Case 14--Multiple Pulmonary Nodules in an Asymptomatic Woman

Clinical summary: A 42-y-old married woman was referred to a pulmonologist for evaluation of bilateral, asymptomatic, pulmonary nodules discovered incidentally during evaluation of blunt chest trauma sustained in a motor vehicle accident. A chest radiograph and a CT scan showed more than 100, non-calcified, round nodules less than 1 cm in diameter. There was no hilar adenopathy. She had no fever, chills, or night sweats. She had occasional cough, but no hemoptysis. No previous chest radiographs were available. She denied having had tuberculosis, valley fever, or collagen vascular disease. She had a 22 pack-year history of smoking cigarettes. Her mother had TB while the patient was a child. The patient's father died of lung cancer at age 50, and her mother now has lung cancer. On physical examination, the patient was obese (323 lb) and 5'7" tall. BP was 150/98, HR 68/min, and oxygen saturation 95%. Lungs were clear to percussion and auscultation. There were no wheezes or rhonchi. The heart was unremarkable. There was no cyanosis or clubbing.

Radiology | Image 1 | Image 2 | Image 3 | Image 4 | Image 5 | Discussion

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