CTICasesSmall Cell Carcinoma Presenting with Bulky Mediastinal Lymphadenopathy
Imaging findings
Initial chest radiograph in a patient with back pain demonstrates subtle right paratracheal widening and widened mediastinum with left paravertebral interface abnormality and apparent fullness of the right hilar and posterior hilum regions. CT two months later confirms massively enlarged right paratracheal, prevascular, and bilateral hilar lymph nodes with axillary lymphadenopathy, consistent with small cell carcinoma with extensive mediastinal disease.
Key takeaways
Small cell lung carcinoma most commonly presents with extensive mediastinal and hilar lymphadenopathy, which may be the dominant or sole finding on chest radiography at presentation. Subtle signs include widening of the right paratracheal stripe, filling-in of the aortopulmonary window, and abnormal fullness of the hilar and subcarinal regions on the lateral view. Failure to appreciate these subtle early radiographic findings delays diagnosis.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Renal Osteodystrophy — Rugger Jersey SignMetabolic
- Erdheim-Chester Disease with Peri-Renal and Mediastinal InfiltrationNeoplastic
- Asymmetric Pulmonary Edema in a Lung Transplant Recipient with Emphysema (Pseudo-PE Phenomenon)Vascular
- Left Subpulmonic Pleural Effusion — Stomach-to-Diaphragm Distance SignOther
- Calcified Fibrin Sheath from Central Venous CatheterIatrogenic
- Pulmonary Vein Occlusion after Pulmonary Vein Ablation with Pseudo-PE PhenomenonIatrogenic
- Salmonella Mycotic Aortic PseudoaneurysmInfection
- Sarcoidosis — Subcarinal and Bilateral Hilar Lymphadenopathy with Upper Lobe Micro-NodulesInflammatory
See all cases from February 4, 2021 →