CTICasesSuperinfected Pulmonary Adenocarcinoma
Imaging findings
Frontal and lateral chest radiographs show a large, rounded, and lobulated mass in the right lower lobe/hilar region. Chest CT shows a markedly low-attenuation, necrotic, or liquefactive mass with a thin peripheral soft-tissue rim. An endobronchial soft-tissue component is present, causing obstruction of the bronchus intermedius. Biopsy confirms mucinous adenocarcinoma, and cultures yield Streptococcus and Aspergillus Niger group.
Key takeaways
Necrotizing lung cancer can occasionally mimic a simple pulmonary abscess or infected cyst. Large central adenocarcinomas causing bronchial obstruction are prone to post-obstructive infection and central necrosis, which can result in positive bacterial and opportunistic fungal cultures (such as Aspergillus or Streptococcus) from the necrotic center.
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