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What Is the Best Approach to a Cavitary Lung Lesion?

The Hospitalist. 2015 March;2015(03):
March 3, 2015 | The Hospitalist
Patrick Rendon, MD ; Charles Pizanis, MD ; Marc Montanaro, MD ; Erik Kraai, MD ; University Of New Mexico School Of Medicine ; Albuquerque

Drs. Rendon, Pizanis, Montanaro, and Kraai are hospitalists in the department of internal medicine at the University of New Mexico School of Medicine in Albuquerque.

Key Points

  • Use associated clinical and radiographic features of the cavitary lung lesion to determine the likely etiology and diagnostic strategy.
  • There are several branching points in the approach to a cavitary lung lesion, the first being to establish whether the condition is infectious or noninfectious.
  • If it is more likely to be infectious, then risk factors and underlying immunocompromise must be considered in the empiric treatment and diagnostic strategy.
  • If it is more likely to be noninfectious, then the patient should be evaluated with biopsy if there is concern for malignancy, appropriate serologies for suspected rheumatologic diseases, or further imaging if the condition is considered related to pulmonary infarct or other, more rare, etiologies.

Additional Reading

References

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