Correct!
1. The wall thickness of a lung cavity should be assessed at its thickest portion

If the thickest portion of the cavity wall is >16 mm, the cavity is very likely malignant in nature; in contrast, if the thickest part of the cavity wall is ˂4 mm, the lesion is very likely benign. When the thickest portion of the cavity measures between 5-15 mm, the cavity is indeterminate- malignant or benign etiologies are nearly equally likely. Characterizing a cavity detected at chest radiography by measuring the cavity wall at its thinnest portion does not reliably discriminate between benign and malignant etiologies. Malignant cavities, often, but not always, produces cavities with lobulated or irregular internal linings, whereas benign causes of lung cavities may produce smooth internal linings. The exception to the latter is pulmonary abscesses, which often produce irregular internal cavity linings.  An air-fluid level is commonly present in pulmonary abscesses and less commonly present in cavitary pulmonary malignancies, but the presence or absence of an air-fluid level within a pulmonary cavity does not reliably establish the etiology of the cavity.

The differential diagnosis of the imaging findings for this patient includes which of the following?

  1. Metastatic disease
  2. Amyloidosis
  3. Rheumatoid lung disease
  4. Granulomatosis with polyangiitis (aka Wegener’s Granulomatosis)
  5. Septic pulmonary emboli
  6. All of the above

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