Is it possible for a pulmonary contusion to be confused with a cancerous mass on X-ray or CT scan?

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Posted on Mon, 27 Jan 2014 in X-ray, Lab tests and Scans
Question: Is it possible for a pulmonary contusion to be confused with a cancerous mass on x-ray or CT scan?
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Answered by Dr. Iven Romic Rommstein 21 minutes later
Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Thanks for the query. There are some similar Xray features of lung contusion and lung masses and sometimes it can be diagnostic challenge,but for experienced radiologist and if there was history of lung trauma, even only xrays is enough for right diagnosis. Contusion shows consolidated areas of lungs and is not restricted by the anatomical boundaries of lungs,it is more diffuse. While lung tumors are usually oval and well defined lesions. Even if there are some doubts on xray exam,CT scan is very sensitive for such patology and I dont think it can be misdiagnosed. Wish you good health. Feel free to ask. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Iven Romic Rommstein 23 minutes later
Thank you for your prompt response! My dad was admitted for right upper lobe pneumonia and in the process of a chest x-ray, then a CT scan, an "area" was detected along the same vicinity of the infiltrate that the physician said was "concerning" for cancer. He's having an MRI in 2 weeks for further investigation. Also, the CT scan showed "spots" on his liver. He had a CT scan about 6 mos ago in which the lungs and liver were unremarkable. However, my mom remembered he had fallen hard in the bathroom 1-1/2 to 2 weeks before the onset of this pneumonia, landing across the toilet, striking his chest and abdomen on the right side. I was just wondering if the trauma could have in fact caused the pneumonia and the other areas they're seeing could also be a result of that trauma, especially since the "area" on his lung is more or less in the same vicinity as the infiltrate....
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Answered by Dr. Iven Romic Rommstein 2 hours later
Brief Answer: Hi Detailed Answer: Well, lung contusion rarely happens without ribs fracture so if there wasnt detected rib fracture,I doubt this was contusion. Also,such injuries shoudnt be directly related to pneumonia,but if he had pain during breathing,he might not ventilate his lungs good enough and it facilitates pneumonia development;this is known mechanism. Infiltrate is in most cases sign of pneumonia,but many other lung disorder can be included in differential diagnosis; emphysema, fibrosis, aspirational pneumonia, but tumors too. His diagnostic results necessiate further tests especially if he is a smoker. MRI is more specific and it should rule out malignancy. Liver spots can be signs of something very bad,but also in most cases these are just liver cysts or adenomas,especially if not larger than 5mm. All in all,cancer is not first thing to think of,but it must be ruled out so that treatment can start on time.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Iven Romic Rommstein

General Surgeon

Practicing since :2008

Answered : 13305 Questions

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