Calcified pulmonary nodules are a subset of hyperdense pulmonary nodules and a group of nodules with a relatively narrow differential.
Pathology
Aetiology
The most common cause of nodule calcification is granuloma formation, usually in the response to healed infection.
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healed infection
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calcified granulomata, e.g. thoracic histoplasmosis, recovered miliary tuberculosis (rare)
most common
2-5 mm
calcification may be central or diffuse
usually with calcification of hilar/mediastinal nodes
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micronodular (1-3 mm)
no associated nodal calcification
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occupational disease/pneumoconioses
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associated with nodal egg-shell calcification
multiple small densely calcified nodules in mid and upper zones
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smaller nodules which may not be visible on plain film
associated with minimal symptoms
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calcified pulmonary metastases
medullary and papillary thyroid carcinomas 6
mucinous carcinomas (colon, ovarian, breast)
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metastatic pulmonary calcification
typically nodules are poorly defined and larger (3-10 mm)
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calcium and phosphate metabolism abnormalities
massive osteolysis caused by metastases
intravenous calcium therapy
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idiopathic pulmonary haemosiderosis
recurrent alveolar haemorrhage
centrilobular nodular opacities
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small multifocal calcified nodules
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pulmonary alveolar microlithiasis
tiny micronodules
apparent calcification of interlobular septa
small subpleural cysts
sarcoidosis (rare)
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