Characteristic Radiographic Features of Pulmonary Carcinoma Associated with Large Bulla

Tsutsui, M; Araki, Yasuo; Shirakusa, Takayuki; Inutsuka, Sadaaki

doi:10.1016/s0003-4975(10)64733-9

Cited by 35 publications

(14 citation statements)

References 8 publications

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“…Such differences are not unexpected and were described in the surgical literature as early as 1925 [16]. In spite of the somewhat variable histologic features of the cystic lesions, the radiographic findings all showed a similar progression of events, which is important for clinical follow-up and patient care, as was reported by others [9]. In all cases found at annual repeat screening, CT scans showed the initial cystic airspace had a thin wall (median diameter, 1.0 mm) that subsequently became thicker; eventually the nodule emerged and the diagnosis of lung cancer was made.…”

Section: Discussionsupporting

confidence: 66%

“…Neither of these scenarios is applicable to the carcinomas in our series, which contained predominately adenocarcinomas of the nonmucinous type. Other studies of carcinomas arising in association with cysts have also reported this predominance of adenocarcinoma [2,6,21,22]; squamous cell and small cell carcinomas have also been reported, although less frequently [4,6,8,9,19].…”

Section: Discussionmentioning

confidence: 93%

“…L ung cancer arising from the wall of a preexisting pulmonary cystic airspace has been reported since the 1940s [1][2][3][4][5][6][7][8][9][10], but this appearance has been described as uncommon. In those reports, it was unclear whether these cystic spaces were congenital cysts or appeared later in life and whether the cyst predated the development or emergence of the lung cancer.…”

mentioning

confidence: 99%

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Lung Cancer Associated With Cystic Airspaces

Farooqi

Cham²,

Zhang³

et al. 2012

American Journal of Roentgenology

106

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

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Lung Cancer Associated With Cystic Airspaces

Farooqi

Cham²,

Zhang³

et al. 2012

American Journal of Roentgenology

106

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“…Some reports have described characteristic roentgenographic and CT appearances of lung carcinoma associated with bullae. 4,5 It is easy to suspect a malignant lesion when a nodule or mass extrudes from the bullous lumen. However, tumors that predominantly invade toward the pleural side, are surrounded by multiple bullae, or are confi ned within the bullous lumen characteristically have a lack of spiculation, notch, and pleural indentation.…”

Section: Discussionmentioning

confidence: 99%

Primary lung cancer arising from the wall of a giant bulla in which positron emission tomography was useful for preoperative diagnosis

Yoshikawa

Misao

Aoe

2011

Gen Thorac Cardiovasc Surg

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We report a case of lung cancer arising from the wall of a giant bulla. A 58-year-old man consulted a physician because of bloody sputum. Chest computed tomography (CT) revealed a left upper giant bulla with partial thickness of the wall. Cytology of both sputum and transbronchial brushing was negative at that time. After 6 months follow-up CT scans showed more thickness of the wall, and positron emission tomography (PET) revealed high accumulation of fluorodeoxyglucose in the thickened wall. Because lung cancer was highly suspected, we performed an operation without a definitive diagnosis. The postoperative pathological diagnosis was large cell carcinoma arising from the wall of a giant bulla. Because a preoperative diagnosis is difficult in the case of lung carcinoma associated with bullous disease due to the lack of a characteristic radiological appearance and the difficulty of pathological examination, we emphasize that PET is a useful diagnostic tool.

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“…The association between lung cancer and bullae has long been recognized on plain radiographs [8], and this phenomenon has also gained attention recently in CT studies [9]. However, malignant and benign opacities in areas of emphysema demonstrate considerable overlap in appearances [10], and so, how such opacities should be managed lacks consensus.…”

mentioning

confidence: 99%

Missed cancers in lung cancer screening – more than meets the eye

Devaraj

2014

Eur Radiol

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In lung cancer, early detection and diagnosis is of paramount importance. In 2011 the National Lung Screening Trial (NLST) demonstrated the effectiveness of computed tomography (CT) screening for lung cancer in reducing mortality, and results from other ongoing trials are expected to be published in the near future. A topic that has not been widely researched to date, however, is the cause for screening failure and missed lung cancers. In lung cancer screening with thoracic computed tomography (CT), there are some parallels but also dissimilarities concerning this issue. The ability of readers to detect lung nodules on CT has certainly been the subject of extensive investigation. In mainly research conditions, it has been shown that even experienced thoracic radiologists may demonstrate only moderate performance in nodule detection [3,4]. However, in contrast to the plain chest radiograph, much emphasis has also been placed on the issue of minimizing "overcalls" (i.e., false-positive nodules) in CT screening. The topic of false negatives in lung cancer screening has gained less attention, which is perhaps a reflection of its very high negative predictive value (>99 %) [5,6].In this issue of European Radiology, the publication by Scholten and colleagues [7] of the NELSON trial is one of the few recent CT lung cancer screening studies to report on the causes of missed lung cancers. In this study, 22 missed lung cancers are described, which were visible in retrospect on the previous screening thoracic CT. What is revealing is not that the majority of misses were due to errors of detection, but rather that in most, there was an "explanation" for the miss.For example, in 5/22 cases, the overlooked opacity manifested as a small endobronchial lesion, in 3/22 cases as mediastinal or hilar lymph nodes, and in 5/22 cases as thickening of a bulla wall. Only in 2/22 cases (both intra-parenchymal nodules) could no explanation be provided other than observational error.The concept of bulla wall thickening as a marker of lung cancer is worthy of discussion. The association between lung cancer and bullae has long been recognized on plain radiographs [8], and this phenomenon has also gained attention recently in CT studies [9]. However, malignant and benign opacities in areas of emphysema demonstrate considerable overlap in appearances [10], and so, how such opacities should be managed lacks consensus.A number of questions arise: what degree of bulla wall thickness should prompt early follow-up CT or further Related publication by Scholten and colleagues can be found at http://dx

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Characteristic Radiographic Features of Pulmonary Carcinoma Associated with Large Bulla

Cited by 35 publications

References 8 publications

Lung Cancer Associated With Cystic Airspaces

Lung Cancer Associated With Cystic Airspaces

Primary lung cancer arising from the wall of a giant bulla in which positron emission tomography was useful for preoperative diagnosis

Missed cancers in lung cancer screening – more than meets the eye

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