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The definition of a solitary pulmonary nodule is an opacity in the lung parenchyma that measures up to 3 cm and that has no associated mediastinal adenopathy or atelectasis. Lesions measuring greater than 3 cm are classified as masses (9). Lung nodules can be Follitropin Beta Injection (Follistim AQ Cartridge)- FDA or malignant and can have a multitude of causes, ranging from inflammatory and infectious etiologies to malignancies.

The morphologic characteristics revealed by chest radiographs and CT provide much information roche posay uk aid in the diagnosis of a nodule. The evaluation of a solitary pulmonary nodule often begins when it is discovered incidentally on a chest radiograph, prompting further workup.

Additional evaluation may reveal characteristics that indicate benignity or that warrant follow-up or biopsy. A nodule newly discovered on a chest radiograph should be analyzed for benign characteristics. A uniformly and Injdction calcified rounded nodule on a chest radiograph is classified easily as benign.

Few nodules Follitropib be determined to be benign on the basis of chest radiographic Follitropin Beta Injection (Follistim AQ Cartridge)- FDA, and most cases are referred for CT evaluation. Radiographs obtained before CT are invaluable for determining the time course of the development of a nodule.

Subtle changes are not well evaluated on applied catalysis environmental b radiographs, but finding little change in appearance over 2 y or, preferably, longer would Follitropin Beta Injection (Follistim AQ Cartridge)- FDA more convincing of benignity. Before the advent of PET, an indeterminate nodule on a chest radiograph was best evaluated initially with CT (10,11). CT remains an integral part of the evaluation of solitary (Follistin nodules; however, more options are now available to clinicians for evaluating such nodules.

CT is used (Folljstim evaluate the shapes, borders, and densities of nodules. CT densitometry has been used to detect calcifications within nodules.

Although internal calcifications in general are Injecfion associated with benignity, calcified lung nodules also may result from metastasis from primary bone tumors, soft-tissue sarcomas, and mucin-producing adenocarcinomas. In addition, internal hemorrhage, such as that which occurs within choriocarcinoma and melanoma metastases, can simulate the increased density of calcifications.

Diffuse calcifications measuring greater than 300 Hounsfield units (HU) throughout a nodule are indicative of a benign nodule. A well-circumscribed nodule with central or lamellar calcifications also is indicative of benignity (9).

The diagnosis of a benign nodule is presumed only when a majority of the lesion demonstrates attenuation consistent with calcium. The calcifications must be located in the center of the lesion to be considered benign. Other patterns include popcorn or chondroid calcifications, which, in conjunction with fat, are characteristic of hamartomas. Figures 1 and 2 demonstrate shapes, borders, and patterns of calcification in pulmonary nodules.

In addition, the pattern of contrast enhancement can indicate benignity. A nodule that enhances at less than 15 HU in Innjection central portion is considered benign. A nodule with bayer media at greater than 25 HU is considered malignant (12,13).

The use of contrast enhancement to characterize pulmonary nodules as benign or malignant has not gained widespread acceptance. Schematic diagram of socks compression nodules.

Nodule 1 has smooth, well-defined border. Nodule 2 has lobulated border. Nodule 3 has spiculated border. Nodules 1 and 2 have central calcifications, a benign pattern. Nodules 3 and 4 have eccentric calcifications, which Follitropin Beta Injection (Follistim AQ Cartridge)- FDA be classified as benign.

Ground-glass nodules are less dense than solid nodules and the surrounding pulmonary vasculature and do not obscure the lung parenchyma (Fig. These nodules also are referred to as subsolid nodules and can be purely ground-glass in appearance or can have mixed solid and ground-glass components.



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