Saturday, July 30, 2011

Radiological picture of lung cancer ( CXR, CT-Scan X-ray Other radiological examinations )

The results of radiological examinations is one which is absolutely necessary investigations to determine the location of primary tumors and metastases, and staging of disease according to TNM system. Radiological examination of lung CXR PA / lateral, if possible thoracic CT-scan, bone scan, bone survey, abdominal ultrasound and CT Brain-is needed to determine the location of abnormality, tumor size and metastasis. 

a. CXR

On examination of chest X-ray PA / lateral will be seen if the tumor with tumor size more than 1 cm. Signs supporting the malignancy is an irregular edge, accompanied by pleural indentation, satellite tumor tumor, etc.In the photo can also be found to have tumor invasion into the chest wall, pleural effusion, pleural metastasis perikar and intrapulmoner. While the KGB's involvement is rather difficult to determine the N was determined by X-ray alone. Physician vigilance against the possibility of lung cancer in a patient with a lung disease that is not the typical picture of malignancy is important to be reminded. A person belonging to the high risk group (GRT) with a diagnosis of lung diseases, must be accompanied by a thorough treatment. Giving OAT showed no improvement or even deteriorate after 1 month should rule out the possibility of lung cancer, but another problem is the treatment of pneumonia that does not work after the administration of antibiotics for 1 week should also raises the possibility of a tumor suspected pneumonia is reversed When the chest X-ray showed pleural effusion broad overview to be followed by emptying the contents of the pleura with WSD installation or repeated puncture and repeated chest X-ray, so that if there is a primary tumor can be demonstrated. Malignancy should considered when liquids are productive, and / or fluid serohemoragik

b.CT-Scan X-ray

This imaging technique can determine abnormalities in the lung are better than chest X-ray. CT scans can detect tumors smaller than 1 cm is more appropriate. Likewise, signs of malignancy are also illustrated process is better, even if there is an emphasis on bronchial, intra-bronchial tumor, atelectasis, pleural effusions are not massive and there has been an invasion into the mediastinum and chest wall even without symptoms. Furthermore with the CT-scan, the KGB's involvement was instrumental to determine the stage is also better because of enlarged lymph nodes (N1 s / d N3) can be detected. Likewise, careful approach to detect possible metastasis intrapulmoner. Other radiological .

c. Other radiological examinations.

Lack of chest radiograph and thoracic CT-scan is not able to detect the occurrence of distant metastases. That requires other radiological examinations, such as Brain-CT for detecting bone metastases in the head / brain tissue, bone scan and / or surveys can detect bone metastases of bone tissue throughout the body. Abdominal ultrasound can view the presence or absence of metastases in the liver, adrenal glands and other organs in the abdominal cavity.

Sunday, July 24, 2011

History and Physical Examination of Lung Cancer

A. History of Lung Cancer

Clinical picture of lung cancer are not much different from other lung diseases, consisting of subjective complaints and objective symptoms. History will be obtained from the primary complaint and the course of disease, as well as other factors that often helps the establishment of the diagnosis.

The main complaint Of Lung Cancer may be: 
  • Cough with / without sputum (phlegm white, can also purulent)
  • Coughing up blood 
  • Shortness of breath
  • Hoarseness 
  • Chest Pain 
  • Difficulty / pain swallowing
  • Lump in the base of the neck
  • Puffy face and neck, sometimes accompanied by pain swollen arm of Great 

Not infrequently the first visible symptoms of lung cancer or complaints are due to metastases outside the lung, such abnormalities that arise due to severe compression of the brain, liver enlargement or a broken bone in his foot.  

Symptoms of lung cancer and complaints are not typical, such as:
  • Weight loss decreases
  • Appetite loss 
  • Fever intermittent
  • Paraneoplastic syndromes, such as' Hypertrophic pulmonary osteoartheopathy ",  thrombosis and neuropatia venaperifer.  

B. Physical examination of LUNG CANCER.

 Physical examination of lung cancer must be done thoroughly and carefully. The results are very depends on the abnormality on examination performed. Lung tumors of small size and is located in the peripheral can provide a normal examination. Tumors with large size, especially if accompanied by atelectasis due to bronchial compression, pleural effusion or vena cava pressure will provide more informative results. This examination can also provide data for determining the stage of disease, such as enlarged lymph nodes or tumor outside the lung. Metastasis to other organs can also be detected with the palpability of the liver, funduscopic examination to detect intracranial pressure elevation and the occurrence of fractures due to bone metastases.