Chest imaging: wall thickness of a cavity: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Chest imaging: wall thickness of a cavity

Sample item

A chest CT of a 60-year-old smoker shows a solitary cavitating lung lesion in the upper lobe with a thick, irregular, nodular wall and an eccentric lumen. Which feature supports malignancy over benign disease?

AMultiple air-fluid levels with surrounding consolidationBCentral lumen with satellite nodules and a fluid level onlyCThick wall with irregular nodular inner marginDThin smooth wall of less than 4 mm

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Thick wall with irregular nodular inner margin

Wall thickness over 15 mm with a nodular, irregular inner surface is much more common with cavitating carcinoma, mainly squamous cell. Thin smooth walls favour benign lesions such as abscess healing or cysts.

Option by option

A. Multiple air-fluid levels with surrounding consolidation
A fluid level with consolidation favours abscess.
B. Central lumen with satellite nodules and a fluid level only
Satellite nodules and a fluid level suggest infection rather than carcinoma.
C. Thick wall with irregular nodular inner margin (correct)
Correct. A thick irregular wall favours carcinoma.
D. Thin smooth wall of less than 4 mm
A thin smooth wall favours a benign process.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Thick wall with irregular nodular inner margin. Wall thickness over 15 mm with a nodular, irregular inner surface is much more common with cavitating carcinoma, mainly squamous cell.

Why is "Multiple air-fluid levels with surrounding consolidation" not the answer?

A fluid level with consolidation favours abscess.

Why is "Central lumen with satellite nodules and a fluid level only" not the answer?

Satellite nodules and a fluid level suggest infection rather than carcinoma.

Why is "Thin smooth wall of less than 4 mm" not the answer?

A thin smooth wall favours a benign process.

What concept does this question test?

It tests Chest imaging: wall thickness of a cavity in Radiology. Thin smooth walls favour benign lesions such as abscess healing or cysts.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: wall thickness of a cavity?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.