The
CT
Ap
pe
aran
ce o
f Sm
all C
ell
Lun
g C
ance
rD
r L
Bro
okf
ield
an
d D
r J
Ho
wel
ls
Lun
gca
nce
ris
resp
on
sib
lefo
r2
0%
of
can
cer-
rela
ted
dea
ths.
Smal
lce
lllu
ng
can
cer
(SC
LC)
acco
un
tsfo
r1
3%
of
alll
un
gca
nce
rs.
Ch
arac
teri
sed
by
anag
gres
sive
nat
ure
,ra
pid
do
ub
ling
tim
ean
dea
rly
met
asta
sis,
SCLC
carr
ies
the
wo
rst
pro
gno
sis
of
all
lun
gca
nce
rs.
(5ye
arsu
rviv
al<5
%).
The
imag
ing
app
eara
nce
of
SCLC
isn
ot
oft
end
escr
ibed
inlit
erat
ure
bu
tit
isty
pic
ally
seen
asa
larg
eh
ilar
or
per
ihila
rm
ass,
wit
hm
edia
stin
alw
iden
ing
cau
sed
by
the
pri
mar
ytu
mo
ur,
bu
lky
lym
ph
aden
op
ath
yo
rb
oth
.9
0%
of
SCLC
are
cen
tral
and
aris
ew
ith
inlo
bar
and
mai
nb
ron
chi
bu
tin
som
eca
ses
ap
erip
her
alp
rim
ary
tum
ou
rm
ayn
ot
be
visi
ble
and
wid
esp
read
lym
ph
aden
op
ath
yis
the
mai
nfi
nd
ing.
This
stu
dy
furt
her
des
crib
esth
eim
agin
gap
pea
ran
ceo
fSC
LCw
ith
par
ticu
lar
focu
so
nSC
LCo
ccu
rrin
gso
lely
wit
hin
the
med
iast
inu
m.
Intr
od
uct
ion
Aim
s
Res
ult
s
Co
ncl
usi
on
•R
etro
spec
tive
ly r
evie
wed
CT
scan
s o
f 1
51
co
nse
cuti
ve p
atie
nts
wit
h p
ure
SC
LC in
Lan
cash
ire
Teac
hin
g H
osp
ital
s Tr
ust
.
•Sc
ans
wer
e re
view
ed lo
oki
ng
at m
ass
size
, ed
gean
d lo
cati
on
⁻M
ass
edge
was
eit
her
sm
oo
th o
r sp
icu
late
d
⁻M
ass
loca
tio
n w
as e
ith
er: i
ntr
a-m
edia
stin
al (
typ
e 1
), in
tra-
med
iast
inal
an
d in
tra-
pu
lmo
nar
y (t
ype
2)
or
intr
a-p
ulm
on
ary
(typ
e 3
).
Met
ho
ds
23
84
43
0
10
20
30
40
50
60
70
80
90
Intr
a-m
ed
iast
inal
(ty
pe
1)
Intr
a-m
ed
iast
inal
an
din
tra-
pu
lmo
nar
y (t
ype
2)
Intr
a-p
ulm
on
ary
(typ
e 3
)
15
0p
atie
nts
had
avi
sib
lem
ass
on
CT
scan
wh
ich
cou
ldb
ere
view
ed.
The
med
ian
surv
ival
len
gth
was
24
3d
ays.
89
(58
.9%
)p
atie
nts
had
can
cers
aris
ing
inth
eri
ght
sid
eo
fth
ech
est
and
61
(40
.4%
)in
the
left
wh
ich
isst
atis
tica
llysi
gnif
ican
t(p
=0
.02
72
).M
ore
than
hal
fw
ere
typ
e2
.Fe
wer
occ
urr
edo
nly
wit
hin
the
lun
gti
ssu
e(t
ype
3)
and
som
eSC
LCm
asse
sw
ere
typ
e1
,o
ccu
rrin
go
nly
wit
hin
the
med
iast
inu
m(C
har
t1
).7
2(4
7.7
%)
had
asm
oo
thed
gew
hile
78
(51
.7%
)w
ere
spic
ula
ted
.Ty
pe
3m
asse
sh
adth
egr
eate
stp
rop
ort
ion
of
spic
ula
ted
mas
ses
wh
ilety
pe
1h
adn
on
e.M
ass
size
ran
ged
fro
m1
0-1
82
mm
wit
ha
med
ian
valu
eo
f5
6m
m.
•In
tra-
med
iast
inal
an
d in
tra-
pu
lmo
nar
y m
ass
mo
st c
om
mo
n
•Si
ze a
nd
ed
ge v
ary
wit
h m
ass
loca
tio
n
•R
igh
t si
ded
mas
ses
are
mo
re c
om
mo
n
Smal
l ce
ll lu
ng
can
cer
can
occ
ur
sole
ly w
ith
in t
he
me
dia
stin
um
1.
This
fin
din
g q
ues
tio
ns
the
his
tolo
gica
l ori
gin
of
thes
e tu
mo
urs
2.
This
fin
din
g co
uld
aid
rad
iolo
gica
l dia
gno
sis
1.T
o d
escr
ibe
the
imag
ing
app
eara
nce
of
smal
l cel
l lu
ng
can
cer
2.T
o a
sses
s h
ow
oft
en s
mal
l cel
l lu
ng
can
cer
may
occ
ur
sole
ly w
ith
in t
he
med
iast
inu
m
Ch
art
1:
Illu
stra
tes
the
var
iati
on
in lo
cati
on
of
the
15
0 m
asse
s in
clu
ded
in
th
e st
ud
y.
Figu
re1
:C
Tim
age
of
a6
9ye
aro
ldm
anw
ho
pre
sen
ted
wit
hb
reat
hle
ssn
ess
and
wei
ght
loss
.Th
isd
emo
nst
rate
sa
~11
2m
mle
ftsi
ded
mas
sw
hic
his
inva
din
gb
oth
the
med
iast
inu
man
dth
elu
ng
tiss
ue.
Figu
re2
:Sa
me
CT
imag
eas
figu
re1
seen
inlu
ng
win
do
wd
emo
nst
rate
sth
esp
icu
late
ded
geo
fth
em
ass.
Figu
re3
:C
Tim
age
of
a5
4ye
aro
ldw
om
anw
ho
pre
sen
ted
wit
hw
eigh
tlo
ss.
The
imag
ed
emo
nst
rate
sa
~40
mm
spic
ula
ted
mas
sin
the
left
low
erlo
be
Figu
re4
:C
Tim
age
of
a5
8ye
aro
ldw
om
anw
ho
pre
sen
ted
wit
ha
sup
racl
avic
ula
rn
eck
lum
p.
The
imag
ed
emo
nst
rate
sa
~9
0m
msm
oo
thm
ass,
con
tain
edw
ith
inth
eri
ght
sid
eo
fth
em
edia
stin
um
.
1.
Can
cerr
earc
hu
k.o
rg [
ho
mep
age
on
inte
rnet
] Lu
ng
can
cer
stat
isti
cs. A
vaila
ble
fro
m:h
ttp
://w
ww
.can
cerr
esea
rch
uk.
org
/hea
lth
-pro
fess
ion
al/c
ance
r-st
atis
tics
/sta
tist
ics-
by-
can
cer-
typ
e/lu
ng-
can
cer.
[C
ited
8 J
un
e 2
01
5].
2.
Go
vin
dan
R, P
age
N, M
org
ensz
tern
D, R
ead
W, T
iern
ey R
, Vla
hio
tis
A e
t al
. Ch
angi
ng
Epid
emio
logy
of
Smal
l-ce
ll Lu
ng
Can
cer
in t
he
Un
ited
Sta
tes
Ove
r th
e La
st 3
0 Y
ears
: An
alys
is o
f th
e Su
rvei
llan
ce, E
pid
emio
logi
c, a
nd
En
d R
esu
lts
Dat
abas
e. J
clin
on
col.
20
06
; 2
4(2
8):
45
39
-45
44
.3
.M
eerb
eeck
J, F
enn
ell D
, De
Ru
yssc
her
D. S
mal
l-ce
ll Lu
ng
Can
cer.
Lan
cet.
20
11
; 37
8:
17
41
-17
55
.4
.M
erri
ll R
, Hen
son
D, B
arn
es, M
. Co
nd
itio
nal
Su
rviv
al a
mo
ng
Pati
ents
wit
h C
arci
no
ma
of
the
Lun
g. C
hes
t. 1
99
9; 1
16
(3
): 6
97
-70
3.
5.
Krei
sman
H, W
olk
ove
N, Q
uo
ixE.
Sm
all C
ell L
un
g C
ance
r P
rese
nti
ng
as a
So
litar
y P
ulm
on
ary
No
du
le. C
hes
t. 1
99
2;
10
1 (
1):
22
5-2
31
.6
.R
osa
do
-de-
Ch
rist
enso
n M
, Tem
ple
ton
P, M
ora
n C
. Bro
nch
oge
nic
Car
cin
om
a: R
adio
logi
c-Pa
tho
logi
c C
orr
elat
ion
. Rad
iogr
aph
ics.
19
94
; 14
(2
): 4
29
-44
6.
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