11 Cavitary Lesions of the Lungs

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig C 11-1 Bacterial lung abscess. (A) Proteus pneumonia. Large, thick-walled left upper lobe abscess with an air-fluid level (arrow) and an associated infiltrate. (B) Staphylococcal pneumonia. Multiple lung abscesses with air-fluid levels (arrows) associated with diffuse air-space consolidation and a large pleural effusion.

• Fig C 11-2 Pneumatocele. Residual thin-walled cystic spaces (arrows) in the pulmonary parenchyma many years after a childhood staphylococcal pneumonia

• Fig C 11-3 Tuberculosis. Multiple large cavities with air-fluid levels in both upper lobes. Note the chronic fibrotic changes and upward retraction of the hila.

• Fig C 11-4 Atypical mycobacteria. Cavitary lesion (arrows) in the left upper lobe. The wall of the cavity is mildly irregular, and there is minimal parenchymal disease

• Fig C 11-5 Coccidioidomycosis. (A) Thin-walled cavity (arrows). (B) Irregular, thick-walled cavity with surrounding infiltrate (arrows).

• Fig C 11-6 Sporotrichosis. Frontal tomogram shows extensive bilateral upper lobe cavities.15

• Fig C 11-7 Mucormycosis. Large thin-walled cavity (arrow) containing a smooth, elliptical, homogeneous mass (arrowheads) representing a fungus ball.

• Fig C 11-8 Water lily sign in pulmonary echinococcal cyst. The endocyst membranes (arrow) are floating on the surface of fluid in a ruptured hydatid cyst.28

• Fig C 11-9 Paragonimiasis. (A) Frontal and (B) lateral chest radiographs demonstrate multiple cysts (arrows) in the right middle lobe. The cysts are thin walled, and most have a prominent crescent-shaped opacity along one side of their borders, the characteristic ring shadow of paragonimiasis.

• Fig C 11-10 Pneumocystis carinii. Innumerable thin-walled cavities.29

• Fig C 11-11 Bronchogenic carcinoma. Large cavitary right upper lobe mass with an air-fluid level (arrows) and associated rib destruction.

• Fig C 11-12 Hematogenous metastases. Extensive cavitation with air-fluid levels (arrows) of squamous cell carcinoma on a film obtained after two cycles of chemotherapy.22

• Fig C 11-13 Septic pulmonary emboli. Large cavity lesions (arrows) in the left lung of an intravenous drug abuser with septic thrombophlebitis.

• Fig C 11-14 Septic pulmonary emboli. Multiple cavitary nodules throughout both lungs representing Nocardia septic emboli in an intravenous drug abuser with AIDS.30

• Fig C 11-15 Wegener's granulomatosis. Multiple thick-walled cavities with irregular, shaggy inner linings.

• Fig C 11-16 Cystic bronchiectasis. Multiple cystic spaces, some with air-fluid levels (arrows), predominantly involve the left lung.

• Fig C 11-17 Pulmonary emphysema. Large bullae in the right upper lung. The presence of air-fluid levels (arrows) in the cystic spaces indicates superimposed infection.

• Fig C 11-18 Cystic fibrosis. Multiple small cysts superimposed on a diffuse, coarse, reticular pattern.

• Fig C 11-19 Papillomatosis. Multiple thin-walled cystic lesions.