Calcification

This radiograph demonstrates multiple bilateral calcified pulmonary nodules and hilar lymph nodes. The most common cause of this finding by far is granuloma formation secondary to healed infection. The calcifications typically do not resolve, but are of no clinical consequence. The infection in many cases is mild or subclinical. In areas of the United States where Histoplasma capsulatum is endemic, it is common to have one or more calcified granulomas without a history of significant infection. In this case, the patient did report a history of histoplasmosis. The exam is otherwise unremarkable.

The differential includes calcified metastasis (such as from osteosarcoma), nodular sarcoidosis, and miliary TB among others, though these are significantly less common.