Occasionally, you may stumble upon a lung mass while evaluating for B lines or other common pathologies. Particularly, ultrasonography is good at detecting primary and metastatic lung masses adjacent to the pleural surface. They typically appear as hypoechoic areas that are distinct from consolidated or hepatized lung, with normally aerated lung appearing in the scan field with respiration. Consolidation and fluid bronchograms may be been seen adjacent to the mass.
It is interesting to note that ultrasonography has been shown to have better sensitivity and specificity (89% and 95% respectively) for assessing chest wall involvement by a lung tumor compared to CT scan. Extension of the tumor beyond the parietal pleura into the chest wall can be determined if the mass breaches the pleura and stops moving with respiration. If trying to find this, use a high resolution linear probe. Spectral Doppler may be helpful in differentiating malignant versus benign masses but it is beyond the scope of NephroPOCUS.