Tracheal web - low-dose lung cancer screening (CT)

Case contributed by Jayanth Keshavamurthy


Low dose chest CT screening for lung cancer in a smoker, uses cocaine and smokes marijuana.

Patient Data

Age: 60 years
Gender: Male

Non-contrast low-dose CT chest


4 mm solid nodule within the lateral left upper lobe (less than 1% chance of malignancy).

Lung-RADS category 2: negative, small left upper lobe nodule (less than 1% risk of being malignant).

Potentially significant incidentals (Lung-RADS category S): Advanced atherosclerotic calcification of the left main, left anterior descending, circumflex, and right coronary arteries. Mild atherosclerotic calcification of the thoracic aorta.

Probable tracheal web. Differential diagnosis thin line of mucus?

Moderate paraseptal emphysematous changes, predominantly apical with large bullous transformation in the left apex. 

Red is areas of emphysema on the automated COPD software.

Case Discussion

Normal PFTs and asymptomatic. So no further testing for the finding in the trachea until next year's lung screening with low dose CT chest. If it persists then it is real and not mucus. The patient should stop smoking cigarettes and using other recreational drugs.

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