Correct!
2. Hemorrhage
The ground-glass opacity surrounding the pulmonary nodules classically refers to hemorrhagic nodules and was first described with invasive aspergillosis in severely immunocompromised patients. Hemorrhagic nodules can also be found with metastatic disease from hypervascular malignancies such as angiosarcoma, choriocarcinoma, thyroid, renal cell carcinoma, melanoma, and Kaposi’s sarcoma. Granulomatosis with polyangiitis can also present with hemorrhagic pulmonary nodules. In addition to hemorrhage, tumor infiltration with lepidic growth patterns such as with adenocarcinoma can demonstrate the CT halo sign, but was not classically described.
Enhanced thoracic CT displayed in soft tissue windows also showed that some of the pulmonary nodules were hyperattenuating, possibly reflecting calcification, such as the left lower lobe pulmonary nodule shown in Figure 3.
Figure 3. Enhanced thoracic CT displayed in soft tissue windows.
Which of the following is not within the differential diagnostic considerations for calcified metastatic pulmonary nodules? (Click on the correct answer to proceed to the fourth of five panels)