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

1
Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy
2
Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, 00189 Rome, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2022, 8(1), 513-528; https://doi.org/10.3390/tomography8010041
Received: 26 December 2021 / Revised: 6 February 2022 / Accepted: 8 February 2022 / Published: 11 February 2022
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. View Full-Text
Keywords: COVID-19; omicron; variants; WHO; 2021; lung cancer; cancer; ground glass; SARS-CoV-2; pneumonia; crazy paving; artificial intelligence COVID-19; omicron; variants; WHO; 2021; lung cancer; cancer; ground glass; SARS-CoV-2; pneumonia; crazy paving; artificial intelligence
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MDPI and ACS Style

Guarnera, A.; Santini, E.; Podda, P. COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies. Tomography 2022, 8, 513-528. https://doi.org/10.3390/tomography8010041

AMA Style

Guarnera A, Santini E, Podda P. COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies. Tomography. 2022; 8(1):513-528. https://doi.org/10.3390/tomography8010041

Chicago/Turabian Style

Guarnera, Alessia, Elena Santini, and Pierfrancesco Podda. 2022. "COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies" Tomography 8, no. 1: 513-528. https://doi.org/10.3390/tomography8010041

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