E5396. Lung Cancer Mimics: Differentiating Suspicious Benign Pulmonary Pathology From Their Malignant Counterparts
  1. Billy Denley; San Antonio Uniformed Services Health Education Consortium
  2. Iulian Dragusin; San Antonio Uniformed Services Health Education Consortium
Lung cancer is the global leader in cancer incidence and mortality, causing an estimated 2 million diagnoses and 1.8 million deaths. Numerous biopsies are performed annually for suspicious nodules, but approximately 50% require repeat biopsy, and greater than 40% of biopsies yield negative results. Biopsy also results in pneumothorax in 25.9% of cases and requires chest tube placement in 6.9% of cases. It is essential that the radiologist use imaging features to limit unnecessary biopsies, patient anxiety, and additional examinations and radiation exposure when possible. This exhibit reviews imaging features of masslike consolidations. We review the epidemiology and, when possible, the specific imaging signs of other diseases that may mimic lung cancer, such as fungal and bacterial infections, collagen vascular disease, and nodular opacities such as granulomatosis with polyangiitis and necrobiotic nodules, sarcoidosis, and fibrotic masses among others.

Educational Goals / Teaching Points
In this exhibit, we review proven primary and secondary lung cancers to differentiate them from benign etiologies. After reviewing this exhibit, the radiologist will be better able to assist the clinical team in directing appropriate referral and imaging management.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will review a spectrum of pulmonary masslike consolidation with benign and malignant diagnoses. We discuss imaging features and epidemiology, including nodule and mass morphology, lobar distribution, hilar and mediastinal findings, and metabolic imaging. We briefly review biopsy risks and benefits.

Numerous benign pathologies commonly mimic lung cancers. Knowledge of these mimics and their imaging features will enable radiologists to suggest appropriate diagnostic steps and add value for referring clinicians and patients.