What is the significance of a 1-centimeter calcified granuloma in a lung lobe?

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Last updated: April 2, 2025 • View editorial policy

Differential Diagnosis for 1cm Calcified Granuloma in Lung Lobe

  • Single most likely diagnosis: + Histoplasmosis: This is a common cause of calcified granulomas in the lung, especially in endemic areas. The calcification is often a result of healed infection.
  • Other Likely diagnoses: + Tuberculosis (TB): A calcified granuloma can be a sequela of healed TB, known as a Ghon complex when associated with lymph node calcification. + Sarcoidosis: While sarcoidosis can cause calcified lymph nodes, it less commonly causes calcified granulomas within the lung parenchyma itself, but it remains a consideration. + Hamartoma: Although typically not calcified in a granulomatous pattern, some hamartomas can contain popcorn-like calcifications, making them a differential for a calcified lung lesion.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed): + Malignancy (e.g., lung cancer with calcification): Although less common, some lung cancers can present with calcifications. Missing a diagnosis of cancer could have severe consequences. + Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This is a form of vasculitis that can cause granulomatous disease in the lungs, and while calcification is not its hallmark, it's a critical diagnosis not to miss due to its potential for severe morbidity.
  • Rare diagnoses: + Cryptococcosis: This fungal infection can cause calcified granulomas, especially in immunocompromised patients, but it's less common than histoplasmosis in most regions. + Coccidioidomycosis: Another fungal infection that can result in calcified lung lesions, particularly in endemic areas of the southwestern United States. + Paragonimiasis: A parasitic infection caused by lung flukes, which can lead to calcified lesions in the lung, though it's rare and typically associated with specific geographic and dietary exposures.

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