The patient told the ordering rheumatologist that her chest radiograph will be abnormal and has had a workup for healed chicken pox previously. This helped so no more tests were ordered.
Know all your differential for miliary lung nodules.
1. Calcified lymph nodes.
2. Other granulomas in liver or spleen.
If these two features are absent even in the absence of an accurate history healed varicella pneumonia should be considered. The patient has had prior varicella pneumonia in the past with extensive workup.