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The Solitary Pulmonary Nodule on Chest Radiography

Can We Really Tell If the Nodule Is Calcified?

William G. Berger1,2, William K. Erly1, Elizabeth A. Krupinski1, James R. Standen1 and Robert G. Stern1,3

1 Department of Radiology, The University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724-5067.
2 Present address: Department of Radiology, San Francisco General Hospital, 100 Potrero Ave., San Francisco, CA 94110.
3 Department of Radiology, Veterans Affairs Medical Center, 3601 S. 6th Ave., Tucson, AZ 85723.



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Fig. 1A. 53-year-old man with "definitely calcified nodule." Posteroanterior radiograph shows right lower lobe nodule (arrows) judged "definitely calcified" by three of 14 observers who interpreted study. Nodule projects over both anterior and posterior ribs, and projection may have made radiograph appear relatively more dense.

 


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Fig. 1B. 53-year-old man with "definitely calcified nodule." CT scan fails to show evidence of calcification.

 


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Fig. 2A. 65-year-old man with "definitely calcified nodule." Posteroanterior radiograph shows ill-defined nodule (arrows) in right mid lung believed to be definitely calcified by one observer. Vessels on end (arrowheads) may have given appearance of central calcification.

 


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Fig. 2B. 65-year-old man with "definitely calcified nodule." CT scan of second nodule misclassified as "definitely calcified" by one observer. Nodule was subsequently shown to be squamous cell carcinoma.

 

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