Intensive Care Medicine (ICM) Practice Exam

What does a large homogeneous mass near the superior aspect of the hilum of the left lung on chest X-ray likely indicate?

1. Tumor

2. Abscess

3. Cyst

4. Normal

The correct answer is: Tumor

A large homogeneous mass near the superior aspect of the hilum of the left lung, as seen on a chest X-ray, most likely indicates a tumor. This area is critical for lung anatomy, where various structures such as major blood vessels, bronchi, and lymph nodes converge. A homogeneous mass suggests that the lesion has similar density throughout, which is characteristic of solid tumors, including primary lung cancers (like adenocarcinoma or squamous cell carcinoma) or metastatic lesions. When analyzing various other possibilities, an abscess typically presents with a specific pattern, including an air-fluid level due to the presence of pus, which would not appear homogeneous. Similarly, a cyst would typically be smaller and demonstrate a thinner wall with air or fluid inside, distinguishing it from a solid mass. A normal finding in this area would not be represented by a significant mass, as healthy hilum features are typically defined by normal vascular and bronchial structures without pronounced abnormalities. Thus, the presentation of a large homogeneous mass in the hilum corresponds to a tumor diagnosis, making this the most appropriate interpretation.