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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Tomography |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2379-139X/8/1/41 |
| _version_ | 1797476360002732032 |
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| author | Alessia Guarnera Elena Santini Pierfrancesco Podda |
| author_facet | Alessia Guarnera Elena Santini Pierfrancesco Podda |
| author_sort | Alessia Guarnera |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T20:56:47Z |
| format | Article |
| id | doaj.art-be3da222881f46f793414265cf2a2b48 |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T20:56:47Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-be3da222881f46f793414265cf2a2b482023-11-23T22:19:52ZengMDPI AGTomography2379-13812379-139X2022-02-018151352810.3390/tomography8010041COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping PathologiesAlessia Guarnera0Elena Santini1Pierfrancesco Podda2Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, ItalyRadiology Department, San Giovanni Addolorata Hospital, 00184 Rome, ItalyRadiology Department, San Giovanni Addolorata Hospital, 00184 Rome, ItalyThe 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.https://www.mdpi.com/2379-139X/8/1/41COVID-19omicronvariantsWHO2021lung cancer |
| spellingShingle | Alessia Guarnera Elena Santini Pierfrancesco Podda COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies Tomography COVID-19 omicron variants WHO 2021 lung cancer |
| 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 | COVID-19 omicron variants WHO 2021 lung cancer |
| url | https://www.mdpi.com/2379-139X/8/1/41 |
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