Learning objectives
To review the radiological features of non-neoplastic chest pathologies that can mimic lung cancer and identify key imaging characteristics and common pitfalls in distinguishing between benign and malignant pulmonary disease.
Background
Chest x-ray has limited sensitivity in distinguishing benign from malignant lung pathologies.
Familiarity with CT features of benign pulmonary conditions as well as the timely and appropriate use of PET CT,
bronchoscopy and lung biopsy is crucial in arriving at the correct diagnosis.
We present a number of cases from our local experience,
which were thought to be malignant but proved to be benign.
Findings and procedure details
Rounded atelectasis
Rounded atelectasis,
also known as folded lung or Blesovsky syndrome is typically found in patients with a past history of asbestos exposure or a pleural effusion.
It is caused by infolding of redundant pleura which may give a false mass-like appearance on CT and particularly,
plain radiographs.
Such a ‘mass’ is almost always seen adjacent to a pleural surface; associated pleural thickening and pulling of bronchovascular bundles gives rise to the typical shape of a crow’s foot or comet tail on CT distinguishing...
Conclusion
Distinguishing benign from malignant lung pathology is a key task for the radiologist.
Awareness of the imaging characteristics of benign lung conditions and avoidance of common imaging pitfalls is crucial in making the correct diagnosis and avoiding unnecessary over-investigation.
References
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Round Pneumonia in a 50-Year-Old Man.
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A Frequent Error in Etiology of...