Pulmonary cavitary nodules on computed tomography: differentiation of malignancy and benignancy

J Comput Assist Tomogr. 2007 Nov-Dec;31(6):943-9. doi: 10.1097/RCT.0b013e3180415e20.

Abstract

Objective: To establish computed tomographic findings that enable accurate differentiation between malignant and benign cavitary lung nodules.

Methods: Computed tomographic scans from 39 patients with malignant cavitary nodules and from 39 patients with benign cavitary nodules were independently assessed by 2 observers. They recorded the computed tomographic findings of both types of cavitary nodules and surrounding pulmonary parenchyma. The computed tomographic findings were then compared using chi test.

Results: The notch was found in 29% of benign cavitary nodule cases and in 54% of malignant cavitary nodule cases (P < 0.01). An irregular internal wall was found in 26% of benign nodules and in 49% of malignant nodule cases (P < 0.01). A linear margin (P < 0.01), satellite nodule presence (P < 0.01), bronchial wall thickening (P < 0.05), consolidation (P < 0.05), and ground-glass attenuation (P < 0.01) were significantly more frequent in benign cavitary nodules than in malignant ones.

Conclusions: Although the computed tomographic findings of benign and malignant cavitary nodules overlap, some computed tomographic findings are useful for differentiating cavitary nodules.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aspergillosis / diagnostic imaging
  • Biopsy
  • Bronchography
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Child
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung Abscess / diagnostic imaging
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases, Fungal / diagnostic imaging
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / secondary
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnostic imaging
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Tomography, X-Ray Computed / methods*
  • Tuberculosis, Pulmonary / diagnostic imaging