CT appearance of solitary and multiple cystic and cavitary lung lesions

Abstract

Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both children and adults. We reviewed the CT findings of the most common cystic and cavitary lung lesions and we defined useful morphological criteria that will help radiologists to distinguish benign from malignant cavitary lesions. However, in many cases the considerable overlap in morphological features of benign and malignant cavities renders transthoracic needle biopsy necessary to establish the correct diagnosis.

Imaging Findings of Focal and Multiple Cystic and Cavitary Lung Lesions

“…However, previous studies have shown that they are more commonly associated with primary squamous cell carcinoma. Cavitating lung metastases have been reported with primary lung, head and neck, thyroid, breast, bone, kidney, pancreas, colon and rectum, urinary bladder, penis, testis (Figure 26), uterine, cervix and skin carcinomas (4,24). The aetiology of the formation of a cavity is not clear.…”

“…In the liteature, several forms of pulmonary aspergillosis have been described, including saprophytic (aspergilloma), invasive, semi-invasive and allergic bronchopulmonary aspergillosis (ABPA) (4,20). The radiographic presentations of pulmonary aspergillosis vary depending on the form of the disease and the patient's clinical setting.…”

“…Eighty percent of cavitating lung tumors are squamous cell carcinomas, whereas the remaining 20 % are adeno and large cell carcinomas. Bronchoalveolar carcinoma may occasionally present as multiple cavitary nodules (1,4,22). Typically, the cavity will have thick walls, nodular extensions of tumor (mural nodules) projecting into the lumen of cavity are frequent ( Figure 25).…”

“…Type 2 lesions have numerous smaller, more uniform-sized cysts (0.5-2 cm in diameter, rarely larger). Type 3 lesions are bulky solid lesions that usually involve an entire lobe or lung (2,4,6). Typical radiographic finding in patients with CCAM is a large air-filled multicystic lesion.…”

“…In untreated disease, nodules tend to in- crease both in size and number and may cavitate ( Figure 13). The cavitary nodules may occasionally become infected to give an air-filled level (4,16).…”