title: Differential Diagnosis of Solitary Pulmonary Inflammatory Lesions and Peripheral Lung Cancers with Contrast-enhanced Computed Tomography.
abstract: To clarify differences between solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography.
  In total, 64 and 132 patients with solitary pulmonary inflammatory masses/nodules and peripheral lung cancers, respectively, were enrolled in this study. Their computed tomographic findings were summarized and compared retrospectively.
  Compared with the peripheral lung cancers, the inflammatory lesions were located closer to the pleura (p<0.0001). The majority of the inflammatory lesions were patchy and oval-shaped (82.8%), whereas most of the tumors were lobulated (82.6%). Almost all the inflammatory cases were unclear (93.8%), whereas most of the tumors had spiculated margins (72.7%). Computed tomography values were significantly higher for the inflammatory lesions than for the cancers (p<0.0001). More than half of the inflammatory lesions had defined necrosis (59.3%). Furthermore, 49.2% of the cancers enhanced inhomogeneously, but only 24.6% had ill-defined necrosis or cavities. The peripheral zones of 98.4% of the inflammatory lesions and 72.7% of the tumors were unclear, with peripheral scattered patches (92.2%) and beam-shaped opacity (66.7%) being the most common findings, respectively. Adjacent pleural thickening was more frequent for the inflammatory lesions than the cancers (95.3% vs. 21.1%, p<0.0001), whereas pleural indentation was found in 67.4% of the subjects with cancer. In addition, hilar (p=0.034) and mediastinal (p=0.003) lymphadenopathy were more commonly detected in the cancers than in the inflammatory cases.
  Contrast-enhanced computed tomography findings for pulmonary inflammatory lesions and peripheral lung cancers were significantly different in many aspects. Developing a comprehensive understanding of these differences is helpful for directing their management.
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Chu
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Sheng
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Meng-Qi
authors.initials: MQ
authors.lastname: Liu
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Fa-Jin
authors.initials: FJ
authors.lastname: Lv
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ouyang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden
chemical_list: D003287:Contrast Media