This document discusses and shows images of multiple pulmonary nodules seen on clinical imaging that can have different underlying causes or diagnoses. It includes images showing septic pulmonary emboli, secondary tuberculosis, blastomycosis, chickenpox pneumonia, CMV pneumonia, Paragonimus westermani infection, hematogenous metastases, Cannonball metastases from choriocarcinoma, alveolar cell carcinoma, Caplan's syndrome, hamartomas, sarcoidosis, and progressive massive fibrosis from silicosis. Each image illustrates the appearance of the nodules associated with these different conditions.

1. 8Multiple Pulmonary Nodules

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig C 8-1 Septic pulmonary emboli. Several
round lesions, many with cavitation, are seen
throughout the lungs in this intravenous drug
abuser with staphylococcal tricuspid
endocarditis.

4. • Fig C 8-2 Secondary tuberculosis. Bilateral
cavitary lesions (arrows) with relatively thick
walls.

5. • Fig C 8-3 Blastomycosis. Bilateral diffuse
intermediate-sized nodules along with patchy
consolidation at the lung bases.24

6. • Fig C 8-4 Chickenpox pneumonia. Multiple ill-
defined and occasionally confluent nodules
throughout the lungs in a young child with
severe combined immunodeficiency disease.26

7. • Fig C 8-5 CMV pneumonia. Multiple small, ill-
defined nodules throughout the lungs that
developed in a patient who had undergone a
renal transplant 3 months earlier and was
receiving immunosuppression therapy.26

8. • Fig C 8-6 Paragonimus westermani. Arrows point
to a few of the multiple cysts in the right middle
lobe. The cysts are thin walled, and most have a
prominent crescent-shaped opacity along one
side of their borders, the characteristic ring
shadow of paragonimiasis.

9. • Fig C 8-7 Hematogenous metastases. Multiple
well-circumscribed nodules scattered diffusely
throughout both lungs.

10. • Fig C 8-8 Cannonball metastases in a patient
with choriocarcinoma.

11. • Fig C 8-9 Alveolar cell carcinoma. Multiple
poorly defined nodules scattered throughout
both lungs.

12. • Fig C 8-10 Caplan's syndrome. Multiple well-
circumscribed, rounded nodules of varying
size in a patient with subcutaneous
rheumatoid nodules.

13. • Fig C 8-11 Hamartomas. Characteristic
calcification of the cartilaginous matrix
(arrow).16

14. • Fig C 8-12 Sarcoidosis. Patchy, ill-defined areas
of air-space consolidation scattered
throughout both lungs.

15. • Fig C 8-13 Progressive massive fibrosis in
silicosis. Non-segmental areas of
homogeneous density in both upper lobes.

16. • Fig C 8-14 Progressive massive fibrosis in
silicosis. Large, irregular nodules in both
perihilar regions.