Recommandé
Recommandé
Contenu connexe
Tendances
Tendances (20)
En vedette
En vedette (20)
Similaire à Coin lesion
Similaire à Coin lesion (20)
Plus de Prasad CSBR
Plus de Prasad CSBR (20)
Dernier
Dernier (20)
Coin lesion
- 1. Coin Lesion Dr.CSBR.Prasad, M.D. CSBRP-Dec-2012
- 2. Coin Lesion Def: Any of various solitary, round, circumscribed shadows appearing in radiographic examinations of the lungs that are believed to be caused by tuberculosis, carcinoma, cysts, infarcts, or vascular anomalies. CSBRP-Dec-2012
- 4. Coin Lesion CSBRP-Dec-2012
- 5. Risk of malignancy increases with the age Patients who are >50yrs, the probability of SPN to be malignant is 50% CSBRP-Dec-2012
- 6. Solitary Pulmonary Nodule Common causes: Less common causes: • Primary lung cancers • Lymphoma • Metastases • Mesothelioma • Infections: TB, Pneumonia • Carcinoid • Pseudotumor • Chondroma • Hamartoma • Cysts – Hydatid • Rheumatoid nodule • Pulmonary sequestration • Pulmonary infarct • AV malformation CSBRP-Dec-2012
- 7. Solitary Pulmonary Nodule • SPN requires prompt and accurate Dx • A nodule that has not changed in size for two years is nearly always benign • Rapidly enlarging nodule suggests either infection or inflammation • CT scans are helpful in DD behaviour • SPN requires histological confirmation • If CT / biopsy fail to confirm the nature of the SPN, surgical excision should be considered CSBRP-Dec-2012
- 8. Solitary Pulmonary Nodule Clinical features: Majority are clinically silent Cough Cervical lymphadenopathy Finger clubbing Source of mets – Abdomen/Breast/Testis Rash – Vasculitis CSBRP-Dec-2012
- 9. Chest X-ray Must be evaluated carefully: Presence of emphysema suggests a significant smoking history An upper lobe location would suggest a TB Presence of heart failure in a patient with a SPN at the horizontal fissure suggests a pseudotumor Calcification indicates benign lesion Malignant lesions have shaggy, spiculated or lobulated margin CSBRP-Dec-2012
- 10. Solitary Pulmonary Nodule Rule-1 A nodule that has not changed in size for two years is nearly always benign CSBRP-Dec-2012
- 11. Solitary Pulmonary Nodule Rule-2 Rapidly enlarging nodule would suggest either infection or inflammation Fast growing tumors are uncommon CSBRP-Dec-2012
- 12. Solitary Pulmonary Nodule Rule-3 A nodule in a patient with a h/o smoking should be considered malignant until proven otherwise CSBRP-Dec-2012
- 13. Solitary Pulmonary Nodule Rule-4 Calcification suggests a benign lesion Patterns of calcification: A central nidus suggests granuloma Lamination suggests granuloma – histoplasma Pop-corn pattern suggests Hamartoma Multiple punctate pattern – Hamartoma / Granuloma CSBRP-Dec-2012
- 14. CSBRP-Dec-2012
- 15. Encysted effusion CSBRP-Dec-2012
- 16. Encysted effusion CSBRP-Dec-2012
- 17. E N D CSBRP-Dec-2012