title: Pulmonary cavitary mass containing a mural nodule: differential diagnosis between intracavitary aspergilloma and cavitating lung cancer on contrast-enhanced computed tomography.
abstract: OBJECTIVE
  The objective of this study was to identify whether there were any significant differences in the computed tomography (CT) findings of an intracavitary aspergilloma and a cavitating lung cancer containing a mural nodule.
  
  
  METHODS
  The CT and histopathological findings of 12 patients (male:female ratio 3:9; aged 51-76 years) with cavitating lung cancer containing a mural nodule and 26 patients (male:female ratio 14:12; aged 29-72 years) with intracavitary aspergilloma were retrospectively reviewed.
  
  
  RESULTS
  The mural nodules within cavitating lung cancer were more enhanced (p<0.001) and showed a nondependent location more frequently (p=0.012) than those of intracavitary aspergillomas. The cavitary walls were thicker in cavitating lung cancer (mean 5.8mm thick) than those in intracavitary aspergillomas (mean 2.6mm thick; p=0.035). Adjacent bronchiectasis and volume decrease of the involved lobe were observed more frequently in intracavitary aspergillomas than in cavitating lung cancers (p<0.001 and p=0.008, respectively).
  
  
  CONCLUSIONS
  Whether a mural nodule within a cavitary lesion is contrast-enhanced or not is one of the most important features in making a differential diagnosis between an intracavitary aspergilloma and a cavitating lung cancer. Assessment of dependent location of a mural nodule within the cavity and wall thickness of the cavity itself can also be helpful for differentiation.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Park
authors.forename: T S
authors.initials: TS
authors.lastname: Kim
authors.forename: C A
authors.initials: CA
authors.lastname: Yi
authors.forename: E Y
authors.initials: EY
authors.lastname: Cho
authors.forename: H
authors.initials: H
authors.lastname: Kim
authors.forename: Y S
authors.initials: YS
authors.lastname: Choi
mesh_terms: D000368:Aged; D001228:Aspergillosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed