Quik Case 1

A) Definition of sign:
Multi-focal hyperdensity scattered lesions in the lung fields seen in both frontal and lateral radiographs confirming location being within lungs rather than extrinsic characterized by linear and branching patterns.

B) Differential Diagnosis:

1-Calcified Granulomas:
-Very common lesions; however density is not extremely high and it does not give branching appearance.

2-Broncholiths:
-Calcified lymph nodes erode lumen of air ways.
-Other features of granulomatous exposure.

3-Pulmonary Ossification:
-So tiny to be seen in radiography.
-Easier seen in CT.

4-Aspirated Barium:
-Extremely dense.
-Follow distribution of air ways.

5-IV Cement Embolization:
-Extremely dense.
-Lower lung distribution suggests hematogeneous process affected by gravity.
-Cement arterial embolization following cement vertebroplasty.

6-IV Mercury Embolization:
-Extremely dense.
-Lower lung distribution suggests hematogeneous process affected by gravity.
-Can occurs accidentally or by intention usually seen in mercury injection as suicidal attend.
-Metallic density= streaks like densities.