EURORAD ESR

Case 14089

Multiple pulmonary nodules: an unfrequent etiology

Author(s)
A. Moujir Sánchez, J.L. Marrero Brito, A.B. Llanos González, M.C. Camacho García, S. Ghiglione, S. Lorenzo Santana

Spain; Email:alejandromsan@hotmail.com
 
Patient
female, 65 year(s)
 
 
  • Figure 1
    Chest X-ray
     

    Multiple pulmonary nodules, the biggest with 25 mm in diameter in the upper segment of the right lower lobe (RLL).

     
    Area of Interest: Lung; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Multiple pulmonary nodules, the biggest with 25 mm in diameter in the upper segment of the right lower lobe (RLL).

     
    Area of Interest: Lung; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Negative image shows better view of smaller nodules at both mid-lung fields.

     
    Area of Interest: Lung; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 2
    Computed tomography
     

    Pulmonary parenchyma showed multiple nodules in both fields.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Pulmonary parenchyma showed multiple nodules in both fields.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Pulmonary parenchyma showed multiple nodules in both fields. The largest one was located in the apical segment of the right lower lobe and was 18 mm in diameter.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Pulmonary parenchyma showed multiple nodules in both fields.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 3
    SPECT

    Absence of pulmonary uptake after intravenous administration of Octreotide-In 111.

     
    Area of Interest: Lung; Imaging Technique: SPECT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 4
    Lung Biopsy
     

    Hematoxylin and eosin stain: This view shows a solid mass of amorphous, eosinophilic, extracellular material. A multinucleated giant cell reaction is present.

     
    Area of Interest: Lung; Imaging Technique: Percutaneous; Procedure: Diagnostic procedure; Special Focus: Pathology;

    This view shows amorphous Congo red-positive deposits.

     
    Area of Interest: Lung; Imaging Technique: Percutaneous; Procedure: Diagnostic procedure; Special Focus: Pathology;

    A Congo red-stained section view under polarizing microscopy demonstrates classic apple-green birefringence.

     
    Area of Interest: Lung; Imaging Technique: Percutaneous; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
Multiple pulmonary nodules, the biggest with 25 mm in diameter in the upper segment of the right lower lobe (RLL).
 
Multiple pulmonary nodules, the biggest with 25 mm in diameter in the upper segment of the right lower lobe (RLL).
 
Negative image shows better view of smaller nodules at both mid-lung fields.
 
Pulmonary parenchyma showed multiple nodules in both fields.
 
Pulmonary parenchyma showed multiple nodules in both fields.
 
Pulmonary parenchyma showed multiple nodules in both fields. The largest one was located in the apical segment of the right lower lobe and was 18 mm in diameter.
 
Pulmonary parenchyma showed multiple nodules in both fields.
 
Absence of pulmonary uptake after intravenous administration of Octreotide-In 111.
 
Hematoxylin and eosin stain: This view shows a solid mass of amorphous, eosinophilic, extracellular material. A multinucleated giant cell reaction is present.
 
This view shows amorphous Congo red-positive deposits.
 
A Congo red-stained section view under polarizing microscopy demonstrates classic apple-green birefringence.
 
 
 
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