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Sections Non-Small Cell Lung Cancer (NSCLC)
- Overview
- Presentation
- DDx
- Workup
- Approach Considerations
- Laboratory Studies
- Chest Radiography
- Computed Tomography
- Magnetic Resonance Imaging
- Bone Scintigraphy
- Positron Emission Tomography
- Sputum Cytologic Studies
- Bronchoscopy
- Biopsy
- Needle Thoracentesis (Ultrasound Guided)
- Thoracoscopy and Mediastinoscopy
- Molecular Testing
- Histologic Findings
- Staging
- Workup for Special Populations
- Screening
- Show All
- Treatment
- Guidelines
- Medication
- Medication Summary
- Antineoplastic Agents
- Antineoplastics, Anaplastic Lymphoma Kinase Inhibitors
- PD-1/PD-L1 Inhibitors
- Anti-CLTA4 Antibodies
- Antineoplastics, EGFR Inhibitor
- Antineoplastics, Anti-HER2
- Antineoplastics, BRAF Kinase Inhibitors
- Antineoplastics, Tyrosine Kinase Inhibitors
- RET Kinase Inhibitors
- MET Tyrosine Kinase Inhibitors
- Antineoplastics, KRAS Inhibitors
- Antineoplastics, Monoclonal Antibodies
- Antiemetic Agents
- Show All
- Questions & Answers
- Media Gallery
- References
Diagnostic Considerations
Non–small cell lung cancer (NSCLC) must be differentiated from small cell lung cancer (SCLC) in order to plan appropriate treatment. SCLC is usually more aggressive than NSCLC and presents as a central lesion with hilar and mediastinal invasion along with regional adenopathy. Many patients with SCLC already have metastatic disease at initial diagnosis. The most common sites of metastasis of lung cancer are the bones, liver, adrenal glands, pericardium, brain, and spinal cord. [43]
Other conditions to be considered include the following:
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Benign lung tumors
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Carcinoid lung tumors
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Granuloma
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Hamartoma
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Metastatic cancer
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Pneumomediastinum
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Pneumonia, empyema, and abscess
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Pneumothorax, tension and traumatic
Differential Diagnoses
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Mycoplasmal Pneumonia
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Non–small cell lung cancer. Symptoms and signs of lung cancer.
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Non–small cell lung cancer. Diagnostic approach for possible lung cancer.
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Staging workup for non–small cell lung cancer.
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Treatment recommendations and future research directions in the management of non–small cell lung cancer.
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Non–small cell lung cancer. Performance status scales for patients with cancer.
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Non–small cell lung cancer. Prognostic factors for lung cancer.
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Non–small cell lung cancer. Bronchoscopy. A large central lesion was diagnosed as non–small cell carcinoma.
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Non–small cell lung cancer. Left pleural effusion and volume loss secondary to non–small cell carcinoma of the left lower lobe. The pleural effusion was sampled and found to be malignant; therefore, the lesion is inoperable.
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Non–small cell lung cancer. Left upper collapse is almost always secondary to endobronchial bronchogenic carcinoma.
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Non–small cell lung cancer. Complete left lung collapse secondary to bronchogenic carcinoma of left mainstem bronchus.
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Non–small cell lung cancer. A cavitating right lower lobe squamous cell carcinoma.
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Non–small cell lung cancer. CT scan shows cavitation and air-fluid level.
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Non–small cell lung cancer. Patient has right lower lobe opacity. This is not well circumscribed and was found to be a squamous cell carcinoma.
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Lung cancer, small cell. Contrast-enhanced CT scan of the chest shows a large left lung and a hilar mass, with invasion of the left pulmonary artery.
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Lung cancer, small cell. Coronal positron emission tomogram shows abnormal areas of increased metabolic activity in the left hilar and left adrenal regions consistent with a hilar tumor with left adrenal metastasis.
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Lung cancer, small cell. Whole-body nuclear medicine bone scanning with anterior and posterior images reveal multiple abnormal areas of increased radiotracer activity in the pelvis, spine, ribs, and left scapula. These findings are consistent with bony metastatic disease. The bones are commonly affected in patients with small-cell lung cancer.
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Lung squamous carcinoma 4x: low power magnification of moderately differentiated squamous cell carcinoma showing irregular nests of tumor cells with focal areas of keratinization (pink-orange areas).
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Lung squamous carcinoma 20x: higher power magnification of moderately differentiated squamous cell carcinoma showing focal areas of keratinization (pink-orange areas) just to the right of center.
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Lung adenocarcinoma 4x: low power magnification of moderately differentiated adenocarcinoma showing rounded nests of pale staining tumor cells with gland lumina within some of the clusters.
Tables
Winston W Tan, MD, FACP Associate Professor of Medicine, Mayo Medical School; Consultant and Person-in-Charge of Genitourinary Oncology-Medical Oncology, Division of Hematology/Oncology, Department of Internal Medicine, Mayo Clinic Jacksonville; Vice Chairman, Division of Hematology/Oncology Education, Chair, Cancer Survivorship Program, Associate Chair, Department of Medicine Faculty Development, Mayo Clinic Florida; Vice President, Florida Society of Clinical Oncology
Winston W Tan, MD, FACP is a member of the following medical societies: American College of Physicians, American Society of Clinical Oncology, American Society of Hematology, Philippine Medical Association, Texas Medical Association
Disclosure: Nothing to disclose.
Syed Huq, MD Fellow, Division of Hematology-Oncology, Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Ellis Fischel Cancer Center
Syed Huq, MD is a member of the following medical societies: American Medical Informatics Association, American Society of Hematology, American Society of Clinical Oncology
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Nagla Abdel Karim, MD, PhD Director of Early Therapeutics, Inova Schar Cancer Institute; Professor of Medicine, University of Virginia School of Medicine
Nagla Abdel Karim, MD, PhD is a member of the following medical societies: American Medical Association, American Society of Clinical Oncology, Egyptian American Medical Association, Egyptian Cancer Society, International Association for the Study of Lung Cancer
Disclosure: Nothing to disclose.
Jeffrey L Arnold, MD, FACEP Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center
Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians
Disclosure: Nothing to disclose.
Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Gino A Farina, MD, FACEP, FAAEM Associate Professor of Emergency Medicine, Hofstra North Shore LIJ School of Medicine and Albert Einstein College of Medicine; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center
Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Edmond A Hooker II, MD, DrPH, FAAEM Associate Professor, Department of Health Services Administration, Xavier University, Cincinnati, Ohio; Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine
Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.
Irfan Maghfoor, MD Consulting Oncologist, Department of Oncology, King Faisal Specialist Hospital and Research Center, Saudi Arabia
Irfan Maghfoor, MD is a member of the following medical societies: American Society of Hematology
Disclosure: Nothing to disclose.
Tamas Peredy, MD Assistant Professor, Department of Emergency Medicine, Maine Medical Center
Disclosure: Nothing to disclose.
Michael Perry, MD, MS, MACP Nellie B Smith Chair of Oncology Emeritus, Director, Division of Hematology and Medical Oncology, Deputy Director, Ellis Fischel Cancer Center, University of Missouri-Columbia School of Medicine
Michael Perry, MD, MS, MACP is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society of Clinical Oncology, American Society of Hematology, International Association for the Study of Lung Cancer, and Missouri State Medical Association
Disclosure: Nothing to disclose.
Peter T Porrello, MD, FACEP Clinical Instructor, Department of Emergency Medicine, Yale University School of Medicine; Chief Medical Informatics Officer, Consulting Staff, Waterbury Hospital
Disclosure: Nothing to disclose.
Mityanand Ramnarine, MD Chief Resident Physician, Department of Emergency Medicine, Albert Einstein College of Medicine at Long Island Jewish Medical Center
Mityanand Ramnarine, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
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Sections Non-Small Cell Lung Cancer (NSCLC)
- Overview
- Presentation
- DDx
- Workup
- Approach Considerations
- Laboratory Studies
- Chest Radiography
- Computed Tomography
- Magnetic Resonance Imaging
- Bone Scintigraphy
- Positron Emission Tomography
- Sputum Cytologic Studies
- Bronchoscopy
- Biopsy
- Needle Thoracentesis (Ultrasound Guided)
- Thoracoscopy and Mediastinoscopy
- Molecular Testing
- Histologic Findings
- Staging
- Workup for Special Populations
- Screening
- Show All
- Treatment
- Guidelines
- Medication
- Medication Summary
- Antineoplastic Agents
- Antineoplastics, Anaplastic Lymphoma Kinase Inhibitors
- PD-1/PD-L1 Inhibitors
- Anti-CLTA4 Antibodies
- Antineoplastics, EGFR Inhibitor
- Antineoplastics, Anti-HER2
- Antineoplastics, BRAF Kinase Inhibitors
- Antineoplastics, Tyrosine Kinase Inhibitors
- RET Kinase Inhibitors
- MET Tyrosine Kinase Inhibitors
- Antineoplastics, KRAS Inhibitors
- Antineoplastics, Monoclonal Antibodies
- Antiemetic Agents
- Show All
- Questions & Answers
- Media Gallery
- References
