pulmonary cavity
DESCRIPTION
radiologyTRANSCRIPT
Pulmonary cavityDr Ayush Goel and Dr Frank Gaillard et al.
Pulmonary cavities are gas-filled areas of the lung in the center of a nodule, mass or area of consolidation. They are usually evident on plain radiography and CT. They are typically thick walled and their walls must be greater than 2-5 mm. They may be filled with air as well as fluid and may also demonstrate air-fluid levels.
TerminologyAccording to the Fleischner society pulmonary cavities are defined "gas-filled space, seen as a lucency or low-attenuation area, within pulmonary consolidation, a mass, or a nodule" 7.
PathologyThe cause of pulmonary cavities is broad. They may develop as a chronic complication of a pulmonary cyst, or secondary to cystic degeneration of a pulmonary mass. They may enlarge or involute over time.
CausesPulmonary cavities may be the result of malignancy, infection, inflammation or be congenital:
cavitating malignancy
o primary bronchogenic carcinoma (especially squamous cell carcinoma)
o cavitating pulmonary metastases
squamous cell carcinoma
adenocarcinoma, e.g. gastrointestinal tract, breast
sarcoma
infection
o pulmonary tuberculosis 3
o pulmonary bacterial abscess /cavitating pneumonia
o post-pneumonic pneumatocoele: a thin walled pneumatocoele is not really a cavity but when infected can be thick walled
o septic pulmonary emboli
o other rare infections
pulmonary coccidioidomycosis
pulmonary actinomycosis / thoracic actinomycosis
pulmonary nocardiosis
melioidosis
pulmonary cryptococcosis 8
non-infective granuloma
o granulomatosis with polyangitis
o rheumatoid nodules
vascular
o pulmonary infarct
trauma
o pneumatocoeles (a thin walled pneumatocoele is not really a cavity)
congenital (not true "cavity")
o congenital cystic adenomatoid malformation (CCAM)
o pulmonary sequestration
o bronchogenic cyst
A helpful mnemonic is CAVITY.
See also pulmonary mass
pulmonary cyst
pulmonary cavity
o pulmonary cavity (mnemonic)
pulmonary nodule
References
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