Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Year 2020 - Volume 46  - Number 2  (March/April)

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Original Article

1 - Multiple cavitary lung lesions on CT: imaging findings to differentiate between malignant and benign etiologies

Lesões escavadas pulmonares múltiplas em TC: achados de imagem para diferenciação entre etiologia maligna e benigna

Irai Luis Giacomelli1, Marcelo Barros1,2, Gabriel Sartori Pacini1, Stephan Altmayer1, Matheus Zanon1, Adriano Basso Dias1, Carlos Schüler Nin1, Roger Pirath Rodrigues3, Edson Marchiori4, Guilherme Watte1,2, Bruno Hochhegger1,2

J Bras Pneumol.2020;46(2):e20190024

Abstract PDF PT PDF EN Portuguese Text

Objective: To determine the CT findings of multiple cavitary lung lesions that allow the differentiation between benign and malignant etiologies. Methods: We reviewed CT scans, including patients with two or more cavitary lung lesions. We evaluated the number of cavitary lesions, their location, cavity wall thickness, and additional findings, correlating the variables with the diagnosis of a benign or malignant lesion. Results: We reviewed the chest CT scans of 102 patients, 58 (56.9%) of whom were male. The average age was 50.5 ± 18.0 years. Benign and malignant lesions were diagnosed in 74 (72.6%) and 28 (27.4%) of the patients, respectively. On the CT scans, the mean number of cavities was 3, the mean wall thickness of the largest lesions was 6.0 mm, and the mean diameter of the largest lesions was 27.0 mm. The lesions were predominantly in the upper lobes, especially on the right (in 43.1%). In our comparison of the variables studied, a diagnosis of malignancy was not found to correlate significantly with the wall thickness of the largest cavity, lymph node enlargement, emphysema, consolidation, bronchiectasis, or bronchial obstruction. The presence of centrilobular nodules correlated significantly with the absence of malignant disease (p < 0.05). In contrast, a greater number of cavities correlated significantly with malignancy (p < 0.026). Conclusions: A larger number of cavitary lung lesions and the absence of centrilobular nodules may be characteristic of a malignant etiology. However, on the basis of our evaluation of the lesions in our sample, we cannot state that wall thickness is a good indicator of a benign or malignant etiology.

 


Keywords: Lung neoplasms/diagnosis; Lung diseases/diagnosis; Tomography, X-ray computed; Neoplasms.

 

 


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