Metastatic involvement (M)
description
Transcript of Metastatic involvement (M)
Metastatic involvement (M) M0 - No metastases
M1 - Metastases present
Metastases (M) M0: No distant metastasis M1: Distant metastasis present; or Separate tumor nodules in the
ipsilateral nonprimary-tumor lobes of the lung. Separate tumor nodules in the contralateral lung are considered M1 if they are of the same histologic cell type as the primary lesion. A contralateral lung tumor with a different cell type is considered a synchronous primary lesion and should be staged independently
Stage Tumor Nodes Metastases
Stage 0
TIS- Carcinoma in situ
IA IB
T1 T2
N0 N0
M0 M0
IIA IIB
T1 T2 T3
N1 N1 N0
M0 M0 M0
IIIAT1 or T2 T3
N2 N1 or N2
M0 M0
IIIBAny T T4
N3 Any N
M0 M0
IV
Any T Any N M1
Advantages MRI has over CT in Tumor assessment Mediastinal and chest wall invasion and
involvement of the diaphragm.MRI is most useful when evaluating spinal
cord compression and brain metastasis . In Pancoast tumours, invasion into the
brachial plexus, subclavian artery or vertebral body by MRI has been found to be 94% accurate as opposed to 63% for CT .
Positron Emission TomographyPET scans appear to be more sensitive,
specific, and accurate than CT scans for staging mediastinal disease.
PET is more accurate than conventional studies in detecting recurrent lung cancer.
False-positive studies do occur secondary to postirradiation inflammatory change and delaying the examination until 4 or 5 weeks postirradiation is recommended
The solitary pulmonary noduleA common incidental CXR finding .CT detects many more lung nodules than
CXR. Numerous differential diagnoses. 50% are malignant: 40% are primary CA,
10% are solitary metastases .Prompt diagnosis and management of
early lung cancer manifesting as SPN may be the only chance for cure.
No significant mortality reduction with screening.
Calcification in SPNCT scanning can further refine the detection
of calcification and fat within nodules. A total 22–38% of noncalcified nodules on chest radiographs appear calcified on CT.
Eccentric or stippled calcification is seen in 10% of lung cancers.
Features of SPN suggesting benignityClinical history, especially of T.B. Compared with old films, no growth over a 2-
yr period.Age <35 yrs,No history of cigarette smoking.No history of extrathoracic malignancy .
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