Chapter 5 The borders of the nodule

Evaluation of Quiz - case 1 (2109)

Summary and comments - 29 colleagues have replied. Click here, to see the case study.

1. How to judge borders of the largest lesion which is in the upper part of the lobe?

0 The borders are regular.
1 The borders are blurred.
15 The borders are not regular but the irregularity is caused only by the presence of multiple nodules next to each other. Therefore, the nodule' borders should not be regarded as irregular.
13 The borders are irregular.

Expert comment. It is a reasonable assumption that the mass in the upper pole of the lobe is composed of more discrete nodules. However, even in this case, there is a nodule which has irregular spiculated margins. See the image here

2. Did you find a lesion or lesions in the right lobe which has or have blurred borders?

7 Yes, the nodular mass in the upper pole have blurred borders.
7 Yes, the nodule in the middle-dorsal part of the lobe has blurred borders.
8 Yes, the nodule in the lower third of the lobe which has macrocalcification, has blurred borders.
7 No, there is no nodule in the right lobe which has blurred borders.

Expert comment. I won't consider any nodules having blurred borders. Due to technical reasons, namely because of the low frame rate of ultrasound (25 frame/sec), we can always find seemingly blurred parts when we move with the transduced. Nevertheless, I would appreciate it if the colleague who doesn't think so would send an e-mail and write which part of which nodule she or he thinks is blurred.