This is a 47 year old healthy male who had a chest radiograph for a chest injury. A nodule was seen in the LUL, and a CT was done. He does not smoke, nor had any exposure history. The CT images are shown. Does this require biopsy or is this a granuloma? It was not present on a CXR 5 years ago.
March 17, 2009 at 7:49 pm |
I think it’s probably a calcified granuloma. Calcifications are also present in the ipsilateral hilar node, and the spleen consistent with histoplasmosis. I would check histo serologies, place a PPD, and plan to do a follow-up CT scan in 3 months. If the nodule grows in the interim you could do a CT/PET or the nodule is probably amenable to CT guided needle biopsy.