CTICasesPulmonary Infarction due to Central Lung Cancer (Dumbbell Phenomenon)
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Imaging findings
Chest radiograph showed peripheral consolidation in the right upper lobe and a large central mass. CT revealed a very large central lung cancer obstructing the right pulmonary artery. The peripheral consolidation showed pseudo-cavitation and no contrast uptake during the levo phase, consistent with infarction. PET showed uptake in the central and lower lobe mass (cancer) but no uptake in the infarcted peripheral area.
Key takeaways
This case demonstrated a rare phenomenon where a central lung cancer (small cell lung cancer) caused a pulmonary infarction by obstructing the pulmonary artery. The peripheral consolidation was an infarct, not cancer, and subsequently scarred down after chemoradiotherapy. This is sometimes referred to as a "dumbbell phenomenon," where a central tumor is combined with a peripheral infarct.
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