Fact-sheet: Bronchial adenocarcinoma
Updated on 04/21/2016 at 11:24 PM
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Definition
The most common primary lung malignancy in women and non-smokers
Clinical features
Pancoast-Tobias syndrome (painful apicocostovertebral syndrome): Shoulder pain radiating to the medial aspect of the Arm down to the last two fingers: C8-T1 neuralgia (Brachial plexus invasion).
Claude Bernard Horner syndrome: invasion of the sympathetic chain and stellate ganglion
CT
- Peripheral / subpleural mass or nodule -
+/- alveolar infiltrate -
+/- multiple nodules -
possible pleural invasion and peripheral involvement mimicking mesothelioma -
often located in the upper lobe -
possible air bronchogram -
rarely peripherally calcified -
may develop on sequelae of tuberculosis, infarction, scleroderma, bronchiectasis...
Pancoast-Tobias syndrome: -
Apical tumor -
Osteolysis of the 1st and 2nd ribs -
Osteolysis of the vertebral bodies +/- invasion of the neural foramina -
Mass effect on the subclavian vessels
Classification
TNM T1: T2: >= 3cm or invasion of the visceral pleura / lobar atelectasis / obstructive pneumonitis / > 2cm from the carina T3: any size if T4: invasion of the heart, great vessels, trachea, esophagus, vertebral body, carina, malignant pleural effusion N1: peribronchial or ipsilateral hilar lymphadenopathy N2: ipsilateral mediastinal lymphadenopathy N3: contralateral hilar, mediastinal, scalene, or supraclavicular lymphadenopathy