D.D of Unilaterally Opacified Lung

• Massive Pleural Effusion.• Massive Collapse.• Pneumonectomy.• Massive Consolidation.

Lung Masses

Benign, malignant

Chest Malignancy

• Central or Peripheral• Central tumours may be associated with atelectasis

or obstructive pneumonitis.• Squamous & Small-cell more commonly central• Adeno & Large-cell commonly peripheral• All types may be assoc. with: pleural effusion,

destruction of ribs or vertebrae, elevation of a hemidiaphragm (phrenic nerve involvement), or mediastinal widening due to lymphadenopathy.

Adenocarcinoma

•Represents 35-40% of all lung cancers.

• usually occurs in a peripheral location within the lung and measure <4 cm in diameter.

• Only 4% show cavitation •Hilar or hilar and

mediastinal involvement is seen in 51% of cases on

chest radiography

Squamous cell carcinoma• Accounts for 25-30% of

all lung cancers.• Strong association with

cigarette smoking. • Often centrally located

within the lung .• Cavitation is seen in up

to 82%.• Commonly causes lung

collapse due to their central location.

Small Cell Lung Cancer• Strong association with smoking .• Rapid growth.• Early spread to distant sites.• Exquisite sensitivity to chemo and

radiotherapy.• Frequent association with distinct

paraneoplastic syndromes. • Surgery usually plays no role in its

management, except in rare situations (<5% of patients) in which it presents at a very early stage as a solitary pulmonary nodule

Small cell lung cancer

• 18% of all lung cancers.• Often present with bulky

hila and mediastinal lymph node masses.

• TNM system does not provide important prognostic information; only useful in <5%.