Cargando…

COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies

The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis...

Descripción completa

Detalles Bibliográficos
Autores principales: Guarnera, Alessia, Santini, Elena, Podda, Pierfrancesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875889/
https://www.ncbi.nlm.nih.gov/pubmed/35202206
http://dx.doi.org/10.3390/tomography8010041
_version_ 1784658039748427776
author Guarnera, Alessia
Santini, Elena
Podda, Pierfrancesco
author_facet Guarnera, Alessia
Santini, Elena
Podda, Pierfrancesco
author_sort Guarnera, Alessia
collection PubMed
description The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis leading to patients’ poor prognosis and late medical treatment. The radiologist plays a pivotal role as CT represents a non-invasive radiological technique which may help to identify possible overlap and differential diagnosis between COVID-19 pneumonia and lung cancer, which represents the most frequent cancer histology in COVID-19 patients. Our aims are: to present the main CT features of COVID-19 pneumonia; to provide the main differential diagnosis with lung cancer, chemotherapy-, immunotherapy-, and radiotherapy-induced lung disease; and to suggest practical tips and key radiological elements to identify possible overlap between COVID-19 pneumonia and lung cancer. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis. It is crucial to search for typical COVID-19 pneumonia phase progression and typical radiological features on HRTC. The evidence of atypical findings such as lymphadenopathies and mediastinal and vessel invasion, as well as the absence of response to therapy, should arouse the suspicion of lung cancer and require contrast administration. Ground-glass areas and/or consolidations bound to radiotherapy fields or pneumonitis arising during and after oncological therapy should always arouse the suspicion of radiation-induced lung disease and chemo/immunotherapy-induced lung disease. The radiological elements we suggest for COVID-19 and lung cancer differential diagnosis may be used to develop AI protocols to guarantee an early and proper diagnosis and treatment to improve patients’ quality of life and life expectancy.
format Online
Article
Text
id pubmed-8875889
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88758892022-02-26 COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies Guarnera, Alessia Santini, Elena Podda, Pierfrancesco Tomography Review The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis leading to patients’ poor prognosis and late medical treatment. The radiologist plays a pivotal role as CT represents a non-invasive radiological technique which may help to identify possible overlap and differential diagnosis between COVID-19 pneumonia and lung cancer, which represents the most frequent cancer histology in COVID-19 patients. Our aims are: to present the main CT features of COVID-19 pneumonia; to provide the main differential diagnosis with lung cancer, chemotherapy-, immunotherapy-, and radiotherapy-induced lung disease; and to suggest practical tips and key radiological elements to identify possible overlap between COVID-19 pneumonia and lung cancer. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis. It is crucial to search for typical COVID-19 pneumonia phase progression and typical radiological features on HRTC. The evidence of atypical findings such as lymphadenopathies and mediastinal and vessel invasion, as well as the absence of response to therapy, should arouse the suspicion of lung cancer and require contrast administration. Ground-glass areas and/or consolidations bound to radiotherapy fields or pneumonitis arising during and after oncological therapy should always arouse the suspicion of radiation-induced lung disease and chemo/immunotherapy-induced lung disease. The radiological elements we suggest for COVID-19 and lung cancer differential diagnosis may be used to develop AI protocols to guarantee an early and proper diagnosis and treatment to improve patients’ quality of life and life expectancy. MDPI 2022-02-11 /pmc/articles/PMC8875889/ /pubmed/35202206 http://dx.doi.org/10.3390/tomography8010041 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Guarnera, Alessia
Santini, Elena
Podda, Pierfrancesco
COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title_full COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title_fullStr COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title_full_unstemmed COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title_short COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies
title_sort covid-19 pneumonia and lung cancer: a challenge for the radiologist review of the main radiological features, differential diagnosis and overlapping pathologies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875889/
https://www.ncbi.nlm.nih.gov/pubmed/35202206
http://dx.doi.org/10.3390/tomography8010041
work_keys_str_mv AT guarneraalessia covid19pneumoniaandlungcancerachallengefortheradiologistreviewofthemainradiologicalfeaturesdifferentialdiagnosisandoverlappingpathologies
AT santinielena covid19pneumoniaandlungcancerachallengefortheradiologistreviewofthemainradiologicalfeaturesdifferentialdiagnosisandoverlappingpathologies
AT poddapierfrancesco covid19pneumoniaandlungcancerachallengefortheradiologistreviewofthemainradiologicalfeaturesdifferentialdiagnosisandoverlappingpathologies