CTICasesAggressive Primary Lung Cancer
Imaging findings
Serial CT chest scans over two years show a stable, slightly contracting spicular pulmonary nodule. A follow-up CT two years later shows rapid progression of the nodule into a very large mass in a patient presenting with an MCA stroke.
Key takeaways
Although the two-year stability rule is highly reliable for benign nodules, a minority of aggressive primary lung cancers (or carcinoids) can remain stable or contract slightly due to scarring before undergoing rapid, malignant growth. Radiologists should be aware of this rare exception.
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