Dear Friends,
Since 100% of you gave correct answers in the previous case, Muppet believes you know it all and is considering retiring to a nunnery. Before he makes his final vows, he wants to show the case of a 35-year-old woman with a solitary calcified lung nodule, discovered in pre-op CT for a gastric tumour.
Diagnosis:
1. Granuloma
2. Chondroma
3. Hamartoma
4. None of the above
35-year-old woman, axial CT
35-year-old woman, coronal CT
Click here for the answer to case 41
Findings: Axial and coronal CT show a heavily calcified lung nodule (arrows).
Fig. 1
Calcification is lineal and does not look like the amorphous clumps of calcium of hamartoma or granuloma. Abdominal CT shows a large cystic tumour (arrows), proven to be a gastric GIST.
Fig. 2
The combination of such a tumour with a calcified mass in the lung suggests that the patient suffers from a Carney’s triad (GIST, chondroma and paraganglioma). It was elected not to operate on the lung tumour, which, after four years, was unchanged.
Final diagnosis: chondroma of the lung (unproven).
Teaching point: for practical purposes, heavily calcified lung nodules are benign. The differential diagnosis lies between hamartomas and granulomas. Other types, as in the case shown here, are very unusual.
chondroma is the diagnosis
pulmonary chondroma
Chondroma.
Chondroma
Hamartoma
Chondroma
I don’t see any surgical change to think of gossypiboma.
Gastric mucinous carcinoma can give calcified mets, but not like this.
Don’t look like a granuloma neither like a typical hamartoma.
I would consider chondroma. Maybe the gastric tumor is a GIST? Could be associated in a Carney triad (GIST, CHONDROMA AND PARAGANGLIOMA).
If it is a GISTthen in the upper zones of the abdominal CT \the gastric wall should be extended to the upper areas .The GIST can reach very big sizes and if you consider the Carney triad ;it means that very big size of GIST .and ma be we can see a clue of GIST /but should need more information _
The gastric tumour might be a GIST…and this looks like a pulmonary chondroma. So the patient might have the Carney triad…which is most often not a triad at all, since only 2 of the 3 tumours of the triad are present.
GIST in young person with Carney Syndrome (chondroma).
how can you say this _
Hamartoma
pulmonary chondroma
First of all it is located at the upper zon of left lower lobe
Second think of the calcification pattern
3.the size of the pulmonary nodule
O think os an hamArtoma
O think that id an hamartoma Pr a condroma
O think that id a codroma Pr an hamarma
Condroma or an hamartoma
La lesione polmonare ha caratteristiche di benignità:le calcificazioni sono grossolane, i limiti netti.Non c’è tessuto adiposo(escludiamo l’amartoma).Vi è un tumore gastrico:donna , giovane.E’ una forma “incompleta” ( per il momento e per…fortuna)della Triade di Carney.Sono sufficienti almeno due , dei 3 tumori, per fare diagnosi, tenendo presenti altri 2 fattori presenti nella triade:la giovane età ed il sesso femminile(80/100). Il Real in difficoltà, in Champion( il Bari in campionato:aspettiamo il ritorno!).
Chondroma
You all did very well. Muppet is running out of difficult cases!
chondroma
what is gist?
It is pulmonary chondroma with GIST- Carneys triad