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

Abstract：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.