Differential Diagnosis of Solitary Pulmonary Inflammatory Lesions and Peripheral Lung Cancers with Contrast-enhanced Computed Tomography

Authors

  • Zhi-gang Chu Chongqing Medical University; Department of Radiolog
  • Bo sheng Chongqing Medical University; Department of Radiolog
  • Meng-qi Liu Chongqing Medical University; Department of Radiolog
  • Fa-jin Lv Chongqing Medical University; Department of Radiolog
  • Qi Li Chongqing Medical University; Department of Radiolog
  • Yu Ouyang Chongqing Medical University; Department of Radiolog

DOI:

https://doi.org/10.6061/clinics/2016(10)01

Abstract

OBJECTIVES: To clarify differences between solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography. METHODS: In total, 64 and 132 patients with solitary pulmonary inflammatory masses/nodules and peripheral lung cancers, respectively, were enrolled in this study. Their computed tomographic findings were summarized and compared retrospectively. RESULTS: Compared with the peripheral lung cancers, the inflammatory lesions were located closer to the pleura (p<0.0001). The majority of the inflammatory lesions were patchy and oval-shaped (82.8%), whereas most of the tumors were lobulated (82.6%). Almost all the inflammatory cases were unclear (93.8%), whereas most of the tumors had spiculated margins (72.7%). Computed tomography values were significantly higher for the inflammatory lesions than for the cancers (p<0.0001). More than half of the inflammatory lesions had defined necrosis (59.3%). Furthermore, 49.2% of the cancers enhanced inhomogeneously, but only 24.6% had ill-defined necrosis or cavities. The peripheral zones of 98.4% of the inflammatory lesions and 72.7% of the tumors were unclear, with peripheral scattered patches (92.2%) and beam-shaped opacity (66.7%) being the most common findings, respectively. Adjacent pleural thickening was more frequent for the inflammatory lesions than the cancers (95.3% vs. 21.1%, p<0.0001), whereas pleural indentation was found in 67.4% of the subjects with cancer. In addition, hilar (p=0.034) and mediastinal (p=0.003) lymphadenopathy were more commonly detected in the cancers than in the inflammatory cases. CONCLUSIONS: Contrast-enhanced computed tomography findings for pulmonary inflammatory lesions and peripheral lung cancers were significantly different in many aspects. Developing a comprehensive understanding of these differences is helpful for directing their management.

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Published

2016-10-01

Issue

Section

Clinical Sciences

How to Cite

Chu, Z.- gang, sheng, B., Liu, M.- qi, Lv, F.- jin, Li, Q., & Ouyang, Y. (2016). Differential Diagnosis of Solitary Pulmonary Inflammatory Lesions and Peripheral Lung Cancers with Contrast-enhanced Computed Tomography . Clinics, 71(10), 555-561. https://doi.org/10.6061/clinics/2016(10)01