9 Multiple Pulmonary Nodules on Computed Tomography

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig C 9-1 Septic pulmonary emboli. Multiple cavitating nodules (Nocardia) in a young immunocompromised man. Note the feeding vessel sign (vessel leading directly to the nodule) in several nodules (arrows).30

• Fig C 9-2 Blastomycosis. Multiple intermediate-sized nodules in a patient with persistent and worsening symptoms of cough, chest pain, and fevers.23

• Fig C 9-3 Hematogenous metastases. Several cavitating nodules (arrows) in both lower lobes with irregular thickening of the walls in a patient with metastatic squamous cell cancer of the lungs.22

• Fig C 9-4 Kaposi's sarcoma. Innumerable, bilateral, poorly defined peribronchovascular micronodules, some of which exhibit coalescence.6

• Fig C 9-5 Bronchioloalveolar carcinoma. (A) Ground-glass lesions bilaterally. The mass in the left lower lobe also contains solid elements, consistent with the diagnosis of bronchoialveolar carcinoma with adenocarcinoma features. (Courtesy of Diana Litmanovich, M.D., Boston) (B) Multiple thin-walled cystic lesions in the right lower lobe.122

• Fig C 9-6 Pulmonary papillomatosis. Multiple cavitating lung nodules, some of which contain air-fluid levels.25

• Fig C 9-7 Lymphoma. Multiple pulmonary nodules on a study obtained 10 months after cardiac transplantation.123

• Fig C 9-8 Wegener's granulomatosis. Multiple irregular nodules in a peribronchovascular distribution.109

• Fig C 9-9 Rheumatoid necrobiotic nodules. Two large, pleural-based nodules (large arrows) are seen at the level of the left upper lobe. The nodules are associated with marked posterior left-sided pleural thickening (small arrows).147

• Fig C 9-10 Sarcoidosis. Two images show parenchymal nodules of high attenuation involving both lungs.148

• Fig C 9-11 Progressive massive fibrosis. Conglomerate masses and adjacent small nodules in coal workers' pneumoconiosis. The arrowhead points to a thoracostomy tube that was placed in the left hemithorax for a pneumothorax.149

• Fig C 9-12 Talc-induced lung disease. Bilateral irregular nodular areas of high attenuation in the upper lobes.10