Posted in cancer, metastasis

Lung Cancer Staging

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New 7th Edition of for Lung Cancer Staging, Radiographics Sept 2010.

Written by lmwong

December 16, 2010 at 4:07 pm

Cervical Cancer Staging

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IA = confined to cervix
IB = extension to uterus
IIA = extension to upper vagina
IIB = extension to parametrium
IIIA = extension into lower vagina
IIIB = pelvic wall (hydronephrosis)
IVA = adjacent organs
IVB = distant organs.

 

Written by lmwong

December 11, 2010 at 7:27 pm

Tumor Cancer Staging

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Nasophyngeal Squamous Cell Carcinoma Head and Neck

  • Tis = carcinoma in situ
  • T1 = confined to 1 site
  • T2 = 2 sites
  • T3 = extends to nasal cavity or oropharynx
  • T4 = invades skull, cranial nerve
  • N0 = no nodes
  • N1 = homolateral node ❤ cm
  • N2 = homolateral node > 3 cm
  • N3 = node > 6 cm
  • M0 = no mets
  • M1 = distant mets

Thyroid Cancer

  • T1a = nodule < 4cm
  • T1b = nodule > 4cm
  • T2 = nodule with partial fixation
  • T3 = nodule with complete fixation
  • N1 = regional nodes
  • N2 = fixed regional nodes
  • M1 = mets

Lung Cancer (TNM)

  • T0 = no tumor
  • T1 ❤ cm
  • T2 >3 cm, >2 cm from carina
  • T3 extends to chest wall, sulus, diaphragm, pleura, pericardium, <2 cm from carina
  • T4 distant mets
  • N0 = no nodes
  • N1 = ipsilateral hilar
  • N2 = ipsilateral mediastinal and subcarinal
  • N3 = contralateral, supraclavicular
  • M0 = no mets
  • M1 distant mets

Stomach Cancer

  • T1 = mucosa
  • T2 = muscle, serosa
  • T3 = penetration
  • T4 = adjacent organs

Renal Cell Carcinoma

  • Stage I = confined to kidney, <7 cm
  • Stage II = confined to kidney, >7 cm
  • Stage III = fatty infiltration, venous invasion, LN mets
  • Stage IV = through Gerota’s fascia, distant mets

Wilm’s Tumor

  • I = kidney
  • II = extend to perinephric space
  • III = LN
  • IV = mets to lung or liver
  • V = bilateral renal involvement

Colon Cancer (Dukes)

  • A = bowel wall only
  • B = serosa
  • C = LN
  • D = mets

Colon Cancer (TNM)

  • T1 = mucosa or submucosa
  • T2 = invasion or muscularis propria
  • T3 = invasion into subseroa
  • T3 = adjacent structures, fistulas
  • N1 = 1-3 LN
  • N2 = >4 LN
  • N3 =  LN along named vascular trunk
  • M = Mets

Bladder Cancer

  • T1 = mucosal and submucosal tumors
  • T2 = superficial muscle layers
  • T3a = deep muscular wall
  • T3b = perivesicular fat
  • T4 = other organs

Prostate Cancer (Jewett)

  • A = nonpalpable, found at biopsy
  • B = palpable, confined to prostate
  • C = through prostate capsule
  • D = mets

Endometrial Carcinoma

  • 1 and 2 = confined to uterus
  • 3 and 4 = extrauterine

Cervical Cancer

  • IA = confined to cervix
  • IB = extend to uterus
  • IIA = extend to upper vagina
  • IIB = parametrial involvement
  • IIIA = extend to lower vagina
  • IIIB = pelvic wall
  • IVA = adjacent organs
  • IVB = distant organs

Ovarian Cancer

  • 1 = ovary
  • 2 = both ovaries +/- ascites
  • 3 = intraperitoneal mets
  • 4 = mets outside peritoneal cavity

Breast Cancer

  • 0 = DCIS
  • 1 = <2 cm
  • 2 = 2-5 cm, axillary nodes
  • 3 = >5 cm, pectoralis involvement or matted LN
  • 4 = distant mets

Written by lmwong

March 30, 2010 at 9:56 am

Hepatocellular Carcinoma (HCC)

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  • most common malignant primary tumor of liver
  • associated with Hep B, Hep C, and cirrhosis
  • ETOH, Wilson’s disease, Type 1 glycogen storage disease, aflotoxin ingestion (Africa)
  • solitary, multifocal, diffuse, or infiltrating
  • typically large dominant lesion with scattered smaller satellite lesions
  • strong association with venous invasion; portal vein >> hepatic veins
  • hypervascular; hyperattenuated on delayed imaging compared to liver

http://brighamrad.harvard.edu/Cases/bwh/hcache/335/full.html

Written by lmwong

September 19, 2008 at 11:27 pm

Posted in cancer, gi, liver, tumor

Gallbladder Carcinoma

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  • 5th most common GI malignancy
  • stones are a risk factor
    • 75% have stones
    • chronic inflammation leads to epithelial dysplasia –> adenocarcinoma
  • 20% 5ys
  • 80% have direct tumor invasion at presentation
  • ST mass in GB lumen, partially or completely obliterates GB lumen
  • Greater than 1 cm (distinguish from polyp)
  • irregular, asymmetric and eccentric wall thickening
  • polypoid intraluminal mass
  • porcelain gallbladder
  • early spread to liver and lymph nodes
  • invades liver, bile ducts, portal veins
  • invades hepatoduodenal ligament –> CBD obstruction

Written by lmwong

June 6, 2008 at 5:21 pm

Metastatic Lung Disease

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Primary tumors that cause lung mets:

  • breast
  • colon
  • kidney
  • uterus
  • prostate
  • head & neck

Patterns

  • Cannonball pattern = colon cancer, sarcoma, RCC, melanoma
  • Miliary pattern = ovarian or thyroid, RCC, melanoma
  • Lymphangitic spread = breast cancer, stomach cancer, pancreatic cancer, prostate cancer, and lung cancers, particularly small cell cancer and adenocarcinoma.
  • Cavitary = uterine cervix, colon, head and neck, squamous cell carcinoma

Spread

  • Direct
  • Hematogenous = pulmonary nodules, lymphangitic carcinomatosis

Written by lmwong

April 8, 2008 at 3:29 am