CTICasesCavitating Squamous Cell Carcinoma mimicking Lung Abscess
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Imaging findings
Chest radiograph shows a subtle air-fluid level on the PA view and a large, thick-walled cavity in the anterior aspect of the left upper lobe on the lateral view. CT shows a thick-walled cavity without significant surrounding inflammation. The patient had emphysema and failed to improve with multiple courses of antibiotics for presumed community-acquired pneumonia.
Key takeaways
Cavitating squamous cell carcinoma can mimic a lung abscess, especially when it is thick-walled and there is minimal surrounding inflammation. Lack of improvement despite antibiotic treatment, presence of emphysema, and characteristic radiographic features (thick wall, minimal surrounding inflammation) should raise suspicion for malignancy rather than just infection. While TB is a possibility with cavities, anterior upper lobe lesions without posterior involvement are less typical for TB. Definitive diagnosis requires biopsy.
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