CTICasesRight Lower Lobe Nodule with Equivocal Fat Attenuation Mimicking Hamartoma
Imaging findings
In a middle-aged patient, a right lower lobe pulmonary nodule identified on an outside radiograph is unchanged years later on follow-up but has grown somewhat larger; on CT it is very well-defined with low internal attenuation, around -2 to -3 Hounsfield units -- distinctly less negative than true fat.
Key takeaways
A well-defined nodule with low but not truly fat-equivalent attenuation should not be assumed to represent a hamartoma on attenuation alone, particularly with lower-dose CT technique where low-contrast discrimination is impaired; this lesion, discussed alongside a second similarly hamartoma-mimicking nodule, proved instead to be a typical carcinoid tumor.
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