Lung cancer with cervical metastases

Case contributed by Dr David Cuete

Presentation

History of treated pulmonary tuberculosis, chronic smoking.

Patient Data

Age: 60
Gender: Female
X-ray

X-ray Chest

Lung volume in normal limits. Diffuse reticular Images. In the periphery of the right upper lobe nodular is seen an opacity about 3cm and partially defined contours. Prominence of the aortic knob, shows calcified atheromas. No signs of pleural effusion or pneumothorax. Dorsal spondylosis. 

CT study is suggested.

CT

CT Chest

CT Shows in the apical segment of the right upper lobe there is a subpleural mass, oval, with clear borders, measuring 4.6 x 3.6 cm in maximum transverse diameters, that enhances with the contrast medium, contacting the chest wall without  tomographic signs of local infiltration. At the inferior lingula there is a solid rounded nodule.

Moderate paraseptal centriacinar emphysema. Bibasal peripheral reticular opacities that can be in the context of interstitial lung disease

CT

CT Neck

Low internal jugular lymph nodes, which compresses the jugular vein ipsilateral without occlude, they have a necrotic center. In the right thyroid lobe there is a rounded  hypodense nodule.

Case Discussion

This case is a good example of a lung tumour with neck metastasis.

Histological confirmation for management and treatment planning is essential. This is an excellent example of where a less invasive and lower risk tissue diagnosis can be ascertained by a ultrasound guided neck node biopsy, rather than a CT guided lung biopsy.

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Case information

rID: 22556
Case created: 7th Apr 2013
Last edited: 11th Nov 2015
Systems: Chest, Head & Neck
Inclusion in quiz mode: Included

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