Presentation
Dry cough and fever. No history of shortness of breath, anorexia, or weight loss. No history of TB or malignancy.
Patient Data
A well-defined oval-shaped opacity is seen in the right upper lung zone. No frank consolidation, pleural effusion or pneumothorax is seen. Mildly elevated right hemidiaphragm.
A well-defined rounded soft tissue nodule measuring 19 X 20 mm is seen in the RUL with central popcorn central calcifications. No detectable fat density is seen within it. No pulmonary fibrosis, bronchiectasis, pleural/ pericardial effusion, pneumothorax/pneumomediastinum, or mediastinal lymphadenopathy is seen. Areas ground-glass opacities are noted mainly in the lower lobes may indicating a lung infection. A tiny calcified subpleural nodule measuring up to 2 mm is seen in the left lower lobe, which is likely an old granuloma. Osteopenia and degenerative changes are seen in the visualized bony skeleton. Slightly prominent adrenal glands, without any obvious focal lesion.
Chest radiographs were taken at 3 and 6 years intervals which show no gross interval change in the right upper lung zone nodule when compared with the baseline imaging.
Case Discussion
Well-defined rounded soft tissue density nodule, containing popcorn type calcifications, noted in the RUL, showing no gross interval change on follow up imaging is most consistent with a pulmonary hamartoma.
This nodule was an incidental finding on the baseline chest radiograph, performed to exclude the clinical suspicion of pneumonia. Later on CT chest was performed for further characterization of this nodule and/or to exclude the possibility of malignancy (primary bronchogenic Versus metastasis), regarding patient's age.
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