Sandbox:landing lung

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Pulmonary mass is generally defined as any area of pulmonary opacification that measures more than 30 mm in the lung. Pulmonary mass can be benign or malignant. On the other hand, pulmonary nodule is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. Pulmonary nodule can be classified into 2 categories: solitary or multiple.

Classification

For more details about each specific type of condition, click on the links in blue in the algorithm below.
In order to distinguish pulmonary mass from solitary pulmonary nodule, click here [Insert link to big table of differentials]

Pulmonary nodule/mass

More than > 30 mm

Less than <30 mm

Pulmonary nodule

Lung mass (also known as Pulmonary mass) (Primary lung cancer 95% of the cases)

Multiple

Single

Liver

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Liver mass detected Adapted from Bonder et al.

Relevant medical history to obtain:

❑ Age and gender ❑ Symptoms: jaundice, pain, nausea ❑ Recent travel ❑ Hepatitis serology ❑ Iron studies ❑ Use of oral contraceptives ❑ AFP levels ❑ From endemic area of hepatitis ❑ History of chronic liver disease ❑ Physical findings

Chronic liver disease Hepatitis B or C

No history of chronic liver disease

Check AFP, triphasic CT or MRI Follow-up screening guidelines as cirrhotic patient

Benign characteristics of a liver mass Follow-up accordingly

Diagnostic Algorithm for a suspected HCC

Liver nodule or mass

Less than < 1 cm

More than > 1 cm

Triphasic CT Enhanced MRI

Increase in size and growth

Repeat ultrasound in 3 months

Arterial hypervascularity and venous washout

Hepatocellular carcinoma

Liver biopsy

Investigate according to size

Stable