Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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REVIEW ARTICLE
Year : 2010  |  Volume : 5  |  Issue : 2  |  Page : 67-79

The calcified lung nodule: What does it mean?


1 North Manchester General Hospital, Pennine Acute NHS Trust, Manchester, Saudi Arabia
2 King Saud University for Health Science, King Adulaziz Medical City, Riyadh, Saudi Arabia
3 The Cardiothoracic Centre Liverpool NHS Trust, The Royal Liverpool University Hospital, UK

Correspondence Address:
Ali Nawaz Khan
North Manchester General Hospital, Pennine Acute NHS Trust, Crumpsall Manchester, M8 6RB UK

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DOI: 10.4103/1817-1737.62469

PMID: 20582171

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The aim of this review is to present a pictorial essay emphasizing the various patterns of calcification in pulmonary nodules (PN) to aid diagnosis and to discuss the differential diagnosis and the pathogenesis where it is known. The imaging evaluation of PN is based on clinical history, size, distribution and the gross appearance of the nodule as well as feasibility of obtaining a tissue diagnosis. Imaging is instrumental in the management of PN and one should strive not only to identify small malignant tumors with high survival rates but to spare patients with benign PN from undergoing unnecessary surgery. The review emphasizes how to achieve these goals. One of the most reliable imaging features of a benign lesion is a benign pattern of calcification and periodic follow-up with computed tomography showing no growth for 2 years. Calcification in PN is generally considered as a pointer toward a possible benign disease. However, as we show here, calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of a calcified lesion include calcified granuloma, hamartoma, carcinoid, osteosarcoma, chondrosarcoma and lung metastases or a primary bronchogenic carcinoma among others. We describe and illustrate different patterns of calcification as seen in PN on imaging.


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