Bronchogenic carcinoma

Case contributed by Dr Mohamed Morsi

Presentation

Cough and chest pain

Patient Data

Age: 45 years
Gender: Female
X-ray

Left upper lung zone mass.

Central trachea. No volume loss. No pleural effusion. No rib pathology.

CT

Large left upper lobe heterogeneously enhancing mass abutting the apical and mediastinal pleura, with lobulated and spiculated borders.

Multiple mediastinal and bilateral supraclavicular small lymph nodes.

Multiple vertebral lytic lesions.

Lumbar vertebral involvement (not shown).

Case Discussion

The features are highly suggestive of bronchogenic carcinoma with metastatic bone disease.
TNM stage is T4N3M1c, as detailed below:

Mass greatest dimension approximately 12 cm: T4 

Mediastinal and supraclavicular lymph nodes: N3

Multiple bone lytic lesions: M1c

The patient was referred to an oncology center.

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