CTICasesNecrotizing Tuberculosis Mimicking Metastatic Disease
Imaging findings
Chest radiography and abdominal CT scout images demonstrate a large, cavitary left upper lobe mass. Non-contrast axial chest CT confirms a large necrotizing and cavitary left upper lobe opacity with adjacent small airways containing intraluminal soft tissue material, representing bronchiolar impaction. A persistent left superior vena cava is also noted as an incidental anatomical variant.
Key takeaways
In patients with a known malignancy such as breast cancer, a solitary cavitary lung mass should not be immediately assumed to represent metastatic disease. The presence of necrotizing changes and intraluminal debris in adjacent small airways strongly points toward an infectious process, such as Mycobacterium tuberculosis or fungal infections, rather than tumor metastases.
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