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Old 01-20-2013
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Lungs Pulmonary Nodule Diagnosis

A 55-year-old man who was an unrestrained driver in a motor vehicle accident was taken to the emergency department and determined to be uninjured. Three days later he presents to his physician because of tenderness over the right side of his chest. He has no other significant medical history and does not smoke. Vital signs are normal. Physical examination reveals bruising and tenderness over the eighth, ninth, and tenth ribs on the right. Imaging studies are negative for fracture but do reveal a single 1.8cm pulmonary nodule with a loculated pattern of calcification in the apex of his right lung, within 8 mm of the superior lobar bronchus.

(A) Adenocarcinoma
(B) Aspergilloma
(C) Bronchogenic cyst
(D) Carcinoid lung tumor
(E) Cavitating abscess
(F) Coccidioidomycosis
(G) Hamartoma
(H) Histoplasmosis
(I) Infection with Mycobacterium tuberculosis
(J) Lipoma
(K) Neurilemmoma
(L) Pulmonary arteriovenous malformation
(M) Rheumatoid nodule
(N) Sarcoidosis
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Old 01-20-2013
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(G) Hamartoma

popcorn calcification
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Old 01-20-2013
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Confuse between (H) Histoplasmosis and (G) Hamartoma
I will go with (H) Histoplasmosis
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Old 01-21-2013
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Hamartoma. The following X-ray (From Medscape) depicts a hamartoma.

Pulmonary Nodule Diagnosis-chest-x-ray.jpg
click image to enlarge
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Old 01-21-2013
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? Hamartoma
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Hamartomas are the most common cause of benign tumors of the lung. The lesions are composed of cartilage surrounded by connective tissue and fat. In the United States, hamartomas represent 5%–8% of all solitary pulmonary nodules and 0.25% of all autopsy cases. Most pulmonary hamartomas are asymptomatic and first noticed as an incidental finding on x-ray of the chest. The typical radiographic appearance is a solitary pulmonary nodule with a “popcorn” calcifi cation. The rib pain in this case is due to bruising and not fractures or the hamartoma.
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Quote:
Originally Posted by heartbeat View Post
Confuse between (H) Histoplasmosis and (G) Hamartoma
I will go with (H) Histoplasmosis
For Histoplasmosis they will have to give you a history of:

Quote:
Histoplasmosis (also known as "Cave disease,"[1] "Darling's disease,"[1] "Ohio valley disease,"[1] "Reticuloendotheliosis,"[1] "Spelunker’s Lung" and Caver's disease)
It is endemic in certain areas of the United States, particularly in states bordering the Ohio River valley and the lower Mississippi River.
H. capsulatum grows in soil and material contaminated with bird or bat droppings (guano). The fungus has been found in poultry house litter, caves, areas harboring bats, and in bird roosts (particularly those of starlings).
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Internal-Medicine-, Pulmonology-, Radiographs-, Step-2-Questions

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