TITLE:
Spreading pattern and CT findings of very early-stage peripheral small-cell lung cancer
AUTHORS:
Takeshi Terashima, Tatsu Matsuzaki, Shotaro Chubachi, Fumio Sakamaki, Minako Satoh, Eri Tomioka, George Horio, Rika Ogawa, Asuka Naitoh, Hiroya Ojiri
KEYWORDS:
SCLC; Small Pulmonary Nodules; Beaded Appearance; Bronchovascular Bundle; CT Scan
JOURNAL NAME:
Advances in Lung Cancer,
Vol.2 No.4,
December
6,
2013
ABSTRACT: Chest CT frequently
reveals small pulmonary lesions. If there is no associated hilar or mediastinal
lymphadenopathy, small-cell lung cancer (SCLC) is considered to be very
early-stage. Few studies, however, have described the characteristic CT
findings of very early-stage SCLC. Clarifying these findings would reduce
diagnostic delay. The purpose of this study was to determine the characteristic
CT findings of very earlystage SCLC. Computed tomography images obtained from
547 consecutive patients with lung cancer between 2003 and 2012 at Tokyo Dental
College Ichikawa General Hospital were reviewed retrospectively. One hundred of
these patients had SCLC and 447 had non-SCLC (NSCLC). These CT images, along
with any that had also been obtained prior to the one on which the final diagnosis
was based, were reviewed. In 5 of the cases reviewed, specific findings and a
characteristic spreading pattern were identified on CT images that might have
allowed a diagnosis of SCLC to have been made sooner. The findings included a
sub-pleural, small nodule accompanied by daughter nodules spreading longitudinally
along the bronchovascular bundle, no air bronchogram or cavitation, and background emphysematous change. These were not identified on CT images of very earlystage NCSLC, however (n = 22). Awareness of the relevance of
these findings would help physicians and radiologists arrive at a differential
diagnosis of small pulmonary nodules.