Calcified multinodular lung lesions: a broad differential diagnosis

Healed Varicella Pneumonia: A Case of Diffuse Pulmonary Microcalcifications

“…Coal worker's pneumoconiosis on the other hand can be distinguished from Varicella pneumonia as it has nodules that will not present on plain film [12]. Table 1 defines certain characteristics of possible differentials when a patient presents with nodular changes in the lung parenchyma [1,10,11,13]. [14].…”

“…Metastatic nodules are also larger ranging from 3 to 10 mm, while Varicella tends to present as nodules ranging from 5 to 10 mm [ 10 ]. Another differential diagnosis to strongly consider is miliary TB which presents with 1-3 mm nodules that are uniformly distributed in the lung [ 1 , 11 ]. The biggest differentiating factor is that miliary TB will elicit a positive TB test.…”

“…Varicella-zoster virus (VZV) is primarily known for causing childhood chickenpox, a highly contagious disease that affects many body systems including the skin, central nervous system, and lungs. Primary chickenpox affects the skin and is generally self-limiting, but Varicella pneumonia is a potentially fatal complication associated with the disease, which may mimic other diseases [ 1 ]. The development of multiple, diffuse pulmonary nodular calcifications with noncalcified lymph nodes is uncommon, with an incidence of 1.0 to 2.3 cases per 400 VZV cases [ 2 ].…”

“…Kim et al described the nodules of Varicella pneumonia on a high-resolution CT scan as a nodule of 1-10 mm in diameter with a distinguished shadow surrounding the node [ 8 ]. Although these findings are not immediately diagnostic of Varicella pneumonia, they allow for a list of differential diagnosis which includes nodular amyloidosis, calcified metastasis, hyalinizing granuloma, epithelioid hemangioendothelioma, necrobiotic nodules of rheumatoid arthritis, multiple pulmonary chondromas, and progressive massive fibrosis [ 1 ].…”