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Q. Is it possible to see lung cancer in CAT scan if pleural effusion is present?

Answered by
Dr. Chitrangada
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 27, 2018

Hello doctor,

How likely is a CAT scan to show a lung cancer if a pleural effusion is present? My husband has a pleural effusion and has had four CT scans, none of which show any suspicious mass. Cytology records are inconclusive. I am wondering if the presence of the pleural effusion limits the visibility of a potential tumor? What about in the presence of a middle lobe collapse, could that be hiding a tumor? He has right side pain, short of breath, and was admitted to hospital and fluid drained.

Dr. Chitrangada

Radiodiagnosis Radiology
#

Hi,

Welcome to icliniq.com.

Detection of tumor on CAT (computed tomography) scan has nearly 85 to 90 percent efficacy which further increases to 95 percent in post-contrast studies. The pleasurable effusion can be due to numerous causes and in your case due to mucous plugging causing lung lobe collapse-tumor need to be the cause always so do not be apprehensive about that. Any heterogenous abnormal enhancement can be a tumor seen in contrast scan which is not present in your scan.


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Thank you doctor,

But is it possible a tumor is there and not visible due to the pleural fluid and lung collapse?

Dr. Chitrangada

Radiodiagnosis Radiology
#

Hi,

Welcome back to icliniq.com.

On CT, we see structures based on their densities. So pleural fluid will have less density than a mass and will be dark whereas a mass or tumor will be more solid and will appear relatively bright even on plain scans and with a contrast, it will become brighter. So, it is highly unlikely to be missed. Take care and if possible, do upload the scans. I can review them for you if you want.


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Thank you doctor,

Can you help me understand whether or not a tumor or mass can be identified if it is in the area of the lung that has collapsed? My husband has a near complete right middle lobe collapse. If there were a tumor in that area of the long, with CAT scan can it be seen?

Dr. Chitrangada

Radiodiagnosis Radiology
#

Hi,

Welcome back to icliniq.com.

Any tumor develops abnormal vessels with leaky channels, therefore, it enhances abnormally on contrast CT scan and is hence detected even in a collapsed lung. Therefore, it is easily detected. Take care.


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