Diagnostic Strategies for Multiple Pulmonary Nodules

Abstract

Multiple pulmonary nodules are often challenging in terms of their workup. Having non-invasive diagnostic methods to exclude benign lesions such as pulmonary hamartomas is desirable and useful in avoiding risky invasive procedures. We present a case highlighting the non-invasive approach which we believe is under recognized. CASE PRESENTATION: A 49 year-old-female with an extensive smoking history was referred for known pulmonary nodules. Chest CT showed multiple ground glass opacities (GGO) within peripheral parenchyma of the lungs [Figures 1-3]. Given the patients history of smoking and the presence of GGO, malignancy was considered. CT imaging was evaluated for intranodular calcification or fat. No calcifications were observed but given the measured fat density of-124 HU a diagnosis of pulmonary hamartomas was made. Comparison with CTs from 15-years prior confirmed the stability and benign nature of the nodules.