Uncategorized

Here is the finalized set of 10 MCQs on Solid Lung Mass, incorporating your suggestions, nuanced details about air bronchograms, and updated references.

MCQs on Solid Lung Mass

Question 1

What is the size threshold for a lesion to be classified as a solid lung mass according to the Fleischner Society?
A. >1 cm
B. >2 cm
C. >3 cm
D. >4 cm

Correct Answer: C. >3 cm
Explanation: “A lung mass is defined as a parenchymal lesion exceeding 3 cm in diameter. Lesions smaller than 3 cm are considered nodules.”
References:

Question 2

Which calcification pattern in a lung mass is most associated with hamartomas?
A. Psammommatous calcifications
B. Popcorn-like calcifications
C. Dystrophic calcifications
D. Central calcifications

Correct Answer: B. Popcorn-like calcifications
Explanation: “Popcorn calcifications are pathognomonic for hamartomas and indicate a benign etiology.”
References:

Question 3

Which feature of a lung mass suggests Castleman disease?
A. Cavitation
B. Dystrophic calcifications
C. Psammommatous calcifications
D. Air bronchogram

Correct Answer: B. Dystrophic calcifications
Explanation: “Castleman disease may present with dystrophic calcifications in a localized mediastinal or pulmonary mass, mimicking a neoplasm.”
References:

Question 4

Which imaging feature of a lung mass is most concerning for malignancy?
A. Popcorn calcification
B. Spiculated or irregular margins
C. Smooth margins
D. Central calcification

Correct Answer: B. Spiculated or irregular margins
Explanation: “Spiculated margins are a hallmark of malignancy, associated with invasive behavior and irregular growth patterns.”
References:

Question 5

What is the most common cause of a solid lung mass?
A. Granulomatous diseases
B. Primary lung cancer
C. Hamartoma
D. Tuberculosis

Correct Answer: B. Primary lung cancer
Explanation: “Primary lung cancer remains the leading cause of solitary lung masses, with adenocarcinoma being the most frequent subtype.”
References:

Question 6

Which feature of a lung mass is characteristic of amyloidosis?
A. Fat attenuation
B. Calcifications with air bronchograms
C. Spiculated margins
D. Cystic appearance

Correct Answer: B. Calcifications with air bronchograms
Explanation: “Amyloidosis can manifest as focal or diffuse pulmonary masses, often demonstrating calcifications and air bronchograms.”
References:

Question 7

Which subtype of lung cancer is commonly associated with a central lung mass?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Large cell carcinoma
D. Metastatic carcinoma

Correct Answer: B. Squamous cell carcinoma
Explanation: “Squamous cell carcinoma frequently arises centrally, near the large airways, and may present as a cavitating mass.”
References:

Question 8

What is the significance of a lung mass with air bronchograms?
A. Pathognomonic for malignancy
B. Suggestive of alveolar filling processes, both benign and malignant
C. Indicative of benignity, commonly seen in amyloidosis
D. Exclusive to infectious etiologies, such as fungal infections

Correct Answer: B. Suggestive of alveolar filling processes, both benign and malignant
Explanation: “Air bronchograms in a solid lung mass are indicative of alveolar filling processes, which can occur in both benign conditions, such as amyloidosis, and malignant processes, such as adenocarcinoma with lepidic growth.”
References:

Question 9

Which lung mass characteristic is most suggestive of malignancy?
A. Rapid growth over weeks
B. Presence of air bronchograms and lepidic growth pattern
C. Presence of fat and popcorn calcifications
D. Associated pleural effusion

Correct Answer: B. Presence of air bronchograms and lepidic growth pattern
Explanation: “Air bronchograms are often seen in malignancy, particularly in adenocarcinoma with lepidic growth, where the tumor cells replace alveolar walls but maintain patent airways.”
References:

Question 10

What is the role of PET-CT in evaluating a solid lung mass?
A. Identifies calcification patterns
B. Distinguishes between solid and cavitating lesions
C. Assesses metabolic activity but can be positive in both malignancy and active infections
D. Evaluates vascular invasion

Correct Answer: C. Assesses metabolic activity but can be positive in both malignancy and active infections
Explanation: “PET-CT is invaluable for assessing metabolic activity of lung masses, with high FDG uptake strongly suggestive of malignancy. However, false positives can occur in active infections and inflammatory processes.”
References: