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L. Carp
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-028 - Wolf in Sheep's Clothing - Primary Lung Cancer Mimicking Benign Diseases (ID 3937)
14:30 - 14:30 | Author(s): L. Carp
- Abstract
Background:
Lung cancer is the biggest cancer killer and typically presents as mass or nodule, round or oval in shape. Recognition and diagnosis of these typical cases is often straightforward, whereas diagnosis of uncommon manifestations of primary lung cancer certainly is far more challenging. The aim of this pictorial essay is to illustrate the Computed Tomography (CT) and histopathology findings of uncommon manifestations of primary lung cancer with focus on these entities that mimic benign diseases.
Methods:
Cases presented were collected during the Multidisciplinary Thoracic Oncology Tumor Board between January 2014 and May 2016 and have histopathologic proof.
Results:
Lung cancer can mimic a variety of benign diseases, including infection, granulomatous disease, lung abscess, postinfectious scarring, mediastinal mass, emphysema, atelectasis and pleural disease. Previous history, clinical and biochemical parameters are certainly helpful and necessary in the assessment of these cases, but often aspecific and inconclusive. Whereas 18FDG-PET is the cornerstone in diagnosis and staging of lung cancer, it’s role in these uncommon manifestations is less straightforward since benign diseases, such as granulomatous and infectious diseases may also present with increased FDG-uptake. Chest CT is the imaging modality of choice and plays a central role in these cases. ‘Irregular air bronchogram sign’ in pneumonia-like lung cancer, ‘drowned lung sign’ in obstructive atelectasis and cortical bone erosion in lung cancer mimicking pleural disease are important signs that point to a malignant etiology. The stippled and eccentric morphology of calcifications in apical lesions aids in differentiating these lesions from postinfectious scarring. Mucinous tumours can mimic a pulmonary abscess and small cell lung cancer can typically present as mediastinal mass without parenchymal abnormalities. Lung cancer presenting with a miliary pattern or cavitating nodules can mimic granulomatous disease. Lung cancer presenting with cystic airspaces and ‘emphysema-like’ morphology is an uncommon entity in which early recognition is crucial since these tumors have an aggressive nature. Key imaging findings and tips and tricks for recognizing these uncommon faces of primary lung cancer will be discussed and illustrated.
Conclusion:
Primary lung cancer can mimic a wide variety of benign entities. Knowledge of these uncommon and atypical manifestations is crucial to avoid delay in diagnosis and treatment. A multidisciplinary approach in these cases is mandatory.
