Keywords:
Oncology, Lung, Thorax, CT, Conventional radiography, Ultrasound, Biopsy, Cancer, Image verification
Authors:
N. Cherif Idrissi El Ganouni, K. ELATIQI, M. Ouali Idrissi; Marrakech/MA
DOI:
10.26044/ecr2019/C-1641
Conclusion
Take home messages:
- Signs of malignancy of the pulmonary nodule: size> 20mm,
spiculated contours,
air bronchogram,
pseudocavitation,
eccentric or irregular calcifications [1].
- Importance of clinical informations: age,
profession.
- Central masses: it's not always cancer.
- Pulmonary apex tumors: do not forget that the chest wall can be the starting point [2].
- Excavated lung cancer: squamous cell carcinoma ++,
centered or eccentric,
wall often thick and irregular.
- Pseudo-tumoral tuberculosis: immunocompetent and immunocompromised,
non-specific symptoms and imaging,
look at the whole parenchyma,
seek associated lesions [3].
- Distinction between tumor and atelectasis can be very hard even after contrast injection,
MRI and Pet scan can be helpful[4].
- Distinction between infectious consolidation and tumor consolidation (table below) [5]:
|
Infectious consolidation |
Tumoral consolidation |
Infection syndrome |
+++ |
- |
Mode |
Acute or sub acute |
Chronic |
Location |
anywhere |
Mostly peripheral |
Number |
unique or multiple |
unique or multiple |
Limits |
Fuzzy or net |
Fuzzy or net |
Angiogram |
+++ |
+++ |
Air bronchogram |
+++ |
+++ |
Ground glass |
++ |
+++ |
Crazy paving |
+ |
+++ |
Pseudo-cavitation |
+ |
+++ |
Bulging fissure |
+ |
+++ |
Pleural thickening |
+++ |
+ |
Extra pleural fat hypertrophy |
+ |
- |
Pleural retraction |
+ |
++ |
Thickening of the bronchial walls |
++ |
+ |
A wide variety of pulmonary conditions produce radiologic findings that might simulate lung cancer.
Understanding these conditions and their pathologic background combined with a careful attention to the clinical informations will help in making a correct diagnosis.