Learning objectives
This exhibit will allow the radiologist to recognise the various causes of calcific and high attenuation lesions in the lungs,
differentiate benignfrom more important malignantand metabolicconditions.
Background
Pulmonary calcification is commonly encountered,
often being visible even on plain radiographs.
CT enables more accurate localization and characterization of calcification which has a wide differential diagnosis.
The radiologist has to know when calcification is due to a benign cause and when it can signify more important malignant or metabolic disease.
Imaging findings OR procedure details
Starting with the benign causes of pulmonary calcification,
one of the most commonly encountered and incidentally found pulmonary nodules are granulomas (Figure 1).
Granulomas are not a specific disease entity unto themselves,
rather,
an end point of an infective or inflammatory process which forms focal aggregation of macrophages due to infection or inflammation.
These are most commonly encountered as small,
well-defined and calcified nodules requiring no further investigation or follow-up as they are often clinically of no significance.[1]
These appearances are typical for a hamartoma....
Conclusion
Pulmonary calcification and high attenuation is commonly encountered with a wide differential diagnosis.
This exhibit helpsenable the radiologist to identify more important pathology and differentiate from benign causes to facilitate accurate ongoing management.
References
Ohshimo S,
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Differential diagnosis of granulomatous lung disease: clues and pitfalls.
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Suut S,
Al-Ani Z,
Allen C,
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Pictorial essay of radiological features of benign intrathoracic masses.Ann Thorac Med.
2015;10(4):231-42.
Miller BH,
Rosado-de-christenson ML,
Mcadams HP et-al.
Thoracic sarcoidosis: radiologic-pathologic correlation.
Radiographics.
1995;15 (2): 421-37.
Helbich TH,
Wojnarovsky C,
Wunderbaldinger P et-al.
Pulmonary alveolar microlithiasis in children: radiographic and high-resolution CT findings.
AJR Am J Roentgenol.
1997;168 (1): 63-5
Peros-Golubicić T,
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