CTICasesMixed-Dust Pneumoconiosis Nodules Mimicking Pulmonary Metastases
Imaging findings
In a patient with a history of breast cancer, two mildly FDG-avid pulmonary nodules were identified, one abutting the pleura posteriorly and a smaller one along the minor fissure; both were resected because of concern for metastatic disease.
Key takeaways
Pathology showed the nodules to contain polarizable, needle-shaped crystals with a stellate, Medusa-head appearance, consistent with mixed-dust or silicotic pneumoconiosis nodules rather than metastatic carcinoma. The patient had extensive occupational exposure through her husband's marble factories, and although the remainder of her lungs showed no evidence of diffuse pneumoconiosis, these focal subpleural and fissural nodules likely represent localized dust accumulation and lymphatic clearance rather than true metastases.
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