All of us come across chest xray or a CT scan report on our patients that mention infiltrates or nodules. Other times they mention a mass, or ground glass opacity. Let us try to understand the basics of these radiographic descriptions.
Infiltrate: generally describes a haziness in the part of lung that is denser than normal lung- it could often be seen in pneumonia. There are other conditions that can cause infiltrates- such as atelectasis (compressed lung segment).
Nodule: a density or opacity that measures less than 3 cm is called a nodule. It can be single or mulitple; it could be subcentimeter or more in size. Nodules are scary because we always worry about them being from cancer. We never want to miss a nodule patient in follow up. Many nodules turn out to be benign, from scar, or granuloma ( old infection). We need to closely monitor the nodule to make sure it is not growing in size. Depending on the size or the risk factor of individual patient, we may decide to either closely follow it by serial CT scan, or send patient for biopsy, or send the patient for thoracic surgery to take the nodule out surgically. Missed lung cancer in a patient with nodule is a high risk to our practice.
Mass: is generally a dense, 3 cm or more density, and it generally is concerning for cancer. Rarely pneumonia, or rounded atelectasis can mimic a mass. A mass usually needs urgent consultation followed by biopsy.
Have you come across other radiographic term that has puzzled you?
Infiltrate: generally describes a haziness in the part of lung that is denser than normal lung- it could often be seen in pneumonia. There are other conditions that can cause infiltrates- such as atelectasis (compressed lung segment).
Nodule: a density or opacity that measures less than 3 cm is called a nodule. It can be single or mulitple; it could be subcentimeter or more in size. Nodules are scary because we always worry about them being from cancer. We never want to miss a nodule patient in follow up. Many nodules turn out to be benign, from scar, or granuloma ( old infection). We need to closely monitor the nodule to make sure it is not growing in size. Depending on the size or the risk factor of individual patient, we may decide to either closely follow it by serial CT scan, or send patient for biopsy, or send the patient for thoracic surgery to take the nodule out surgically. Missed lung cancer in a patient with nodule is a high risk to our practice.
Mass: is generally a dense, 3 cm or more density, and it generally is concerning for cancer. Rarely pneumonia, or rounded atelectasis can mimic a mass. A mass usually needs urgent consultation followed by biopsy.
Have you come across other radiographic term that has puzzled you?
What are the benefits of ordering a cat scan with contrast vs. without contrast vs. with high resolution cuts?
ReplyDeleteCT scn with contrast is ordered generally when we are ruling out pulmonary embolism, or when we are concerenced about chest lymph nodes, because contrast clarifies it better.
ReplyDeleteHigh resolution CT chest is ordered to evaluate diffuse lung disease such as pulmonary fibrosis, or other forms of "interstitial" lung diseases- due to inflammation and scarring. HRCT also is a way to diagnose emphysema.