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Do Hemodynamic Studies of Stage T1 Lung Cancer Enable the Prediction of Hilar or Mediastinal Nodal Metastasis?

Sung Shine Shim1, Kyung Soo Lee1, Myung Jin Chung1, Hojoong Kim2, O Jung Kwon2 and Seonwoo Kim3

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3 Biostatistics Unit, Samsung Medical Center, Seoul, Korea.


Figure 1
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  		Fig. 1A —Stage T1 adenocarcinoma in 54-year-old woman with left lower paratracheal lymph node metastasis on histopathologic examination. Axial thin-section (2.5-mm collimation) CT scan using lung window setting obtained at level of distal left main bronchus shows 22-mm nodule (arrow) with lobulated and spiculated margin in left upper lobe. Other mediastinal window setting images did not show any evidence of lymph node enlargement in mediastinum or hilum.

 

Figure 2
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  		Fig. 1B —Stage T1 adenocarcinoma in 54-year-old woman with left lower paratracheal lymph node metastasis on histopathologic examination. Serial images obtained at similar level to A show enhancement dynamics of nodule. Peak enhancement was 127 H and net enhancement was 72 H. Colored graph denotes dynamic enhancement curve of nodule.

 

Figure 3
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  		Fig. 2A —Stage T1 large cell neuroendocrine carcinoma in 70-year-old man with visible enlarged mediastinal nodes on CT, but without nodal metastasis on histopathologic examination. Axial thin-section (2.5-mm collimation) CT scan obtained using lung window setting at level of left interlobar pulmonary artery shows 18-mm nodule (arrow) with lobulated margin in left upper lobe.

 

Figure 4
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  		Fig. 2B —Stage T1 large cell neuroendocrine carcinoma in 70-year-old man with visible enlarged mediastinal nodes on CT, but without nodal metastasis on histopathologic examination. Axial CT scan obtained using mediastinal window setting at level of azygos arch shows enlarged lymph node (arrow) with short-axis diameter of 11 mm in right lower paratracheal area. Also note smaller left lower paratracheal node (arrowhead).

 

Figure 5
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  		Fig. 2C —Stage T1 large cell neuroendocrine carcinoma in 70-year-old man with visible enlarged mediastinal nodes on CT, but without nodal metastasis on histopathologic examination. Serial images obtained at similar level to A show enhancement dynamics of nodule. Peak enhancement was 98 H and net enhancement was 40 H. Colored graph denotes dynamic enhancement curve of nodule.

 

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