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Common blind spots on chest CT

Case contributed by Jayanth Keshavamurthy
Diagnosis almost certain

Presentation

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

Patient Data

Age: 60 years
Gender: Female
  • Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Study 1

ct

FINDINGS:

Lung Screening Specific (Lung-RADS category 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.

Study 2

ct

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.

Study 3

ct

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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