24M from Albania no PMH, move to US * 2 years, present with cough * 2 months, right post upper back pain, night sweats, poor appetite for months
Found to have RLL cavity 6.5 x 5 x 6 cm with scattered nodular, tree and bud capacities
What is the differential diagnosis ?
answerMnemonic C-A-V-I-T-Y
- C: cancer
- bronchogenic carcinoma: most frequently SCC
- cavitatory pulmonary metastasis(es): again most frequently SCC
- A: autoimmune; granulomas from
- Wegener’s granulomatosis (granulomatosis with polyangiitis)
- rheumatoid arthritis (rheumatoid nodules) etc.
- V: vascular (both bland and septic pulmonary embolus)
- I: infection (bacterial/fungal)
- T: trauma – pneumatocoeles
- Y: youth
- CPAM (congenital pulmonary airway malformation)
- pulmonary sequestration
- bronchogenic cyst
from: https://radiopaedia.org/articles/pulmonary-cavity-mnemonic
Characteristics of Lung Cavities:
Thin < 4mm more likely to be related to infection or rheumatic disease
Thick > 4mm, with areas of necrosis more likely to be related to malignancy