Cavitating Lung Mass

History: 65 year old male with chronic lymphocytic leukemia presents with cough and left sided chest pain. 

Lung mass: Single axial CT scan of the chest in lung windows shows a mass in the medial left upper lobe extending towards the left hilum.

Cavitary lung mass: Two weeks later in the same patient, the same mass is seen, although now there is frank cavitation.

The differential for cavitating lung mass is wide, including neoplasms such as non-small cell lung cancer (NSCLC), lung metastases, lung abscess, mycobacterial pneumonia, fungal pneumonia, and septic pulmonary emboli. This patient underwent bronchoscopy which turned out to be negative for infection. The final diagnosis was cavitary pulmonary lymphoma, which is a rare manifestation of lymphoma.

Read about the differential diagnosis of lung masses here!