What is the differential diagnosis for a cavitating pulmonary mass lesion?
The differential is broad and includes malignancy (primary or secondary), infection (abscess, TB), inflammation (Wegeners, rheumatoid), vascular (infarction), trauma and congenital causes.
What would you suggest as fas as further investigation?
CT and referral to the local lung cancer clinic or MDT. Bronchoscopy may be able to reach this lesion depending on the local expertise. Small peripheral lesions can be reached with ultrasound and virtual bronchoscopy. A CT guided biopsy is the other option.
Irregular opacity (yellow dotted line) has a central air density lucency (red dotted line) with a horizontal inferior margin (blue arrows) consistent with an air-fluid level, indicative of cavitation.