Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘tumor’ Category

Spinal Mass Differential

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A. Intradural, Intramedullary: astrocytoma, ependymoma, hemangioma, cavernoma, dermoid/epidermoid
B. Intradural, Extramedullary:  nerve sheath tumors, meningioma
C. Extradural: bone neoplasm, mets, abscess, TB, hematoma, disk, synovial cyst, lipomatosis, neuroblastoma/ganglioneuroma

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Written by lmwong

December 17, 2010 at 1:14 pm

Posted in differential, neuro, tumor

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

Pediatric Renal Tumors

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  • Wilm’s tumor
  • nephroblastomatosis
  • Clear cell sarcoma
  • Rhabdoid tumor
  • Hamartoma
  • Angiomyolipoma
  • Ossifying Renal Tumor of Infancy
  • Metanrphric Adenoma
  • Adjacent Neuroblastoma from adrenal gland

Written by lmwong

March 20, 2010 at 10:57 am

Pituitary Adenoma

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  • >10 mm = macroadenoma
  • <10 mm = microadenoma
  • 75% hormonally active = prolactinoma (MC), growth hormone (acromegaly)
  • from anterior lobe of gland
  • pseudocapsule demarcates from normal gland
  • bromocriptine – high incidence of adenoma hermorrhage

Written by lmwong

January 25, 2010 at 11:31 am

Posted in neuro, tumor

Ventricular Tumors

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Ventricular Tumors

  • choroid plexus papilloma (24%)
  • choroid plexus carcinoma
  • ependymoma (18%)
  • subependymoma (11%)
  • central neurocytoma (10%)
  • subependymal giant cell astrocytoma
  • all other astrocytomas
  • meningioma
  • colloid cyst
  • met

Lateral Ventricle Mass by Age and Location

  • 0-10y
    • body: primative neuroectodermal tumor, teratoma, choroid plexus papilloma
    • trigone: choroid plexus papilloma
  • 10-40y
    • foramen: subependymal giant cell astrocytoma, pilocytic astrocytoma
    • body: ependymoma, pilocytic astrocytoma, central neurocytoma
  • >40y
    • body: subependymoma
    • trigone: meningioma, met

3rd Ventricle Masses

  • craniopharyngioma
  • colloid cyst
  • meningioma
  • choroid plexus papilloma
  • hamartoma
  • glioma
  • vascular lesion
  • granulomatous disease

4th Ventricle Masses

  • Choroid plexus papilloma/ca
  • Ependymoma
  • Medulloblastoma
  • Meningioma
  • mets

read more

Written by lmwong

January 22, 2010 at 3:08 pm

Posted in differential, neuro, tumor

Malignant Bone Tumors by Age

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Age Type
1 Neuroblastoma
1-10 Ewing of tubular bones
10-30 Osteosarcoma, Ewing of flat bone
30-40 reticulum cell sarcoma (Primary histiocytic lymphoma), fibrosarcoma, parosteal osteosarcoma, malignant giant cell tumor, lymphoma
>40 metastatic carcinoma, multiple myeloma, chondrosarcoma

Written by lmwong

January 16, 2010 at 9:59 am

Posted in bone, differential, msk, tumor

Thymic tumors

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  • anterior mediastinal mass
  • thymoma (MC); invasive, can spread locally
  • thymic hyperplasia
  • thymolipoma
  • thymic cyst
  • thymic carcinoma; metastatic disease
  • thymic carcinoid

Written by lmwong

January 12, 2010 at 8:22 am

Posted in chest, mediastinal, tumor