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

ABSTRACT 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 loca...

Full description

Bibliographic Details
Main Author: Giacomelli,Irai Luis (author)
Other Authors: Barros,Marcelo (author), Pacini,Gabriel Sartori (author), Altmayer,Stephan (author), Zanon,Matheus (author), Dias,Adriano Basso (author), Nin,Carlos Schüler (author), Rodrigues,Roger Pirath (author), Marchiori,Edson (author), Watte,Guilherme (author), Hochhegger,Bruno (author)
Format: article
Language:eng
Published: 2020
Subjects:
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132020000200200
Country:Brazil
Oai:oai:scielo:S1806-37132020000200200
Description
Summary:ABSTRACT 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.