Granuloma or not?

February 5, 2009

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.