Coin lesion (lung)

Last revised by Daniel J Bell on 13 Jun 2022

A coin lesion refers to a round or oval, well-circumscribed solitary pulmonary lesion. It is usually 1-5 cm in diameter and calcification may or may not be present 1,3. Typically but not always the patient is asymptomatic 1

The differential diagnosis for such lesions is  1-3:

Not every round opacity projected over the lung is within the actual lung itself. Possible mimics include:

  • external artifacts (eg. button on clothing, ECG dot)
  • nipple shadow
  • prominent first costal cartilage calcification 
  • rib fracture with expansible callous or other sclerotic bone lesion
  • pleural pseudotumor due to encysted pleural fluid
  • summation of markings (eg. overlap of vessels and ribs)
  • cutaneous lesion (e.g. cutaneous neurofibroma)

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