Differential Diagnosis for Ground Glass Opacities and Modular Infiltrates with Calcified Granulomas
- Single Most Likely Diagnosis
- Histoplasmosis: This fungal infection is known for causing calcified granulomas, particularly in the lingula and middle lobes, and can also present with ground glass opacities and nodular infiltrates in the lungs, especially in individuals who have been exposed to the fungus, often through bird or bat droppings.
- Other Likely Diagnoses
- Sarcoidosis: A systemic disease that can cause granulomatous inflammation in various parts of the body, including the lungs. It often presents with bilateral hilar lymphadenopathy but can also cause nodular infiltrates and ground glass opacities. Calcified granulomas can be seen in chronic stages.
- Tuberculosis (TB): Both pulmonary and extrapulmonary TB can present with a wide range of radiographic findings, including ground glass opacities, nodular infiltrates, and calcified granulomas, especially in the context of healed or chronic infection.
- Do Not Miss Diagnoses
- Miliary Tuberculosis: A form of TB that is characterized by a widespread dissemination into the lungs and beyond, presenting as numerous small nodules. It's critical to consider this diagnosis due to its potential for severe morbidity and mortality if not promptly treated.
- Lymphoma: Certain types of lymphoma can involve the lungs and present with a variety of radiographic patterns, including ground glass opacities and nodular infiltrates. The presence of calcified granulomas might be less common but could be seen in the context of treated disease or specific subtypes.
- Rare Diagnoses
- Cryptococcosis: A fungal infection that can cause pulmonary disease, including ground glass opacities and nodular lesions, particularly in immunocompromised individuals. Calcified granulomas are less commonly associated with this infection.
- Blastomycosis: Another fungal infection that can present with a variety of pulmonary findings, including ground glass opacities and nodular infiltrates. While calcification is not the hallmark, it could be considered in endemic areas with appropriate clinical context.