Lung Cancer: Chest Wall and Pleural Invasion

Axial CT image shows a large left upper lobe mass (star) with adjacent rib destruction (arrow) in a patient with T3 lung cancer.

Facts

• Contiguity of the neoplasm with pleural surface is not equivalent to invasion
• Major CT finding of pleural and chest wall invasion is bone destruction or a chest wall mass
• Other CT criteria: extent of contact of the mass and its angle with the pleura, presence of fat plane between the tumor and chest wall
• Chest wall and pleural invasion is considered T3 disease

Reference:

UyBico SJ, Wu CC, Suh RD, et al. Lung cancer staging essentials: the new TNM staging system and potential imaging pitfalls. Radiographics 2010; 30:1163-1183.