Learning objectives
Define the solitary round pulmonary lesion (SRPL) and familiarize with its prevalence in the pediatric population.
Help radiologists efficiently partake in the diagnosis,
workup and follow up of the SRPL,
by working alongside the clinician in order to combine the clinical information & lab results with the radiological findings.
Background
A SRPL is a round or oval lesion in the lung that is seen with a CXR or CT scan.
It is a rare finding in the pediatric population.
As a result when stumbled upon,
even an experienced radiologist might find it challenging to narrow down its vast differential diagnosis.
A CXR is usually adequate in assessing the workup of a SRPL.
Ultrasound could be a valuable tool,
when targeted use is being applied.
CT,
MRI,
PET CT and nuclear scan should be retained unless...
Findings and procedure details
There are numerous etiologies of a SRPL that could optimally be categorized as shown in the table below:
▪ INFLAMMATORY
▪ Round Pneumonia
The commonest etiology of a SRPL is round pneumonia,
mostly occurring in patients aged <8 years old,
after which age there should be increased suspicion of other underlying causes.
The patient usually presents with cough & fever.
CXR: Soft tissue density solitary lesion,
which doesn’t contain an air-fluid level.
More common posteriorly and in lower lobes.
In this clinical scenario of a...
Conclusion
The radiologist should be familiar with the imaging manifestations of the SRPL.
Radiographic features that can be used in the assessment of a SRPL include size,
border,
calcification,
density,
growth,
contrast enhancement,
origin,
ground glass appearance,
and metabolic activity.
Imaging findings along with the patient’s general health status,
vaccinations,
previous medical history,
laboratory results and clinical examination help in elaborating and narrowing down the differential diagnosis aiding in the diagnostic approach.
Helpful clues for diagnosis - take home messages - are offered in the conclusive...
Personal information
Contact details:
Nick Arkoudis,
MD,
M.Sc Canditate,
Radiology Resident
2nd Department of Radiology,University General Hospital of Athens "Attikon"
Email:
[email protected]
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