Nodule – ChestDB.com

Case 47

Normal & Variants / Age <30, Calcification, Cervical Rib, Congenital, Histoplasmosis, Nodule, Thoracic Outlet Syndrome

This radiograph demonstrates bilateral cervical ribs, right greater than left. They are congenital and may be of no clinical significance. In some individuals, it can cause or contribute to thoracic outlet syndrome by compressing the subclavian vein, artery, and/or nerve. Cervical ribs may be resected in these cases.

There is also an incidental small, dense (likely calcified) nodule in the right lower lung and a probable calcified right hilar lymph node. This patient lives in an endemic area for Histoplasma capsulatum. Remote infection is the most likely etiology.

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Case 31

Chronic & ILD, Infectious/Inflammatory / Age 31-60, Calcification, Granulomatous Disease, Histoplasmosis, Nodule

This radiograph demonstrates multiple bilateral calcified pulmonary nodules and mediastinal/hilar lymph nodes. This is usually due to a remote history of granulomatous inflammation. Sarcoidosis and fungal infections (in endemic areas) are common causes. The calcifications do not resolve but are of no clinical consequence. This patient reported a history of histoplasmosis, and the extent of the calcifications suggest it was a more advanced case. However, in areas of the United States where Histoplasma capsulatum is endemic, it is common to have a few calcified nodules and/or lymph nodes without a reported history of significant infection. The differential for calcified nodules does include a few more serious entities including calcified metastases (such as from osteosarcoma) and tuberculosis infection.

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