CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer

Objective:To investigate CT findings of tuberculosis nodules or masses misdiagnosed as lung cancer and analyze their causes.Methods:40 patients with tuberculosis lesions≥1cm in diameter were misdiagnosed as lung cancer on CT.The shape,internal features,enhanced features,margin,adjacent lymph nodes and lung tissue changes were analyzed retrospectively.The causes of misdiagnosis were also analyzed.Results:(1)The shape and location of the lesion:oval in 22 cases,lobulated in 10 cases,irregular in 8 cases.18 cases in upper lobe,12 cases in lower lobe,10 cases in middle lobe.(2)Internal features:inhomogeneous density in 28 cases,cavitation in 3 cases,calcification in 7 cases,cavitations with calcification in 2 cases.(3)Lesion enhancement characteristics: moderate inhomogeneous enhancement in 18 cases,moderate homogeneous enhancement in 5 cases,slightly inhomogeneous enhancement in 6 cases,no enhancement in 11 cases.(4)Marginal features and adjacent tissue changes:irregular margin in 40 cases,12 cases of ill-defined margin,spicule sign in 18 cases,satellite lesions in 40 cases,pleural thickening and adhesions in 11 cases,pleural indentation in 3 cases,drainage of the bronchial wall by thickness in 5 cases.(5)Hilar and mediastinal lymph nodes:Lymph nodes enlargement in 31 cases. Lymph nodes homogeneous enhancement in 21 cases,ring enhancement in 4 cases,no enhancement in 6 cases. Conclusion:CT findings of tuberculosis nodules or masses misdiagnosed as lung cancer were not typical.Nodules or masses with satellite lesions may be suggestive of tuberculosis,but biopsy to confirm the diagnosis was necessary.