Abstract
ABSCTRACT:
BACKGROUND:
The term cavity is a gas-filled space that appears on imaging as an area of low attenuation surrounded by a variously thickened wall within a pulmonary consolidation, mass, or nodule. Multidetector computed tomography (CT) of the chest is the current technique of choice for evaluating lung cavities.
OBJECTIVE:
To assess the role of some computed tomography criteria in differentiating benign from malignant solitary cavitary lung lesion.
PATIENT AND METHODS:
This was a cross sectional study done in the Computed Tomography unit of Al-Immamain Al-Kadhmain Medical city in Baghdad, Iraq between October, 2016 and June, 2017. All patients presented with solitary pulmonary cavitary lesions detected by chest x-ray referred for different reasons. Examination of the chest was performed by multi-detector CT (Somatom definition edge, SIEMENS medical system, Germany (256 slices)) with 2 sets of CT examination one before and another after giving IV nonionic iodinated contrast medium (Ultravist 370 mg /ml), 1.5 ml/kg Body weight. The final diagnosis was obtained depending on the sputum culture for AFB, bronchoscopy and biopsy, bronchoscopy and brush cytology and true cut biopsy.
RESULTS:
The study included 50 patients with solitary pulmonary cavitary lesions, 54% were male and 46% were females. Final diagnosis was 80% diagnosed as benign and 20% as malignant lesions. Enhancement was significant among 20% of studied patients. The common associated CT scan features were pleural effusion (24%), consolidation (12%), consolidation and tree in Bud (10%), pleural effusion and mediastinal lymph nodes (8%), tree in bud (10%), mediastinal lymph node and consolidation (8%), ground glass opacification, honeycombing and tree in bud (6%), pleural effusion and tree in bud (4%), fibrosis (2%) and encysted hydro-pneumothorax (2%). There was a highly significant association of significant enhancement and Pleural effusion with malignant solitary cavitary lesions (p<0.001 and p=0.003). A highly significant association was observed between increased mean thickness of lesion and malignant solitary cavitary lesion (p<0.001)
CONCLUSION:
The common computerized tomography characteristics of malignant solitary pulmonary cavitary lesions were significant enhancement, pleural effusion and increased diameter and thickness of pulmonary cavities.
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