A lung mass (also called pulmonary mass) is usually found on a chest X-ray or chest CT scan during a medical examination. When a lung mass is found, people may become concerned. However, there are different causes for lung mass. Further tests are often recommended to diagnose the cause and then appropriate treatment is given for the condition.
What is a lung mass?
A lung mass is an abnormal growth in the lung. On imaging, a lung mass is a round-like shadow measuring 3 cm or more with clear margins. Those smaller than 3 cm are considered to be lung nodules.
Causes
The common causes of lung mass are benign (non-cancerous) tumors, malignant (cancerous) tumors, and non-tumorous lesions.
Generally, lung mass is classified as benign or malignant. Benign masses are mostly caused by infectious granuloma, hamartoma, and other benign lesions. Malignant masses are often caused by lung cancer and metastatic cancer, which spreads from other parts of the body to the lungs.
Symptoms
Symptoms of a lung mass often include abnormal breathing, chest pain, weakness, chronic cough, and possibly weight loss and coughing up blood. They may vary depending on the nature, size, and location of the mass.
Diagnosis
A lung mass needs to be assessed for its likelihood of being benign or malignant. The assessment is based mainly on the size, margins, contour, and growth of the mass. In general, a mass with poorly defined borders, burrs, lobules, and pleural traction is more likely to be malignant. There are exceptions, however, which, despite their “ugly” appearance, may be benign. Some other features of the mass and the clinic features of the patient are also helpful in the evaluation of lung mass.
There are various diagnostic methods for patients with lung masses, chosen according to their condition. Commonly used methods are
- Physical exam and symptoms: clinical signs such as the patient’s symptoms and physical condition.
- Medical history: history of smoking, history of lung diseases, and history of exposure to hazardous materials, etc.
- Lab studies: lab evaluations include blood tests and sputum tests.
- X-ray: a chest x-ray may be helpful in the evaluation of lung mass.
- CT scan: CT scan of the chest is the most common and preferred method for the diagnosis of lung mass. Conventional CT, thin-section CT, and contrast CT are commonly used.
- PET-CT: an expensive and comprehensive examination.
- Biopsy: a biopsy of tissue in the lungs can enable a definitive diagnosis of lung mass.
- Bronchoscopy: minimally invasive and enables direct observation of lesions.
Treatment
The diagnosis of a lung mass is made on a case-by-case basis to determine the nature of the lesion and, once this has been confirmed, to decide on the course and type of treatment to be given.
Benign masses are slow-growing and do not usually spread. Benign masses are often not treated but are followed up regularly by a repeat chest CT based on the criteria. A mass that continues to grow during follow-up should be treated and managed aggressively. Benign masses can sometimes be treated symptomatically such as with anti-infective drugs or anti-tuberculosis treatment.
For cancerous masses, the appropriate treatment option depends on a number of factors. Common ones are whether the mass is primary or metastatic, central or peripheral, the stage of the mass, and the patient’s general condition. Surgery is the main treatment for cancerous lung masses. It allows complete removal of the primary focus and potentially metastatic lymph nodes in the chest. Other options are radiotherapy, chemotherapy, immunotherapy, etc.
Prevention
Prevention of lung masses starts with quitting smoking. Secondly, it’s helpful for your lung health to establish a proper lifestyle in your daily life, such as breathing fresh air, eating fruits and vegetables, exercising, etc.
In addition, if you have a lung mass, regular follow-up as prescribed by your doctor is necessary.