Wolf in Sheep's Clothing: Primary Lung Cancer Mimicking Benign Entities

Annemie Snoeckx, Amélie Dendooven, Laurens Carp, Damien Desbuquoit, Maarten J. Spinhoven, Patrick Lauwers, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)


Lung cancer is the most common cancer worldwide. On imaging, it typically presents as mass or nodule. Recognition of these typical cases is often straightforward, whereas diagnosis of uncommon manifestations of primary lung cancer is far more challenging. Lung cancer can mimic a variety of benign entities, including pneumonia, lung abscess, postinfectious scarring, atelectasis, a mediastinal mass, emphysema and granulomatous diseases. Correlation with previous history, clinical and biochemical parameters is necessary in the assessment of these cases, but often aspecific and inconclusive. Whereas 18F-fluorodeoxyglucose (18F-FDG) Positron Emission Tomography is the cornerstone in staging of lung cancer, its role in diagnosis of these uncommon manifestations is less straightforward since benign entities can present with increased 18F-FDG-uptake and, on the other hand, a number of these uncommon lung cancer manifestations do not exhibit increased uptake. Chest Computed Tomography (CT) is the imaging modality of choice for both lesion detection and characterization. In this pictorial review we present the wide imaging spectrum of CT-findings as well as radiologic-pathologic correlation of these uncommon lung cancer manifestations. Knowledge of the many faces of lung cancer is crucial for early diagnosis and subsequent treatment. A multidisciplinary approach in these cases is mandatory.

Original languageEnglish
Pages (from-to)109-117
Number of pages9
JournalLung Cancer
Publication statusPublished - 1 Oct 2017
Externally publishedYes


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