Lung mass imaging: Difference between revisions
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==Overview== | ==Overview== | ||
Computed tomography is the method of choice for the evaluation of lung mass. The evaluation of lung mass will depend on several characteristics, such as: calcification, margins, location, distribution, and attenuation. Further evaluation of lung mass, should include other diagnostic studies, such as: bronchoscopy, sputum cytology, or mediastinoscopy. Other imaging study useful for the malignancy evaluation of lung mass is [[PET]] scanning, which may be helpful for the detection of occult disease and malignancy assessment.<ref name="pmid19835344">{{cite journal |vauthors=Albert RH, Russell JJ |title=Evaluation of the solitary pulmonary nodule |journal=Am Fam Physician |volume=80 |issue=8 |pages=827–31 |year=2009 |pmid=19835344 |doi= |url=}}</ref> | Computed tomography is the method of choice for the evaluation of lung mass. The evaluation of lung mass will depend on several characteristics, such as: calcification, margins, location, distribution, and attenuation. Further evaluation of lung mass, should include other diagnostic studies, such as: bronchoscopy, sputum cytology, or mediastinoscopy. Other imaging study useful for the malignancy evaluation of lung mass is [[PET]] scanning, which may be helpful for the detection of occult disease and malignancy assessment.<ref name="pmid19835344">{{cite journal |vauthors=Albert RH, Russell JJ |title=Evaluation of the solitary pulmonary nodule |journal=Am Fam Physician |volume=80 |issue=8 |pages=827–31 |year=2009 |pmid=19835344 |doi= |url=}}</ref> | ||
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==Imaging Evaluation== | ==Imaging Evaluation== | ||
The evaluation of lung mass will depend on 5 characteristics: calcification patterns, size, location, margins, and attenuation. | The evaluation of lung mass will depend on 5 characteristics: calcification patterns, size, location, margins, and attenuation.<ref name="pmid7208937">{{cite journal |vauthors=Kundel HL |title=Predictive value and threshold detectability of lung tumors |journal=Radiology |volume=139 |issue=1 |pages=25–9 |year=1981 |pmid=7208937 |doi=10.1148/radiology.139.1.7208937 |url=}}</ref><ref name="pmid21697415">{{cite journal |vauthors=Hochhegger B, Marchiori E, Sedlaczek O, Irion K, Heussel CP, Ley S, Ley-Zaporozhan J, Soares Souza A, Kauczor HU |title=MRI in lung cancer: a pictorial essay |journal=Br J Radiol |volume=84 |issue=1003 |pages=661–8 |year=2011 |pmid=21697415 |pmc=3473490 |doi=10.1259/bjr/24661484 |url=}}</ref> | ||
* '''Calcification:''' Calcification patterns are commonly seen in granulomatous disease and hamartomas. They are normally a sign of benign lung mass. The characteristic benign calcification patterns of lung mass, include: | * '''Calcification:''' Calcification patterns are commonly seen in granulomatous disease and hamartomas. They are normally a sign of benign lung mass. The characteristic benign calcification patterns of lung mass, include: | ||
**Diffuse | **Diffuse | ||
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* '''Margins:''' The different types of margins for lung mass include lobulated or scalloped margins and smooth margins. The lobulated or scalloped margins are associated with intermediate malignancy probability whereas smooth margins are associated with benign nature of lung mass. | * '''Margins:''' The different types of margins for lung mass include lobulated or scalloped margins and smooth margins. The lobulated or scalloped margins are associated with intermediate malignancy probability whereas smooth margins are associated with benign nature of lung mass. | ||
* '''Attenuation:'''Lung mass may have different types of attenuation. Common types of attenuation are solid (malignancy rate of only 7%), calcified, partly solid (malignancy rate of 63%), and ground glass (malignancy rate of 18%). | * '''Attenuation:'''Lung mass may have different types of attenuation. Common types of attenuation are solid (malignancy rate of only 7%), calcified, partly solid (malignancy rate of 63%), and ground glass (malignancy rate of 18%). | ||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Oncology]] | [[Category:Oncology]] | ||
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Revision as of 16:56, 27 February 2018
Lung Mass Microchapters |
Diagnosis |
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Treatment |
Lung mass imaging On the Web |
American Roentgen Ray Society Images of Lung mass imaging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Akshun Kalia M.B.B.S.[3]
Overview
Computed tomography is the method of choice for the evaluation of lung mass. The evaluation of lung mass will depend on several characteristics, such as: calcification, margins, location, distribution, and attenuation. Further evaluation of lung mass, should include other diagnostic studies, such as: bronchoscopy, sputum cytology, or mediastinoscopy. Other imaging study useful for the malignancy evaluation of lung mass is PET scanning, which may be helpful for the detection of occult disease and malignancy assessment.[1]
Imaging
Lung mass can be divided into 2 categories:
- Hyperdense pulmonary mass
- Cavitating pulmonary mass
Hyperdense pulmonary mass
- Hyperdense pulmonary mass is defined as a pulmonary mass with internal calcification
- The most common causes of hyerdense pulmonary mass, include: granuloma (most common), pulmonary hamartoma, bronchogenic carcinoma, carcinoid tumors, and pulmonary metastases.
Cavitating pulmonary mass
- Cavitating pulmonary mass is defined as a gas-filled area of the lung in the center of a nodule, mass or area of consolidation
- It is also characterized by a thick wall (must be greater than 2-5 mm)
- The most common causes of cavitating pulmonary mass, include malignancies, infections, inflammation processes, and congenital malformations.
- The table below summarizes the most common causes of cavitating pulmonary mass
Cavitating causes | Conditions | Description |
---|---|---|
Malignancy |
Cancer
|
Cancer
|
Infection |
|
Abscess:
Empyema:
|
Non-infectious |
|
|
Vascular |
|
|
Trauma |
|
|
Congenital |
|
|
Imaging Evaluation
The evaluation of lung mass will depend on 5 characteristics: calcification patterns, size, location, margins, and attenuation.[2][3]
- Calcification: Calcification patterns are commonly seen in granulomatous disease and hamartomas. They are normally a sign of benign lung mass. The characteristic benign calcification patterns of lung mass, include:
- Diffuse
- Central
- Laminated
- Popcorn
- Size: Any area of pulmonary opacification that measures more than 30 mm (3cms) has to be evaluated to determine the histotype of the tissues.
- Location: Common location of lung mass are pleural, endobronchial, and parenchymal locations.
- Margins: The different types of margins for lung mass include lobulated or scalloped margins and smooth margins. The lobulated or scalloped margins are associated with intermediate malignancy probability whereas smooth margins are associated with benign nature of lung mass.
- Attenuation:Lung mass may have different types of attenuation. Common types of attenuation are solid (malignancy rate of only 7%), calcified, partly solid (malignancy rate of 63%), and ground glass (malignancy rate of 18%).
References
- ↑ Albert RH, Russell JJ (2009). "Evaluation of the solitary pulmonary nodule". Am Fam Physician. 80 (8): 827–31. PMID 19835344.
- ↑ Kundel HL (1981). "Predictive value and threshold detectability of lung tumors". Radiology. 139 (1): 25–9. doi:10.1148/radiology.139.1.7208937. PMID 7208937.
- ↑ Hochhegger B, Marchiori E, Sedlaczek O, Irion K, Heussel CP, Ley S, Ley-Zaporozhan J, Soares Souza A, Kauczor HU (2011). "MRI in lung cancer: a pictorial essay". Br J Radiol. 84 (1003): 661–8. doi:10.1259/bjr/24661484. PMC 3473490. PMID 21697415.