Jonathan Hickle MD, Presenter: Nothing to Disclose

Daria Manos MD, FRCPC, Abstract Co-Author: Author, Springer Science+Business Media Deutschland GmbH

Joy Nina Borgaonkar MD, FRCPC, Abstract Co-Author: Nothing to Disclose

There is considerable overlap in the appearance of benign and malignant cavitary pulmonary lesions; CT features alone are not sufficiently reliable to distinguish malignant from benign cavitary lesions. An algorithmic approach combining CT appearance with key demographic and clinical features, can improve the radiologist’s assessment of cavitary lesions and can provide a practical approach to management. Immunocompromised patients, or those at risk for aspiration may present with infectious cavitary lung lesions that demonstrate malignant CT features. Both inflammatory and malignant lesions are FDG avid; the utility of PET in distinguishing malignant from benign inflammatory lesions is dubious.

Review the pathophysiology of pulmonary cavitation. Case based review of common mimics of cavitary lesions. Review imaging predictors and features of malignancy and benignity described in the literature and discuss the limitations of this approach. Application of the described features in pathology or culture proven local cases including: Mycobacterium tuberculosis, MAC, mixed pulmonary abscess, Coxiella burnetti, aspergillus, sarcoidosis, non-small cell lung cancer, metastases, pulmonary infarction and vasculitis. Provide a suggested algorithm for evaluating cavitary pulmonary lesions.  

http://abstract.rsna.org/uploads/2014/14004476/14004476_6643.pdf

Hickle, J, Manos, D, Borgaonkar, J, Cavitary Pulmonary Lesions: Are There Holes in Our Approach?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004476.html