pleural pathology and lung cancer

Q: Which of the pleural findings on imaging is usually more of a sign of concern for cancer?

A) Nodularity

B) Plaque

Answer: A

Any of the following findings in the imaging should raise suspicion of lung cancer.

• Lesions >3 cm that are new
• Measurable growth in any nodule or mass from the previous
• Pleural nodularity 
• Asymmetric or significantly enlarged hilar or paratracheal nodes
• An endobronchial lesion
• An area of consolidation thought to be pneumonia that fails to resolve with medical management

Pleural plaques usually indicate significant asbestos exposure.

#pulmonary

#oncology

#radiology

References:

1. Del Giudice ME, Young SM, Vella ET, Ash M, Bansal P, Robinson A, Skrastins R, Ung Y, Zeldin R, Levitt C. Guideline for referral of patients with suspected lung cancer by family physicians and other primary care providers. Can Fam Physician. 2014 Aug;60(8):711-6, e376-82. PMID: 25122814; PMCID: PMC4131959.

2. Hyldgaard C, Trolle C, Harders SMW, Engberg H, Rasmussen TR, Møller H. Increased use of diagnostic CT imaging increases the detection of stage IA lung cancer: pathways and patient characteristics. BMC Cancer. 2022 Apr 27;22(1):464. doi: 10.1186/s12885-022-09585-2. PMID: 35477356; PMCID: PMC9047294.

3. Erasmus LT, Strange TA, Agrawal R, Strange CD, Ahuja J, Shroff GS, Truong MT. Lung Cancer Staging: Imaging and Potential Pitfalls. Diagnostics (Basel). 2023 Nov 1;13(21):3359. doi: 10.3390/diagnostics13213359. PMID: 37958255; PMCID: PMC10649001.