Primary carcinoma of the lung overlooked at CT: analysis of findings in 14 patients.
OBJECTIVE
To describe the appearances of overlooked lung cancer at computed tomographic (CT) examination and to analyze the reasons for failure to diagnose these lesions.


METHODS
Fourteen patients with 15 overlooked lung cancers were identified by radiologists at three institutions. Location, shape, and cell type of each cancer were reviewed, and other relevant findings of CT examinations were assessed.


RESULTS
The missed tumors manifested as endobronchial lesion (n = 10), solitary parenchymal nodule (n = 2), area of focal peripheral air-space disease (n = 2), or pleural-based thickening (n = 1). Eleven (73%) of the 15 lesions were located in a lower lobe. In six (43%) of 14 patients, major distracting findings were present elsewhere in the thorax.


CONCLUSIONS
Endobronchial location and lower lobe predominance were the most common characteristics of overlooked lung cancer at CT. The presence of unrelated major abnormalities at CT may also have contributed to failure to diagnose the tumor.
White
C S
CS
Department of Radiology, University of Maryland Medical Center, Baltimore 21201, USA.
Romney
B M
BM
Mason
A C
AC
Austin
J H
JH
Miller
B H
BH
Protopapas
Z
Z
D003951:Diagnostic Errors; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008318:Malpractice; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods