What do you see? Check the images below, leave your thoughts for us in the comments section, and come back on Friday for the answer.
Findings: the chest radiograph shows numerous calcified masses in the right lung (A). The type of calcification is amorphous (B, arrows) and the first impression that came to mind is chondromatous tumours or amyloid. I believe the unilateral location goes against metastases.
I spoke to the patient (highly recommendable technique!) and he said that an oncologist was treating him for an abdominal tumour. I called the oncologist, who confirmed a previous GIST. He told me that the lung lesions had been stable for the last ten years (C, D) and that the clinical diagnosis was Carney’s triad.
Final diagnosis: Pulmonary chondromas in a patient with Carney’s triad.
Congratulations to Genchi Bari, who was the first to mention multiple chondroid tumours and MK, who jumped to the right diagnosis with a little help.
Teaching point: I got the diagnosis of this unusual case after speaking to the patient. Don’t forget that the patients are an important source of information!
This is the last case of 2016. Dr. Pepe and I are leaving on vacation and will be back on January 9 with new cases.
Happy Holidays to you all!
Hello.
Maybe all these opacities could be vascular (arterial aneurysms) in origin. Does this patient have Behçet`s disease?
No, he does not have Behçet´s disease
Pulmonary hamartoma
Multiple lobulated nodules with irregular cloudy calcifications seen at right middle and lower lobes , narrowing of right main bronchus with hyperiflation of right middle and lower lobes.possibility of bronchopulmonar amyloidosis shoud be considered.
…condromi multipli polmonari…
Amyloidosis
Other rare causes for benign lung nodules, with calcification: hamartomas, endobronchial adenomas.
Múltiple nodular pulmonary right lesions, with focal high densities (calcifications).
The trachea is little increased in side like the right principal bronchious.
Pulmonary hamartomas?
Multiple hamartomas?
Multiple calcified chondromas as calcification appears ring shaped .other differentials may be hamartomas, metastasis calcified granulomas
Those are intrapulmonary masses with strong calcifications. Hamartomas vs carcinoid tumors
What would you think if I you knew that the patient has other tumors?
…..non vale Professore…..hai suggerito la diagnosi !
You will get credit because you were the first one to mention chondromas. It was my first diagnosis, too.
Carney’s triad? Pulmonary chondromas, gastric leyomiosarcoma, extraadrenal paragnglioma.
Obvious diagnosis 😉
Multiple calcified chondromas
In the right and left lung. On left on the level of 1st rib
I think that the left one is the articulation of the first rib
Yes, you are right.
This is the calcification lesion , with incomplete border sign, without opacifying pulmonary vessels —> it’s a chest wall lesion and may affect the ribs (second large nod in anterior). If we have another tumor , may be this is metastasis?! But even if, I think it’s still not a rapid developing lesion. Dear , Prof.
A radiograph taken three years earlier showed no change. The diagnosis has already been mentioned
Thanks Prof
multiple well defined masses in right lung showing polymorphic and popcorn calcification mostly represent hamartomas
..Feliz Navidad …..mitico Professore…..parto per la Serbia, Belgrado…..
Have a good time, old friend