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AM Report: Multiple pulmonary nodules

cavitarylung

From Chest. 2003;123(1):277-279. doi:10.1378/chest.123.1.277.

 

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!

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