Lung cavity

This article is about abnormal lung cavities. For the normal lung cavity, see pleural cavity.
Lung cavity
Other namesPulmonary cavity, lung cavitary lesion, lung cavitation
Chest X-ray of a person with advanced tuberculosis: Infection in both lungs is marked by white arrow-heads, and the formation of a cavity is marked by black arrows.
SpecialtyPulmonology
ComplicationsAspergilloma
CausesTuberculosis, Lung cancer

A lung cavity or pulmonary cavity is an abnormal, thick-walled, air-filled space within the lung.[1] Cavities in the lung can be caused by infections, cancer, autoimmune conditions, trauma, congenital defects,[2] or pulmonary embolism.[3] The most common cause of a single lung cavity is lung cancer.[4] Bacterial, mycobacterial, and fungal infections are common causes of lung cavities.[5] Globally, tuberculosis is likely the most common infectious cause of lung cavities.[6] Less commonly, parasitic infections can cause cavities.[5] Viral infections almost never cause cavities.[7] The terms cavity and cyst are frequently used interchangeably; however, a cavity is thick walled (at least 5 mm), while a cyst is thin walled (4 mm or less). The distinction is important because cystic lesions are unlikely to be cancer, while cavitary lesions are often caused by cancer.[3]

Diagnosis of a lung cavity is made with a chest X-ray or CT scan of the chest,[2] which helps to exclude mimics like lung cysts, emphysema, bullae, and cystic bronchiectasis.[5] Once an imaging diagnosis has been made, a person’s symptoms can be used to further narrow the differential diagnosis. For example, recent onset of fever and productive cough suggest an infection, while a chronic cough, fatigue, and unintentional weight loss suggest cancer or tuberculosis.[2] Symptoms of a lung cavity due to infection can include fever, chills, and cough.[5] Knowing how long someone has had symptoms for or how long a cavity has been present on imaging can also help to narrow down the diagnosis. If symptoms or imaging findings have been present for less than three months, the cause is most likely an acute infection; if they have been present for more than three months, the cause is most likely a chronic infection, cancer, or an autoimmune disease.[5]

The presence of lung cavities is associated with worse outcomes in lung cancer[7] and tuberculosis;[8] however, if a lung cancer develops cavitation after chemotherapy and radiofrequency ablation, that indicates a good response to treatment.[2]

  1. ^ Bell, Daniel, Gaillard, Frank. "Pulmonary cavities". Radiopedia. Retrieved 12 February 2021.{{cite web}}: CS1 maint: multiple names: authors list (link)
  2. ^ a b c d Canan A, Batra K, Saboo S, Landay M, Kandathil A (15 September 2020). "Radiological approach to cavitary lung lesions". Postgraduate Medical Journal. 97 (1150): 521–531. doi:10.1136/postgradmedj-2020-138694. PMID 32934178. S2CID 221747977.
  3. ^ a b Ryu J, Swensen S (June 2003). "Cystic and Cavitary Lung Diseases: Focal and Diffuse". Mayo Clinic Proceedings. 78 (6): 744–752. doi:10.4065/78.6.744. PMID 12934786.
  4. ^ Cite error: The named reference Differential Diagnosis 2016 was invoked but never defined (see the help page).
  5. ^ a b c d e Gafoor K, Patel S, Girvin F, Gupta N, Naidich D, Machnicki S, Brown KK, Mehta A, Husta B, Ryu JH, Sarosi GA, Franquet T, Verschakelen J, Johkoh T, Travis W, Raoof S (June 2018). "Cavitary Lung Diseases: A Clinical-Radiologic Algorithmic Approach". Chest. 153 (6): 1443–1465. doi:10.1016/j.chest.2018.02.026. PMID 29518379.
  6. ^ Cite error: The named reference Clinical Aspects of Chronic Cavities was invoked but never defined (see the help page).
  7. ^ a b Cite error: The named reference Cavitary Pulmonary Disease was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Cavitary Tuberculosis was invoked but never defined (see the help page).