CTICasesSpontaneous Regression of a Calcified Hilar Lymph Node (Caseous Necrosis)
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Imaging findings
A patient was noted to have a large, calcified supra-hilar mass with dense calcium in 2013, which initially resembled fibrosing histoplasmosis. Subsequent CT scans in 2014 and January 2015 showed progressive shrinkage of the lesion, with the calcium largely disappearing, ultimately regressing to a much smaller calcified node. It caused minimal mass effect on an adjacent artery but no occlusion.
Key takeaways
This unusual case demonstrates the spontaneous regression and near-disappearance of a large calcified hilar lymph node. It is speculated that this represents a caseous lymph node from a granulomatous infection (e.g., histoplasmosis or tuberculosis) where the calcified material was either resorbed or coughed out. This phenomenon is rarely observed and provides an interesting example of dynamic changes in calcified lesions.
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