CTICasesSquamous Cell Carcinoma of the Lung
Imaging findings
Chest radiograph and CT chest show a shaggy, speculated, and hypervascular right hilar mass causing compression of the bronchus intermedius and right upper lobe bronchus. PET-CT shows intense FDG avidity (SUV max >20). Bronchoscopy confirmed squamous cell carcinoma, after three prior non-diagnostic biopsies.
Key takeaways
This case highlights the risk of anchoring bias, where a shaggy hilar mass was misdiagnosed as Castleman's disease after three non-diagnostic biopsies. A highly speculated, necrotic hilar mass with extreme FDG avidity must be treated as bronchogenic carcinoma until proven otherwise, often requiring repeat bronchoscopy for diagnostic tissue.
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