1. What is the main finding?
There is a large non calcified mass within the right lower lung seen near the right heart border on the AP view and overlies the heart shadow on the lateral view. The lesion appears adjacent to the right hilum.
2. What is your differential diagnosis?
Differential considerations would include but are not limited to mass such as bronchogenic carcinoma, metastasis, round pneumonia, lung abscess, lymphoma, infarct, hematoma, and atelectasis secondary to pulmonary embolism. A proper history may be helpful in narrowing the differential list and direct appropriate follow up.
3. What test would you perform next?
Imaging wise, CT and PET scan can be used to further assess the characteristics of the lesion, search for any radiographically occult lesions or lymphadenopathy. If the lesion is determined to cancer both can also be used to stage the disease for proper management.
Diagnosis: Bronchogenic carcinoma, small cell.
There are multiple types of tumors that can affect the lung, both benign and malignant. Bronchogenic carcinoma is a general term for primary malignant tumors of the lung, of which there are several subtypes including small cell, non small cell, squamous cell, and adenocarcinoma. Diagnosis of the subtype can be made via CT guided biopsy and cytology. Sites of metastatic disease from primary lung cancer include the lung itself, the brain, spine, adrenals, liver, and lymph nodes.
This is the lung CT on the same patient:
There is a large non calcified mass within the right lower lung seen near the right heart border on the AP view and overlies the heart shadow on the lateral view. The lesion appears adjacent to the right hilum.
2. What is your differential diagnosis?
Differential considerations would include but are not limited to mass such as bronchogenic carcinoma, metastasis, round pneumonia, lung abscess, lymphoma, infarct, hematoma, and atelectasis secondary to pulmonary embolism. A proper history may be helpful in narrowing the differential list and direct appropriate follow up.
3. What test would you perform next?
Imaging wise, CT and PET scan can be used to further assess the characteristics of the lesion, search for any radiographically occult lesions or lymphadenopathy. If the lesion is determined to cancer both can also be used to stage the disease for proper management.
Diagnosis: Bronchogenic carcinoma, small cell.
There are multiple types of tumors that can affect the lung, both benign and malignant. Bronchogenic carcinoma is a general term for primary malignant tumors of the lung, of which there are several subtypes including small cell, non small cell, squamous cell, and adenocarcinoma. Diagnosis of the subtype can be made via CT guided biopsy and cytology. Sites of metastatic disease from primary lung cancer include the lung itself, the brain, spine, adrenals, liver, and lymph nodes.
This is the lung CT on the same patient: