Differential Diagnosis for Necrotic Mass of Lungs
- Single most likely diagnosis
- Lung cancer (e.g., squamous cell carcinoma): This is a common cause of necrotic lung masses, especially in smokers or those with a history of smoking. The necrosis can be due to the tumor's rapid growth outpacing its blood supply.
- Other Likely diagnoses
- Pulmonary abscess: A localized collection of pus within the lung tissue, often caused by bacterial infection. It can appear as a necrotic mass on imaging studies.
- Tuberculosis (TB): Although more commonly associated with granulomatous changes, TB can cause caseous necrosis, leading to a necrotic appearance of lung masses.
- Fungal infections (e.g., aspergillosis): In immunocompromised patients, fungal infections can cause necrotic lung lesions.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism with infarction: Although not typically a mass, a large pulmonary embolism can cause infarction of lung tissue, which may appear necrotic.
- Septic emboli: Bacterial endocarditis or other sources of sepsis can lead to septic emboli in the lungs, causing necrotic lesions.
- Rare diagnoses
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): A form of vasculitis that can cause necrotic lung lesions.
- Pulmonary lymphoma: Primary or secondary lymphoma of the lung can cause necrotic masses, although this is less common.
- Echinococcal (hydatid) cysts: In endemic areas, these parasitic cysts can cause necrotic-appearing lung masses if they become infected or rupture.