Cavitary Lung Cancer Research Articles

Cystic and Cavitary Lung Cancer: Its Characteristic Features on CT and FDG-PET Scans

Background: Cystic and cavitary lung cancer (CCLC) is infrequently observed on computed tomography (CT) scans; however, its diagnosis is often overlooked or delayed. Objectives: The current study aimed to investigate the CT and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) features of CCLC. Patients and Methods: A total of 809 patients who underwent lung tumor resection were examined in this study, and the presence of cystic and cavitary lesions on CT scans was investigated. Based on the CT scans, CCLC was identified in 102 consecutive patients. The diameters of the whole nodule and the airspace portion of the lesion, morphological patterns of cystic and cavitary lesions, presence of ground glass opacity (GGO), and loculation pattern (including the presence of a septum) were evaluated. The positron emission tomography (PET) scans of CCLC were also assessed visually and semi-quantitatively. Results: A total of 104 CCLC lesions were evaluated in this study. The histological analysis indicated 85 cases of adenocarcinoma (AD) and 19 cases of squamous cell carcinoma (SCC). The morphological patterns of cystic and cavitary lesions were classified into four types. The presence of GGO, type 4 morphological pattern (a soft-tissue-density structure intermixed within clusters of a cavitary lesion), and multilocular with septum (MS) loculation pattern were significantly different according to the histological type. The maximum standardized uptake value (SUVmax) on PET scans was significantly lower in AD compared to SCC (P = 0.002). In the solid nodule part of cystic and cavitary lesions, the MS pattern was significantly more common in AD (P = 0.044). Conclusion: When cystic and cavitary lesions are observed on CT scans, the presence of GGO and the MS pattern should be considered, as it may help differentiate the histological findings.

Embolization of a Proximal Pulmonary Artery Pseudoaneurysm in a Cavitary Lung Cancer

Embolization of a Proximal Pulmonary Artery Pseudoaneurysm in a Cavitary Lung Cancer

Clinicopathological characteristics of solitary cavitary lung cancer: a case-control study.

BackgroundWith the emerging radiological techniques and the increasing incidence of adenocarcinoma, the composition and structure of cavitary lung cancer have been significantly changed. The aim of the study was to demonstrate clinicopathological characteristics of solitary cavitary lung cancer which was ≤3 cm.MethodsA case-control study was designed through retrospective data analysis of clinicopathological data of 946 cases with solitary lung cancer smaller than 3 cm. Univariable and multivariable analysis were used to identify the risk factors of cavitation.ResultsCavitary lung cancer occurred more frequently in patients who were elderly (P=0.044), male (P=0.004), who had a smoking history (P=0.018), higher carcinoembryonic antigen (CEA) level (P<0.001), peripheral lesions (P=0.017), solid nodules (P<0.001), spiculation (P=0.003), vascular convergence (P<0.001), air bronchogram (P=0.004), larger tumor size (P<0.001), advanced T stage (P<0.001), lymph node metastasis (P=0.028) and advanced pTNM stage (P=0.004). In addition, cavitary lung cancer was more common in papillary predominant tumors (P=0.017), while noncavitary lung cancer occurred more frequently in AIS/MIA (P=0.002) and lepidic predominant tumors (P<0.001). It was confirmed that cavitation was significantly associated with elderly (P=0.013), male (P=0.003), larger maximum tumor diameter (P<0.001), solid nodules (P<0.001), larger pT size (P=0.016) and advanced pN stage (P=0.036) in multivariable analysis. ROC curves showed that the AUV was greater in maximum tumor diameter than in pT size predicting cavitation (0.71 vs. 0.66). A cut off value of 20.9 mm showed a discriminatory power of cavitation with a sensitivity of 68.7% and a specificity of 71.2%.ConclusionsComparing with noncavitary lung cancer, cavitary lung cancer smaller than 3 cm may have worse prognostic clinical, radiological and pathological characteristics. Especially, cavitary lung cancer present as more solid nodules on CT images and present with more invasive on pathological findings.

Aspergilloma formation in peripheral cavitary lung cancer

<h3></h3> <i>Aspergillus fumigatus</i> — наиболее распространенный патогенный гриб, который часто вызывает у людей тяжелое поражение, приводящее к смерти. В последние годы отмечается увеличение числа случаев инвазивного аспергиллеза легких, которое обусловлено рядом причин,связанных с иммуносупрессией. Самой частой формой инвазивного аспергиллеза является аспергиллема. Мы наблюдали пациента 66 лет, у которого аспергиллема возникла в полости, расположенной внутри периферического плоскоклеточного рака легкого. После лечения амфотерицином В больному выполнена нижняя лобэктомия слева.

Thin-Walled Cavitary Lung Adenocarcinoma: A Rare Unusual Case

: Thin-walled cavitary lung adenocarcinoma is not common. When cavitary lung cancer was classified as a histologic subtype, squamous cell carcinoma was the most common, followed by adenocarcinoma and finally large cell carcinoma. Cavitation was not found in small cell lung cancer. Some cases of thin-walled cavitary lung adenocarcinoma have been reported. Thin-walled cavitary lung cancer can be detected by the following radiological signs: irregular thickening of the cavity wall, wall nodule formation, the presence of compartments in the cavity, increased standard uptake values (SUVs) on positron emission tomography (PET). A thin‑walled cavity accompanied by mediastinal lymph node or distant metastasis, or enlargement of the lesion on long term follow-up. We report on a case of thin walled cavitary lung cancer whose cavity tended to enlarge during a 10-month follow-up, but no other evidence of imaging finding indicated potential lung cancer. It suggests that the unidirectional check-valve mechanism could make enlarging thin walled cavitary lesion due to lepidic growth pattern.

Carcinoma broncogénico extensamente cavitado simulando una hernia de hiato paraesofágica

Carcinoma broncogénico extensamente cavitado simulando una hernia de hiato paraesofágica

Cavitary lung cancer with cartilage tissues in the wall mimicking aspergilloma

A 65-year-old female presented with a cavitary lesion in the right upper lung field (figure 1A). The diagnosis was aspergilloma because of the chest CT appearance of a fungus ball-like...

直接癌性空洞内部を観察しえた原発性肺癌の 1 例

直接癌性空洞内部を観察しえた原発性肺癌の 1 例

Cavitary lung cancer presenting as subcutaneous emphysema on the contralateral side

Bronchocutaneous fistula is an extremely rare complication of lung cancer and is frequently seen following biopsy or radiotherapy. A 67-year old male patient was administered to our hospital due to sudden onset of shortness of breath and subcutaneous emphysema on the right side. Chest computed tomography revealed a cavitary lesion in the left upper lobe in connection with the subcutaneous emphysema on the right side through sternum and anterior chest wall. The pathological examination of the biopsy performed during tube insertion revealed a well-differentiated squamous cell carcinoma of the lung. The patient was referred for adjuvant therapy to local oncology hospital. He passed away 9 months following diagnosis.

Cavitary Lung Cancer Lined with Normal Bronchial Epithelium and Cancer Cells

Reports of cavitary lung cancer are not uncommon, and the cavity generally contains either dilated bronchi or cancer cells. Recently, we encountered a surgical case of cavitary lung cancer whose cavity tended to enlarge during long-term follow-up, and was found to be lined with normal bronchial epithelium and adenocarcinoma cells.

An Aspergilloma in an Echinococcal Cyst Cavity

Aspergilloma is a saprophytic infection which can colonize preexisting lung cavities. The most common underlying diseases are tuberculosis, sarcoidosis, cavitary lung cancer, etc. Although aspergilloma can also occur in operated hydatid cyst cavities, only a few cases have been reported in literature. A 32-year-old female patient underwent cystectomy for the diagnosis of perforated intraparenchymal giant hydatid cyst located in the right upper lobe, reaching down to the hilum. Capitonnage was not performed and it was observed that a residual cavity remained in the cystectomy area. The patient was discharged; however, during clinical and radiological follow-ups, it was found that the residual cyst cavity had expanded. As it was thought that one of the drainage bronchi in the cyst cavity could have opened, the patient was reoperated. During the operation, it was noted that purulent fluid and necrotic tissues were present in the cystic cavity. It was seen that the posterior upper lobe segment was consolidated and not ventilated. Contents of the cavity were removed and the posterior upper lobe segment was resected. Histopathological examination revealed that the tissue in the cavity was that of an aspergilloma, and that chronic organized pneumonia and diffuse interstitial fibrosis were present in the resected segment. Refraining from surgical obliteration (capitonnage) of cyst cavities in cases of giant hydatid cysts extending to the hilum can lead to opportunistic infections such as aspergilloma.

A Case of Cavitary Pulmonary Metastases of Primary Cavitary Lung Cancer

Many disorders and abnormalities are accompanied by cavitary lesoin of the lung and one of the most common causes of cavitary lung disease are primary and metastatic lung neoplasms. but cavitary formation of primary lung cancer is not frequent and cavitary or cystic pulmonary metastases of this is also rare. We report a case of cavitary pulmonry metastases of primary lung cancer proven by bronchoscopic biopsy and chest CT. The patients was 60 year-old heavy smoker who had no known underlying lung diseases 7 years ago and complained chronic cough. The chest CT showed primary lung cancer in right low lobe with multiple cavitary or cystic metastases in both lungs and multiple lymphatic metastases.

Different cutoff values of Cyfra 21-1 for cavitary and noncavitary lung cancers

Study objectives: Cell lysis and tumor necrosis release cytokeratin, a tumor marker of lung cancer, into the serum. The serum cytokeratin level can also be elevated in benign cavitary lung diseases. The purpose of this study was to evaluate whether Cyfra 21-1 can differentiate malignant lung diseases from benign diseases with cavitary lesions. Design: This study is a retrospective review of the case records of patients with lung lesions seen during a 4-year period from January 1993 to May 1996. Setting and patients: Serum Cyfra 21-1 levels were measured in 306 patients with lung cancer ( n=143) or benign lung disease ( n=163). The patients were grouped according to radiologic evidence of cavitary lung lesions. Lung cancer included both non-small cell ( n=123) and small cell ( n=20) lung cancers, and the benign diseases include tuberculosis ( n=87), abscess ( n=26), pneumonia ( n=4), and others ( n=46). Measurements and results: Although Cyfra 21-1 clearly differentiated cavitary lung cancer (15.0, 9.1–29.8 ng/ml, median and interquartile range, n=39) from benign cavitary disease ( P<0.001), and noncavitary lung cancer from benign noncavitary disease (1.7, 0.9–2.6 ng/ml, n=108, P<0.001), it could not differentiate noncavitary lung cancer (5.0, 2.1–12.4 ng/ml, n=104) from benign cavitary diseases (3.3, 1.4–8.3 ng/ml, n=55, P=0.45). Conclusions: Serum Cyfra 21-1 is a useful tumor marker for differentiating benign from malignant lung diseases. However, different cutoff values are needed, depending on the presence of cavitary lesions. We recommend cutoff values of 30 ng/ml for cavitary lung diseases and 6 ng/ml for noncavitary lung diseases. If there are no radiologic data, a cutoff value of 15 ng/ml is recommended.

Cavitary lung cancer with an aspergilloma-like shadow

A 66-year-old man who complained of cough and haemoptysis had a cavitary lesion with the meniscus sign in the right lower lung field on his chest X-ray and CT scan. He had smoked 40 cigarettes daily, for about 46 years. Initially, he was diagnosed with aspergilloma and given an antifungal agent. After 2 months, the cavitary lesion showed a slight irregularity of the inner border. The walls were irregularly thickened and were surrounded by infiltrative densities compared with the previous chest radiograph. Enlargement of right hilar and mediastinal lymph nodes was also observed. The fungus ball-like shadow was fixed on the anterior wall of the cavity and its position was not altered with the patient’s movements. These radiographic findings led to suspicion that the lesion might be malignant. Transbronchial lung biopsy of the cavity wall and CT guided needle aspiration biopsy of the fungus ball-like lesion were performed. Microscopic examination revealed a squamous-cell carcinoma in both the cavity wall and the fungus ball-like lesion. There was no evidence of fungal elements. In conclusion, the meniscus sign is most often associated with benign diseases such as aspergilloma, however, one should remember that carcinoma may be a cause.

Clinical features of cavitary lung cancer: Suzuki N, Ohno S, Kitamura S. Department of Pulmonary Medicine, Jichi Medical School, Kawachi-gun 329-04. Lung Cancer (Japan) 1994;34:355–361

Clinical features of cavitary lung cancer: Suzuki N, Ohno S, Kitamura S. Department of Pulmonary Medicine, Jichi Medical School, Kawachi-gun 329-04. Lung Cancer (Japan) 1994;34:355–361

Oral treatment with itraconazole of aspergilloma in cavitary lung cancer

We report a case of aspergilloma in a necrotic small cell lung cancer, where poor pulmonary function and performance status of the patient precluded surgical treatment. High dose Itraconazole, a new oral anti-mycotic drug, was given for 13 months. During this treatment there was a decrease of the fungus ball size and no haemoptysis. Moreover control of the aspergilloma allowed chemotherapeutic treatment of the underlying bronchocarcinoma.