Sunday, November 2, 2008

How to differentiate granuloma from end-on vessels?

A small 3mm granuloma in the right upper zone located in the outer 1/3 of the lung field.

End-on vessels can certainly mimic granuloma. How do you tell the difference?

a. Granuloma is more likely if the ‘nodule’ is in the upper zones or the outer 1/3 of the lung fields
b. Granuloma is less likely if the ‘nodule’ is in the medial 1/3 of the lung fields.
c. Granuloma is less likely if there is a vascular structure leading to or adjacent to the ‘nodule’.
d. Granuloma is less likely if there is an end-on bronchus next to it(appears as a rounded hollow shadow).
e. Granuloma is more likely if the ‘nodule’ is calcified

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