Diffuse pulmonary nodules (differential diagnosis)

Last revised by Yahya Baba on 10 Apr 2023

A number of differentials must be kept in mind while approaching diffuse or multiple pulmonary nodules. Interpretation is easier if nodules are the only abnormality.

Differential diagnosis

These differentials can be narrowed down based on several criteria:

Based on appearance 
Based on pattern of distribution
Based on lobar involvement

There is a lot of overlap in pathology, but as a very crude guide consider:

  • upper and middle lobes: silicosis

  • upper lobe: sarcoidosis, respiratory bronchiolitis

  • peripheral: infection

  • peripheral and lung bases: metastases

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