Apical Cap Lesions

Synonyms

Apical cap fibrosis; Apical scar; Pulmonary apical cap

Definition

Apical cap lesion is a localized form of pulmonary fibrosis. Apical cap lesion typically affects the apical pleura of the upper lobes but can also affect lower lobes. The lesion is usually an incidental finding but patients may seldom present with hemoptysis. Higher resolution imaging has allowed for better visualization of this lesion, which may resemble a neoplasm, and prompt a biopsy or resection.

Clinical Features

• Incidence

  Apical cap lesion is relatively rare.

• Age

  Apical cap lesion is typically found in patients in the sixth decade of life.

• Sex

  There is no known gender predilection.

• Site

  Apical lesion is frequently bilateral and occurs in the apices of upper lobes and less commonly the apices of the lower lung lobes.

• Treatment

  Excision is curative but unnecessary for this benign condition.

• Outcome

  Apical cap lesion is uniformly benign.

Macroscopy

Apical cap lesions typically have a gray, wedge shape, and...