Small cell lung cancer with pleural metastasis

Case contributed by Dr Jayanth Keshavamurthy


Cough and weight loss. 50 pack year history of smoking.

Patient Data

Age: 70 years
Gender: Female

A masslike opacity is identified within the left lung apex, which exhibits broad contact with the left pleural surface along with bulky mediastinal lymphadenopathy, multifocal left pleural metastatic disease, a left adrenal nodule is highly concerning for left adrenal metastasis, and widespread hepatic metastasis (soft tissue window is not shown). Background emphysematous changes seen. 

Overall, findings are favored to represent advanced lung carcinoma. Correlation with image guided tissue sampling or bronchoscopic tissue sampling is recommended, if not already performed.


Nuclear medicine


Findings most consistent with widespread metastatic malignancy, if left upper lobe is presumed to be a primary site, lung cancer stage would be T4 N3 M1B.
1. Presumed intensely hypermetabolic left upper lobe apical primary with small volume mediastinal extension. Additional tumor nodule in the left upper lobe.
2. Extensive intensely hypermetabolic left pleural involvement.
3. Extensive bilateral middle and anterior mediastinal nodal involvement. Small volume right supraclavicular nodal involvement.
4. Extensive intensely hypermetabolic liver metastatic disease probably involving more than 50% of liver volume. Periportal and retroperitoneal nodal involvement. Probable involvement of the left
adrenal gland.

Case Discussion

Received 6 cycles of chemo with carboplatin and etoposide for small cell lung cancer diagnosed by lung biopsy.

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Case information

rID: 43815
Published: 25th Mar 2016
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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