09/07/2026
A cavitary lesion in the lung cannot be called benign from an image. The only way to know is tissue.
We recently resolved this matter with a radiologist and a gastroenterologist in lieu of trial.
Our clients’ father drove a truck most of his life. He liked the work, the miles, and the independence. Four kids, six grandchildren, and still working when this started.
He saw a gastroenterologist for reflux and bloating. Routine workup, including an abdominal CT.
The radiologist saw a two centimeter thick-walled cavitary lesion at the base of the right lung and called it ‘likely related prior infection.’ There was nothing to support that. No comparison imaging, no records, no history of infection. The finding never made the impression, malignancy was never in the differential, and no chest CT was recommended.
The gastroenterologist got that report and told him the scan was unrevealing. Through two years of follow-up visits, admittedly, nobody ever mentioned there was something in his lung.
Twenty-eight months later he came in short of breath with bilateral pulmonary emboli. The lesion was now over five centimeters. Adenocarcinoma of the lung was diagnosed, which had spread to spine and brain. He was now Stage IV and incurable.
At the original scan it was Stage IA, eighty to eighty-five percent five year survival, treatable with surgery alone. Instead he got immunotherapy that slowed nothing, clotting that cost him part of a foot, and a stroke. He died at home five months after diagnosis, in his fifties.
Every physician deposed agreed imaging alone cannot separate infection from cancer here. Two specialists had the finding in front of them. The patient was the only one who never learned it existed.
Findings do not act on themselves. Somebody has to tell the patient.