Cavitary lung lesion: Two different diagnosis with similar appearence Poster No.: P-0043 Congress: ESTI 2015 Type: Educational Poster Authors: M. Yesildag, H. Kalkan, K. Ödev; Konya/TR Keywords: Infection, Biopsy, CT, Lung DOI: 10.1594/esti2015/P-0043 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myesr.org Page 1 of 6
Learning objectives Pulmonary and systemic diseases with lung cavity have broad spectrum. We aimed to present two patients who had similar clinical symptoms and radiologic appearences of cavitary lung lesion. Background There are various lung diseases with cavitary lesion such as tuberculosis, broncogenic cancer and bacterial infections. Laboratory examination, radiologic and bronchoscopic methods are used for diagnosis. However, we have difficulty and delay in the diagnosis. As in our cases, CT guided fine needle aspiration biopsy is considered to be a good choice. Imaging findings OR Procedure details Case 1 63 year old-woman applied for fever, cough,and weight loss. She had increased sedimentation, leukocyte and CRP levels. She was performed thorax CT. It revealed cavitary lesion with thick-walled in the right lung lower lobe(fig 1). Her laboratory values for tuberculosis, cyst hidatic and rheumatoogic diseases were negative. CT -guided fine needle aspiration biopsy was performed and the pathologic result was nonspesific chronic inflamation. She was treated for nonspesific infection and improved uneventfully. Case 2 68 year-old woman applied for fever, cough and anorexia. She had high levels of sedimentation and CRP. Thorax CT revealed thick-walled,cavitary lesion with air-fluid level(fig 2). Her all laboratory values for tuberculosis such as sputum and bronchoscopic lavage ARB were negative. She was performed CT -guided fine needle aspiration biopsy. Pathology report was consisted with caseified granulomatous infection. There was no need to wait for culture results for tuberculosis and immediate tuberculosis treatment was started. She improved clinically and radiologically. Page 2 of 6
Images for this section: Fig. 1: Axial CT showed the thick-walled cavitary lesion that represents nonspecific inflammation in the right lung lower lobe. Page 3 of 6
Fig. 2: Axial CT showed the cavitary lung lesson that represents the tuberculosis infection. Page 4 of 6
Fig. 3: Axiial CT image of an another patent with cavitary lung lesion at the left and micronodular densities that represents endobronchial spreading due to tuberculosis. Page 5 of 6
Conclusion It must be kept in mind that CT-guided transthoracic biopsy is a preferable method to diagnose the suitable localized cavitary lung lesions in a short time. We presented these cases to emphasize the importance of CT-guided transthoracic fine needle aspiration biopsy in quick diagnosis of the cavitary lung lesions with similar radiologic and clinical presentations. References 1.L. B. Gadkowski, Jason E. Stout,Cavitary Pulmonary Disease Clin Microbiol Rev. 2008 Apr; 21(2): 305-333. Personal Information Page 6 of 6