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Media Gallery

Right upper lobe nodule shows peripheral calcification and high Hounsfield unit enhancement, suggesting that the lesion is a calcified, benign pulmonary nodule.
A 1.5-cm coin lesion in the left upper lobe in a patient with prior colonic carcinoma. Transthoracic needle biopsy findings confirmed this to be a metastatic deposit.
Mediastinal windows of the patient in the previous image
Right lower lobe nodule demonstrating central calcification. The most likely diagnosis is histoplasmosis.
Close-up view of a right lower lobe nodule demonstrating central calcification. The most likely diagnosis is histoplasmosis.
Left upper lobe cavitating solitary nodule eventually identified as active pulmonary tuberculosis from percutaneous needle biopsy findings.
A left upper lobe nodule with central lucency and poorly circumscribed margins was diagnosed as actinomycosis based on needle biopsy findings.
Computed tomography (CT) scan of the patient in the previous image. After needle biopsy, the presence of classic sulfur granules confirmed a diagnosis of actinomycosis.
A right lower lobe solitary pulmonary nodule that was later identified as a hamartoma.
Wedge-shaped peripheral (pleural based) density observed secondary to pulmonary infarction (pulmonary embolism). This is termed the Hampton hump.
Left upper lobe 1.5-cm nodule shows negative computed tomography (CT) scan numbers, suggesting fat in the lesion consistent with hamartoma.
A left upper lobe solitary pulmonary nodule. The differential diagnosis in such cases is large, but computed tomography (CT) scan findings help to narrow the differentials and establish the diagnosis.
Cavitating right lower lobe nodule later confirmed to be primary pulmonary lymphoma. Calcium deposits may also be present in the lesion.
This left lower lobe carcinoid tumor was quite bloody after a percutaneous needle biopsy was performed.
Lateral radiograph of the patient in the previous image.
Computed tomography (CT) scan of a patient with a left lower lobe carcinoid tumor shows a well-circumscribed lesion.
A popcorn calcification in the left lung nodule indicates a benign lesion or hamartoma. No further tests or observations were needed for this patient.
A 1.5-cm right upper lobe nodule on a computed tomography (CT) scan was determined to be a benign, fibrous lesion on needle biopsy. A follow-up at 2 years showed no change in the size of this lesion.
The parenchymal lesion in this computed tomography (CT) scan demonstrates low attenuation within the lesion, indicating the presence of fat. Fat density is observed only in hamartoma and lipoid pneumonia. The likely diagnosis is hamartoma
This patient has a low risk for malignancy of the right upper lobe nodule. Therefore, continued observation with repeat chest radiographs to establish a growth pattern is the best treatment option.

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Author

Pujan H Patel, MD Consultant in Respiratory Medicine, Royal Brompton Hospital, UK

Pujan H Patel, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, European Respiratory Society, Society of Critical Care Medicine

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: GSK; TEVA Pharmaceuticals; AstraZeneca; Novartis<br/>Received income in an amount equal to or greater than $250 from: GSK; AstraZeneca and Novartis.

Coauthor(s)

Setu K Patolia, MD, MPH Assistant Professor of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Director of Interventional Pulmonary Services, Associate Program Director for Pulmonary and Critical Care Fellowship, St Louis University School of Medicine

Setu K Patolia, MD, MPH is a member of the following medical societies: American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Guy W Soo Hoo, MD, MPH Professor of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Director, Medical Intensive Care Unit, Chief, Pulmonary, Critical Care and Sleep Section, West Los Angeles VA Healthcare Center, Veteran Affairs Greater Los Angeles Healthcare System

Guy W Soo Hoo, MD, MPH is a member of the following medical societies: American Association for Respiratory Care, American College of Chest Physicians, American College of Physicians, American Thoracic Society, California Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Nader Kamangar, MD, FACP, FCCP, FCCM Professor of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Chief, Division of Pulmonary and Critical Care Medicine, Vice-Chair, Department of Medicine, Olive View-UCLA Medical Center

Nader Kamangar, MD, FACP, FCCP, FCCM is a member of the following medical societies: Academy of Persian Physicians, American Academy of Sleep Medicine, American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, American College of Critical Care Medicine, American College of Physicians, American Lung Association, American Medical Association, American Thoracic Society, Association of Pulmonary and Critical Care Medicine Program Directors, Association of Specialty Professors, California Sleep Society, California Thoracic Society, Clerkship Directors in Internal Medicine, Society of Critical Care Medicine, Trudeau Society of Los Angeles, World Association for Bronchology and Interventional Pulmonology

Disclosure: Nothing to disclose.

Asif Alavi, MD Resident Physician, Department of Internal Medicine, University of California, Los Angeles, David Geffen School of Medicine, Olive View Medical Center

Asif Alavi, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Oluyinka S Adediji, MD Consulting Staff, Department of Adult and General Medicine, Health Services Incorporated, Montgomery, Alabama

Oluyinka S Adediji, MD is a member of the following medical societies: American College of Physicians and American Medical Association