Lung mass imaging: Difference between revisions
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==Overview== | ==Overview== | ||
CT scan is the method of choice for evaluation of lung mass. On imaging, 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. For occult disease and assessment of malignancy additional tests such as PET scan may also be done. | [[CT scan]] is the method of choice for evaluation of lung mass. On [[imaging]], 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]]. For occult disease and assessment of [[malignancy]] additional tests such as [[PET scan]] may also be done. | ||
==Imaging== | ==Imaging== | ||
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'''Hyperdense pulmonary mass''' | '''Hyperdense pulmonary mass''' | ||
*Hyperdense pulmonary mass is defined as a pulmonary mass with internal calcification. | *Hyperdense pulmonary mass is defined as a pulmonary mass with internal [[calcification]]. | ||
*The most common causes of hyperdense pulmonary mass are granuloma (most common), pulmonary hamartoma, bronchogenic carcinoma, carcinoid tumors, and pulmonary metastases. | *The most common causes of hyperdense pulmonary mass are [[granuloma]] (most common), pulmonary [[hamartoma]], [[bronchogenic carcinoma]], [[carcinoid tumors]], and pulmonary [[Metastasis|metastases]]. | ||
'''Cavitating pulmonary mass''' | '''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. | *Cavitating pulmonary mass is defined as a gas-filled area of the lung in the center of a [[nodule]], mass or area of [[Consolidation (medicine)|consolidation]]. | ||
*Cavitating pulmonary mass is also characterized by a thick wall (must be greater than 2-5 mm). | *Cavitating pulmonary mass 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 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. | * The table below summarizes the most common causes of cavitating pulmonary mass. | ||
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</small> | </small> | ||
==Imaging Evaluation== | ==Imaging Evaluation== | ||
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> | 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]] | ||
**Central | **[[Central]] | ||
**Laminated | **Laminated | ||
**Popcorn | **[[Popcorn lung disease|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. | * '''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. | * '''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 | * '''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 lesion|calcified]], partly solid ([[malignancy]] rate of 63%), and [[Ground glass opacification on CT|ground glass]] ([[malignancy]] rate of 18%). | ||
==References== | ==References== | ||
Revision as of 15:26, 9 March 2018
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Lung Mass Microchapters |
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Diagnosis |
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Treatment |
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Lung mass imaging On the Web |
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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
CT scan is the method of choice for evaluation of lung mass. On imaging, 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. For occult disease and assessment of malignancy additional tests such as PET scan may also be done.
Imaging
On imaging, lung mass can be divided into two categories such as hyperdense pulmonary mass or cavitating pulmonary mass.[1]
Hyperdense pulmonary mass
- Hyperdense pulmonary mass is defined as a pulmonary mass with internal calcification.
- The most common causes of hyperdense pulmonary mass are 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.
- Cavitating pulmonary mass 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
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Cancer
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| Infection |
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Abscess:
Empyema:
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Non-infectious |
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Vascular |
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Trauma |
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| Congenital |
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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:
- 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.