Common blind spots on chest CT

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Third lung screening CT in a smoker. Each one year apart.

Patient Data

Age: 62
Gender: Female
CT

Study 1

FINDINGS:

Lung Screening Specific (LUNG-RADS 2):
Nodule 1 (image 80, series 2): 5 mm ground glass,  parenchymal nodule in the right upper lobe.

Potentially Significant Incidentals (LUNG RADS category S): None

Other Incidentals: Calcified granulomata are demonstrated in the right lower lobe with normal size calcified right hilar lymph nodes. Mild pleural parenchymal scarring involves the posterior medial left upper lobe, adjacent to the posterior aortic arch

IMPRESSION:

1. LUNG-RADS category 2: Negative, benign findings with very low probability of lung cancer.

2. LUNG-RADS category S: Negative, no new/unknown potentially  significant incidental findings requiring urgent additional evaluation.

 

CT

Study 2

Pulmonary Incidentals: Again visualized are multiple calcified granulomata of the right lower lobe. Right hilar calcified lymph nodes are again demonstrated. There is redemonstrated mild
pleural-parenchymal scarring of the posterior medial left upper lobe,  posterior to the aortic arch.
 

Again Lung RADS 2.

CT

Study 3

Lung Screening Specific (LUNG-RADS -4)

There is a 2.1 cm effective diameter spiculated left upper lobe lung nodule adjacent to the left upper thoracic spine and aortic arch. Maximum Hounsfield units 435. Maximum diameter 3.2 cm. This is highly suspicious for a primary lung neoplasm.
 

Case Discussion

Patient is being worked up for lung cancer currently. Read up the article reference #1.

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Case information

rID: 56485
Case created: 3rd Nov 2017
Last edited: 9th Nov 2017
System: Chest
Inclusion in quiz mode: Included
Institution: Augusta University

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