Great AM report by Dr. Liza Buchbinder! Today we presented a patient who was found to have an anterior mediastinal mass and multiple cavitary pulmonary lesions.
Learning points:
- There is a broad differential for multiple pulmonary nodules, which may be narrowed based on CT characteristics.
- When describing lung lesions on imaging, consider the following characteristics:
- Pattern: reticular, nodular, or reticulonodular
- Density of lesions: hypodense (COPD vs. cysts) vs. hyperdense (ground-glass vs. airspace consolidation)
- Distribution: Central vs. peripheral, upper vs. lower
- Relationship to secondary lobule: Are lesions perilymphatic, centrilobular, or random?
- A nice primer on reading CTs
- Specifically for cavitary lung lesions, consider:
- Infection: bacterial abscess, fungal disease (mycobacterial, cocci, histo), septic emboli
- Malignancy: lymphoproliferative, SCC, angiosarcoma, Kaposi’s Sarcoma
- Collagen vascular disease: GPA.
Have a great weekend and continue the great work!