Small cell lung cancer: CT evaluation and comparison with non-Hodgkin's lymphoma

Abstract

We a naly zed plain radiographic a nd com puted tomographic(CT) fea tures of 26 b iopsy proven sma11 ce11 lung ca n cer(SCLC). E leven cases of n onHodgkin' s lymphoma involving the thorax werc a lso r eviewed a nd compared with the s ma11 ce11 lung ca ncer for differential diagnos tic clues Centra 11y manifesting lym pha d e nopa thy was the main findin gs of SCLC in both pla in ra diog rap h s and CT. The m ost freq u ently involved lymph nodes were subcarina l. right lowe r pa ratracheal, left lovrer pa ratrac h eal. a nd right tracheob ronc hia l n ode. T h e most difficult site to ide ntify the lymphadenopathy w ith simple radiograp h was s ub carinal. paraesophageal. pulmo n ary ligam e nta l' a nterior m ed iastinal(g roup 6). a nd lc ft upper pa rat rac h cal nodcs CT sca n revea le d ly mpha de nopathy clearly in a 11 of these Groups.Right lower paratracheal and s ubcarina l nodes were involved frequ ently in both SCLC' s a nd ly mphomas. Bilateral t racheobronchial a nd bilatera l intrap ulmona ry nodes w ere invo lved m ore freque ntl y in SCLC" s while a nte rior mediastina l. upper paratrach eal. a nd aorticopu lmo n a ry(AP) window nodes were involved p r edominantly in lymphomas . Cystic low atte n uation. presumed n ecrotic ly mphad e nopathy . was noted in two cases of ly mphomas but n ot found in SCLC' s at a 11 ln co nclusion. th e CT could de tcc t invol ved ly mphadenopath y in SCLC more acc uratcl y than p la in rad iograph a nd th c s ites of in vo lvcd lYll1 phadenopa thy may give a differe ntia l diagnostic c lu e between SCLC an d Iymphom a