Right Lower Lobe Lung Mass

Author: Paul Schipper, MD
Institution: OHSU
Date Reviewed: June 2025
Original Case: Mark Allen, MD
Learning Domain: General Thoracic
Learning Objective: Diagnosis and Management of large mass in the RLL
PowerPoint File: Right Lower Lobe Lung Mass

Discussion Points

• Interpretation of Diagnostic tests
  • Review CXT and CT
• Why are the PFTs so poor
  • Low MVV – poor effort
• Therapeutic options
  • Biopsy (TTNA), bronchoscopy, surgery
• What incision to use?
  • Lateral thoracotomy, clam shell, median sternotomy

Learning Points

• Read the CXR and CT carefully
• Understand what can spuriously lead to low PFTs
• Large tumors may need different approach

Pathology

• Metastatic Leiomyoma from the endometrial cancer
• Right lower lobectomy done via thoracotomy