calcified pulmonary nodules
Calcified pulmonary nodules are a subset of hyperdense pulmonary nodules and a group of nodules with a relatively narrow differential.
Pathology
Etiology
The most common cause of nodule calcification is granuloma formation, usually in the response to healed infection.
- healed infection
- calcified granulomata, e.g. thoracic histoplasmosis, recovered miliary tuberculosis (rare)
- most common
- 2-5 mm
- calcification may be central or diffuse
- usually with calcification of hilar/mediastinal nodes
- healed varicella pneumonia
- micronodular (1-3 mm)
- no associated nodal calcification
- calcified granulomata, e.g. thoracic histoplasmosis, recovered miliary tuberculosis (rare)
- occupational disease/pneumoconioses
- silicosis
- associated with nodal egg-shell calcification
- multiple small densely calcified nodules in mid and upper zones
- coalworker's pneumoconiosis
- smaller nodules which may not be visible on plain film
- associated with minimal symptoms
- silicosis
- pulmonary hamartomas
- metastatic pulmonary calcification
- typically nodules are poorly defined and larger (3-10 mm)
- calcium and phosphate metabolism abnormalities
- chronic renal failure
- multiple myeloma
- secondary hyperparathyroidism
- massive osteolysis caused by metastases
- intravenous calcium therapy
- pulmonary hemosiderosis
- idiopathic pulmonary hemosiderosis
- recurrent alveolar hemorrhage
- centrilobular nodular opacities
- mitral stenosis
- small multifocal calcified nodules
- Goodpasture syndrome
- idiopathic pulmonary hemosiderosis
- pulmonary alveolar microlithiasis
- tiny micronodules
- apparent calcification of interlobular septa
- small subpleural cysts
- sarcoidosis
- calcifying fibrous pseudotumor of lung
- pulmonary amyloidosis
- pulmonary hyalinising granuloma
- calcified pulmonary metastases
See also
