CTICasesDisseminated Varicella Pneumonia and Unilateral Metastatic Pulmonary Calcification
Imaging findings
Chest CT reveals randomly distributed pulmonary nodules with surrounding ground-glass halos (the halo sign) throughout both lungs. In addition, the left lower lobe shows high-attenuation consolidation with a fluffy, calcified appearance, and a dense calcified filling defect is present within the left lower lobe branch of the pulmonary artery. A follow-up CT obtained months later demonstrates resolution of the ground-glass halos, leaving small residual nodules that can eventually calcify, while the left lower lobe calcified consolidation and pulmonary artery filling defect remain unchanged.
Key takeaways
Disseminated varicella-zoster virus (VZV) pneumonia classically presents in immunocompromised hosts, such as renal transplant recipients, with randomly distributed nodules showing ground-glass halos. These lesions typically heal, leaving small, sometimes calcified micronodules. The unilateral left lower lobe consolidation likely represents localized metastatic pulmonary calcification secondary to a remote calcified pulmonary infarction.
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