Lung mass evaluation
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Lung Mass Microchapters |
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Diagnosis |
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Treatment |
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Lung mass evaluation On the Web |
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American Roentgen Ray Society Images of Lung mass evaluation |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
A hallmark feature in the evaluation of lung mass is the malignancy assessment. The evaluation approach of lung mass will mainly depend in the initial morphological evaluation of the mass (size, margins, contours, calcification pattern, and growth). Other characteristics, such as: location, clinical features, and distribution may be helpful for the therapeutical management, surveillance, and follow-up of lung mass. Lung mass can be divided into 2 categories: benign pulmonary mass and malignant lung mass. Based upon these categories, complementary diagnostic studies and management, include: PET/CT scan, CT scan, non-surgical biopsy, and surgical resection.
Lung Mass Evaluation
- The algorithm below summarizes the initial lung mass evaluation according to imaging features.
Lung Mass Detected | |||||||||||||||||||||||||||||||
Step 1: Assess likelihood of cancer ❑ Request enhanced CT scan | |||||||||||||||||||||||||||||||
| Step 2: What are the imaging features? | |||||||||||||||||||||||||||||||
| Hyperdense pulmonary mass ❑ Internal calcification | Cavitating pulmonary mass ❑ Gas-filled area ❑ Thick wall (must be greater than 2-5 mm) | ||||||||||||||||||||||||||||||
| Other diagnostic studies ❑ Sputum cytology ❑ Endobronchial ultrasound ❑ Endoscopic ultrasound ❑ Bronchoscopy ❑ Mediastinoscopy ❑ PET/CT | |||||||||||||||||||||||||||||||
| Biopsy | |||||||||||||||||||||||||||||||
| Lung opacity on Chest X ray (CXR) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Size >3 cms; classified as lung mass | Size <3 cms; classified as pulmonary nodule | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Check previous CXR | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Previous CXR normal (no opacity) | Previous CXR shows opacity but stable since then | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chest CT scan | Follow up every 2-3 yrs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||